Posted on Leave a comment

Get answers to your questions about eating disorder treatment

We held a Q&A webinar with eating disorder therapist John Levitt, Ph.D. on May 5, 2019. Here are some important questions he answered for us.

1. Do you have any advice about FBT for eating disorders?

Answer recap: FBT (family therapy) is one of the evidence-based therapies available for eating disorders. It’s effective for a certain group of patients. Its primary outcome is to cause weight gain.

2. Should I send my child to residential treatment for an eating disorder?

Answer recap: The purpose of a program is to stabilize and refeed to manage the critical side effects of an eating disorder. I’m concerned about sending a child away from their family and recommend asking: how is the family involved, and how does the family sustain recovery when they return home? Often a local treatment program can achieve the same goals.

3. What should I do if my child is in treatment for an eating disorder and the behaviors aren’t stopping?

Answer recap: If your child is in a treatment center and their behaviors aren’t stopping, it’s important to understand why that is. Ask questions, and understand the goals and treatment plan.

4. Parents are doing their best, why isn’t child recovering from their eating disorder?

Answer recap: Your child not recovering doesn’t mean you’re doing anything wrong. Most people recover from an eating disorder, but it can take time. Recovery depends on many factors, including how long they have had the eating disorder. It’s OK to sit down with the therapist and ask how treatment is going. You should have some sort of treatment plan to guide the process.

5. What is evidence based treatment for an eating disorder?

Answer recap: Evidence-based treatments have been tested with group studies in which there have been random assignments to different treatment types. Certain therapies have been statistically proven to be more effective. It’s important to ask the therapist or treatment center what it means to use “evidence-based” treatment and how do they use it?

6. Why, if the eating disorder behaviors are under control, does my child still need therapy?

Answer recap: When someone recovers from an eating disorder, they may still have trauma symptoms, anxiety, depression, self-harm, and other residual symptoms that existed in addition to the eating disorder. These conditions and symptoms can be a good reason to continue therapy beyond eating disorder treatment.

7. If my child has trauma and an eating disorder, will an eating disorder treatment center treat both?

Answer recap: If possible, find an integrated treatment approach that addresses eating disorders and other challenges like trauma, self-harm, etc. Be sure to ask your treatment team or therapist whether they are using an integrated approach.

8. How do I find a good therapist for my child who has an eating disorder?

Answer recap: Ask a lot of questions! The therapist is a guide, and it’s their job to facilitate recovery with the child and the parents. We should be available to answer parents’ questions. If your child is not responding to treatment, it’s not always because the therapist isn’t “good,” but it is important to talk to the therapist about the treatment plan and that they can communicate with you and your child.

9. Our therapist told me to be patient with my child who has an eating disorder – what does that mean?

Answer recap: I’d ask “what does ‘patient’ mean?” and try to find out what the therapist is asking for. Yes, treatment takes time, but you should see some results. If your child is medically compromised, you don’t have time to be patient. But if you’re talking about therapy, it’s a process. It does take time. Ask what you should be doing while you’re “being patient.”

10. My child’s in treatment for an eating disorder, what should I be doing?

Answer recap: Ask your child’s therapist! You should receive suggestions from the program or therapist regarding what they think will be helpful. Your outpatient therapist should regularly give you recommendations about what to do. I suggest parents provide support, love the child, supervise the food, weight, eating, and be mindful of purging. If the child is at a more acute stage of eating disorder behavior, parents may need to be more active in preventing the behaviors.

Ginny Jones is on a mission to empower parents to raise kids who are free from eating issues, body shame and eating disorders.

She’s the founder of and a Parent Coach who helps parents navigate disordered eating, eating disorder recovery, and other challenging emotional and behavioral issues.

Posted on Leave a comment

Trauma plus an eating disorder requires specialized treatment

treatment Trauma plus an eating disorder requires specialized treatment

by John Levitt, PhD

Estimates tend to vary, but data suggests that approximately 68%-98% of people who attend eating disorder treatment programs report histories of sexual, and other, abuse or trauma. This suggests that when we treat eating disorders we need to be prepared to treat a potentially underlying trauma history and even, possibly, Post Traumatic Stress Disorder (PTSD).

When I work with someone who has a persistent eating disorder, coupled with potentially long-term Post Traumatic Stress Disorder (PTSD), they have often had a very hard time receiving comprehensive treatment. Unfortunately, many providers who treat trauma regularly are not as well-versed in how to treat eating disorders; and many people who regularly treat eating disorders are not as well-versed in how to treat trauma. That is, they struggle with providing a unified approach to treating both!

Indeed, while most of our treatments for eating disorders are interdisciplinary in nature, models of treatment for long-term persistent problems that include trauma generally need an integrated approach to address both.

Trauma-specific treatment

The majority of evidence-based trauma-specific treatment models are 12 -16 weeks or so. These approaches may be effective for treating cases of an immediate response to a distinct traumatic event. In such situations, therapists can move quickly to address the trauma before symptoms can be entrenched and before the client develops trauma-related symptoms such as dissociation and/or other complex secondary coping mechanisms such as an eating disorder.

But I find that eating disorder/trauma clients’ treatment generally requires considerable time, skill, and patience! The majority of my clients have experienced multiple traumas over a long time. Their eating disorders, drug use, cutting, and other behaviors are often employed as one of their way of managing trauma symptoms.

The greatest challenge I frequently face is that I must support a person undergoing treatment for an eating disorder without re-traumatizing the person by addressing the trauma too quickly or too aggressively. It has been my experience that if I push too hard on the trauma, I can actually exacerbate the eating disorder behaviors. That is why I have developed an integrated approach to organizing treatment for both eating disorders and trauma-related disorders or symptoms.

Getting started

The first thing I do when I’m working with a client who has PTSD-like symptoms and an eating disorder is to teach them how to manage both the eating disorder as well as the trauma-related experiences. Trauma-related reminders such as body changes, like arousal and numbing, along with traumatic intrusions (e.g., memories) often serve as “triggers” for eating disorder behaviors.

I educate the client about how to regulate their behavior and emotions in such situations as well as how to modulate their mood, eating, and sleep patterns. Once those elements are stable, there may be an opportunity for addressing the memory components of the traumatic experience.

The clients I work with are very sensitive to re-traumatization, so exposure therapy too early can kick their eating disorder and other coping mechanisms into high gear. Instead, I work over time to educate and empower the client. With time, the person is able to reduce their reliance on self-defeating coping mechanisms and regulate much more effectively.

Eating disorder as comfort

In cases of PTSD, the eating disorder has often become a comfort. It is a powerful management tool, and if we take it away too soon, or if we don’t adequately support the development over time of new alternative coping skills, then we can leave the person in a tenuous recovery situation. At this point, relapse, or exacerbation of eating disorder symptoms, may become more likely. I see relapse as a sign that more time and more practice are needed to integrate understanding, skills, and support mechanisms. This is one reason why complex eating disorders individuals often require time to fully recover. And, importantly, we need to remember that healing looks different for everyone.

Once we have built confidence in terms of handling traumatic feelings and experiences with adaptive behaviors, we may choose to address the trauma head-on, but that is always dependent on the client’s individual choice and situation. Not everyone who has undergone trauma must re-experience the events to recover from PTSD. It is definitely case-dependent.

Something that we have to address when working with PTSD and eating disorders is the acknowledgment that we live in a victimization-oriented society. We tend to see people as victims, especially when they are traumatized as children. It’s true that trauma is devastating and often criminal, but my goal as a therapist is to move a client from being a victim to being a survivor who can cope, and who is empowered to live a full, satisfying life. People who have been traumatized are not responsible for what happened to them, but that doesn’t mean we need to view them as victims. They are capable of becoming responsible for how they interact with their current world.

Considering abuse

When I’m working with someone who has an eating disorder and has PTSD stemming from abuse, my goal is to take steps to help that person accept responsibility and implement efficacious actions for their own recovery. Rather than potentially re-traumatizing the person by “taking away” the eating disorder, I believe that healing must remain within the person’s own power, control and choice.

In the case of working with children or adolescents, this is why I tell parents that I’m not “fixing” their child, but I am here to help the child to become empowered to make more effective choices in their life rather than feel victimized by others, or their disorder.

How parents can help

Parents can be really helpful when they recognize that their child’s PTSD treatment is not generally about what the parents did or did not do to protect their child, but is focused instead on supporting the child’s coping skills over time. It doesn’t take long to learn coping skills conceptually, but they take time to become integrated; especially if they are replacing a powerful behavior like an eating disorder.

It should be said that if parents do feel “guilt” for what happened to their child, whether from abuse or the eating disorder itself, they would be best advised to seek out their own individual, and/or couple treatment.

I’d also like parents who have a child with both PTSD and an eating disorder to remember that their child’s behaviors are not criminal acts. Yes, it is frustrating, unhealthy, and hard to watch one’s child struggle with any problem. An eating disorder can appear to a parent as disobedient or possibly even “crazy.” This does not mean parents should not set limits or expect healthy behaviors, It does mean that the less charged the parents are around the eating disorder behavior itself, and the more they can support their child in learning new coping skills, the easier it is for the child to find their way towards recovery (and the easier it will be for the parent to live with the child).

John Levitt, PhD

John Levitt, PhD, CEDS, FAED, FIAEDP has been treating people who have complex eating disorders, including trauma and self-injury, for more than 40 years. He teaches classes at Argosy University on trauma and counseling which covers the complexities involved in treating trauma-related disorders such as PTSD and associated disorder, such as eating disorders. John is the co-editor of the books Self-Harm Behavior and Eating Disorders: Dynamics, Assessment, and Treatment, Personality Disorders and Eating Disorders, and Handbook for Assessing and Treating Addictive Disorders. He was on the Editorial Board of Eating Disorders: The Journal of Treatment and Prevention. He can be reached at Email: Phone: (847) 370-1995

Posted on Leave a comment

Hope Is Essential When Working With People Who Have “Chronic” Eating Disorders, by John Levitt, PhD

I never use the word “chronic” or “difficult” when describing a person who has been struggling with an eating disorder for a long time and who has required medical stabilization numerous times. These people may have been in and out of treatment, and they may require more or different care from others, but they always have hope. I believe that if we lose sight of the hope for a person, we damage their chance of recovery.

After more than 40 years of working with people who have eating disorders, I have learned that the vast majority of them can be treated and a significant portion do actually recover. Most people who have eating disorders are not stuck intractably, destined to continue their disordered behaviors for life.

What I have found, however, is that personal therapy that is specifically designed to support these people through their recovery is critical. While we may need to rely on hospitals and treatment centers to medically stabilize these people, they often only fully recover when under long-term care from a trained psychotherapist.

I understand how scared and exhausted parents can be by their child’s eating disorder. It’s not easy to parent a child who has an eating disorder, and repeated trips to the hospital and/or treatment center(s) can be emotionally and financially draining. I understand why some parents may lose hope that recovery for their child will ever be possible; but at that point, I’d like those parents to seek their own therapy so that they can bring hope and strength to the parent-child relationship.

In fact, if parents are feeling really run-down by the care required to support a child who has an eating disorder, I encourage them to not only seek therapy, but also to go on vacation, spend time building other relationships and hobbies, and expand their lives even as their child pursues recovery from an eating disorder. It may sound strange to tell a parent who has a child who has an eating disorder to go on vacation, but sometimes that’s exactly what is needed for the parent to have the strength and resilience to continue providing the care and acceptance needed for healing.

There is no magic bullet in eating disorder recovery, but if there were, it would be in the form of ongoing supportive and fully accepting relationships. A therapist can be one of the people who can provide this unwavering acceptance of the person who has an eating disorder, and that is a big part of how healing takes place. The therapeutic relationship is key to providing a safe space for the person to find his or her own motivation to recover.

It’s important to know that there is no single definition of recovery, and it’s also important that we find ways to enable the person who has an eating disorder to define what recovery will look like for them personally. We don’t make much progress when we push our own ideas of what recovery is, because each person has their own thoughts, opinions and internal motivation. We don’t succeed in long-term recovery by forcing our own ideas of what the person needs to do, but we can make great progress by helping the person tap into their own vision of recovery.

Someone who has an eating disorder really benefits from having people who believe that they will recover. Parents, therapists, and others can provide this belief, hope and acceptance. What we work towards is helping the person accept some of that hope into his or her own mentality, and to begin to feel true hope in their own future after an eating disorder. Remember that having an eating disorder is not a crime. It cannot be punished away, and instead needs to be treated with respect of the person’s own perspective.

When a person who has an eating disorder begins to have self-determination and thoughts of a future without an eating disorder, then we see tremendous change in both behavior and mental condition. This takes time. I can’t put a definite timeline on it, but most of my clients come to see me once per week, sometimes for a year or even more. This is the long-term investment that people must make in full recovery from a challenging mental disorder like an eating disorder. The good news is that when the investment is made, people can and do recover from eating disorders – even the most “chronic” or “difficult” cases.

Screen Shot 2017-04-21 at 9.27.21 PMJohn L Levitt, PhD, CEDS, FAED, FIAEDP, is the coeditor of the book, Self-Harm Behavior and Eating Disorders: Dynamics, Assessment, and Treatment , and was on the Editorial Board of Eating Disorders: The Journal of Treatment and Prevention Email: Phone: (847) 370-1995

Posted on 2 Comments

Questions To Ask Before You Send Your Child to Local Eating Disorder Therapists or an Eating Disorder Treatment Center, by John Levitt, PhD

If you have a kid with an eating disorder, then you probably have a lot on your plate. Finding the right healthcare providers is critical to helping your child recovery, but it can be challenging to identify which professionals or treatment centers will be most helpful.

Unless it is medically prohibited, it’s a good idea to begin your child’s eating disorder with local resources that allow you to maintain a regular home and school environment for your child during eating disorder treatment.

Beginning with your local treatment providers allows you, as a parent, to learn the skills necessary to support recovery at home. These skills are critical to full recovery because while inpatient centers can treat the symptoms of eating disorders very well, there is a long tail of true recovery.

Even if the eating disorder behaviors and symptoms get under control in a few weeks-months, there may be many more months, or even years, required to achieve remission and, ideally, full recovery.

Questions To Ask Your Child’s Eating Disorder Therapist

There are many professionals who are available to guide and support you in helping your child recover from an eating disorder. It is very important, however, to make sure that the professionals you choose are actively trained and experienced in treating eating disorders in particular vs. those that are generalized psychotherapists. While well-meaning, general practitioners of psychotherapy may not have the specific knowledge that may be necessary to help your child heal as quickly and completely as possible. Here are just some of the questions to ask therapy providers:

  • How long have you been practicing psychotherapy?
  • What is your licensure?
  • How long have you been treating eating disorders specifically?
  • What has been your eating disorder treatment training?
  • What is your experience treating eating disorders?
  • What is your treatment approach and how does it apply to the treatment of eating disorders?
  • What are your typical treatment outcomes with the eating disorder patients?
  • In your experience, how long does it generally take you to see symptom/behavior recovery?
  • Why do you believe that you can you help my child more effectively than someone else?
  • If you don’t have much experience in eating disorders, who do you consult with?
  • How are you getting training and experience in this field?
  • When you organize therapy, what do you do to organize your approach to treatment? That is, what is your general treatment plan? This goes beyond the form of therapy (CBT, DBT, etc.) this is about having a treatment plan with specific goals toward eating disorder recovery.
  • How are you going to include me, the parent(s), in treatment and recovery?
  • What resources or guidance will you provide me with to optimize the recovery process?

The most important thing for parents to know about these questions is that they should be welcomed and expected by your child’s therapists. Parents are a critical part of eating disorder recovery, and they have both a right and a need to ask meaningful consumer questions about what they can expect from the therapist who is working with their child. Don’t abdicate responsibility for this. Setting up the right therapy for your child makes all the difference in their recovery path.

Questions To Ask Yourself When You Are Considering Sending Your Child to an Eating Disorder Treatment Center

I recommend being judicious about anyone sending their child away from home. Before making the decision to even seek a treatment center, consider these questions:

  • Why do I think my child should be in a treatment program?
    • Is this my idea or a recommendation from the therapist?
    • Has the therapist/parents sought second opinions or consultation on the child’s treatment progress?
  • What makes me think this is the best next step to take?
  • Have I done adequate research into the pros and cons of the treatment centers/programs?
  • Do I have a realistic understanding of what treatment centers/programs can and cannot achieve?
  • If the local therapist isn’t succeeding, does that mean I need a treatment center or just a different therapist?
  • Has my child’s therapist involved me in my child’s treatment?
    • Do I understand the skills I need to have to help my child heal?
  • Have I followed my child’s therapist’s recommendations regarding changes in the home and in my parenting?
  • What is truly motivating this decision?
    • Frustration? Our child’s well-being? Not knowing what else to do?

Questions to Ask Eating Disorder Treatment Centers

If you believe that an eating disorder treatment center/program is essential to your child’s recovery path, then consider asking the following questions of the treatment center:

  • What is your treatment approach? On what evidence is your treatment approach based? What is the data suggesting the effectiveness of your program?
  • Specifically how do you treat people with my child’s type of eating disorder? What is the general treatment plan/approach?
  • What is the daily schedule, and who specifically will be working with my child?
  • Can I see my child’s clinical team’s credentials and interview them?
  • In addition to the clinical team, who else will be working with my child? What are their credentials?
  • How do you control for the fact that sometimes eating disorder treatment clinics are learning opportunities for how to become better at eating disorder behavior? What control systems do you have in place to avoid this?
  • What is your success rate in terms of full recovery after a person leaves the treatment center? What are your extended outcomes? What is your relapse rate?
  • How do you involve parents in treatment? What are we to do while the child is in treatment?
  • What are we expected to do in order to prepare for our child’s return home?
  • How will you know when what you’re doing with my child isn’t being effective? If such a situation were to arrive, what are the alternatives?
  • How do you ensure that a person who goes through your program is successful beyond the program?
  • How much does treatment typically cost? How much is usually the parent’s share of costs? What happens if we are unable to afford the treatment or continued treatment?

Treatment centers and programs are generally run by very good people who are trying to do very good work; but without parental involvement and ongoing treatment after the child returns home (or leaves the program), the rate of relapse may be quite high. Parents, as consumers of these programs, need to be thoughtful about their reasons behind sending their child to the program and realistic about their expectations. Parents need to remember that they are employing the program/providers to treat their child.

Finally, parents should try to keep in mind that the treatment centers/programs represent a lot of money and a lot of time, and a lot of heartache and concern for one’s child. The parent definitely wants to make sure that they understand what they are getting for their your financial, emotional, and loving investment and commitment.

Screen Shot 2017-04-21 at 9.27.21 PM

John L Levitt, PhD, CEDS, FAED, FIAEDP, is the co-editor of the book, Self-Harm Behavior and Eating Disorders: Dynamics, Assessment, and Treatment, and was on the Editorial Board of Eating Disorders: The Journal of Treatment and Prevention Email: Phone: (847) 370-1995

Posted on 9 Comments

What I want parents to think about before sending their child to an Eating Disorder Treatment Center, by John Levitt, PhD

parents should carefully consider the implications of sending a child away to a treatment center for eating disorder treatment

I often get calls from parents asking me about how to get their child into a (usually inpatient or residential) eating disorder treatment program, but I almost never get calls from parents who want to know how they can avoid sending their child to a treatment center.

I think many parents assume that a treatment center is the only option for their child, but that’s often just not the case. There are definitely times when an inpatient or residential treatment center is the best option for their child’s eating disorder recovery, but it’s important to know that the potential costs for sending one’s child to a treatment center (financially, personally, and socially) are possibly very high — and relapse rates can also be very high as well!

Treatment centers are run by good people who are generally doing good work. That said, treatment centers are businesses, and you as parents are the consumers. Don’t be afraid to be a smart consumer. Ask a lot of questions. Ensure you understand what you are getting into. That is, make sure you know what you will be paying for and what outcome(s) you can expect. Parents should become the experts on what they are “buying” before taking the leap to send their child anywhere!

First, it’s important to know what treatment centers can – and can’t – do. Treatment centers are places where your child can stabilize his or her eating disorder symptoms. Their weight will hopefully improve and likely stabilize and their eating disorder symptoms will likely be reduced or even eliminated completely while they are staying at the treatment center.   Associated symptoms of depression and anxiety and so forth are also likely to improve.

That said, when they get home, they are faced with the same life stressors and conditions that may have at least bred the eating disorder, or minimally, were associated with the eating disorder prior to going to going to treatment!   Once home, this is where the true treatment begins. Your child needs to learn to live with a sense of self-worth and self-efficacy that is enduring and resilient across people, places, and situations — and they often won’t find that in a treatment center. You just can’t practice all of the requirements of life in a controlled setting. Full treatment does not happen in a program, it happens in life.

I recommend that parents ask treatment centers a variety of questions such as: how long does it usually take to stabilize a child’s eating disorder(s) (including issues related to mood etc.), how will the treatment center ensure that you, the parent(s), are an essential part of the treatment, and how will the treatment center prepare your child, and the parents, for the child’s return home — ensuring the maintenance of their treatment gains.   In addition, even at admission or pre-admission, parents should ask about what will be needed upon the child’s return home; after completing that treatment. That is, what will your child need following their stay at the center? You should not receive vague answers to any of these questions because they are critical to efforts to achieve full recovery.

I understand how frustrating it can be to have a child who has an eating disorder at home. I understand the desire to send the child “away” to get better because you just don’t know what else to do. But I would be very judicious about sending one’s child away. As long as your child is going to return home to the parent, that parent is going to need to get his/her own tools and support to continue the healing process.

Parents need to be educated, supported and trained to support their children in healing from an eating disorder. Some treatment centers build that into their programs. Ask them about it.  Make sure that they will involve you and make up your mind to be involved!

Also, don’t be afraid to ask about the costs involved. Many treatment (e.g., residential) centers are running 60 days. That’s a long time for your child to be away from home and away from school. It’s can also be about $60,000 plus. That doesn’t take into account post-center treatment. That can be equivalent to your child’s college tuition.

I don’t want to discourage parents from using inpatient or residential treatment centers. I just want parents to understand what is involved in some types of treatments, carefully review the alternatives, if any, and enter treatment with realistic expectations and get their questions answered! It’s important for parents to be really clear about what is realistic to expect.

Screen Shot 2017-04-21 at 9.27.21 PM

John L Levitt, PhD, CEDS, FAED, FIAEDP, is the co-editor of the book, Self-Harm Behavior and Eating Disorders: Dynamics, Assessment, and Treatment, and was on the Editorial Board of Eating Disorders: The Journal of Treatment and Prevention Email: Phone: (847) 370-1995

Posted on 1 Comment

A Perspective on Eating Disorder Recovery: From a therapist who has been in the field for 40+ years, by John Levitt, PhD

In 40 years of working with eating disorders patients, I can say without any doubt is that there is no easy panacea for those struggling with recovering from an eating disorder. Ultimately, the only way someone truly gets better is through building his or her recovery in the actual aspects of their life. Indeed, if you’re not experiencing life, building relations where you feel cared for, engaging in work or school, or building a lifestyle that is meaningful, it is very hard to sustain and effectively recover from an eating disorder.

Eating disorders serve a protective purpose for the individual. There are some who use it for other reasons, but in my experience most people use it to serve a social/relational purpose or as a way to manage their emotions or manage their self-worth. These purposes are, in fact, meaningful and intense for the person who has an eating disorder.  Consequently, an individual can appear recovered behaviorally (i.e., reduction in eating disorder symptoms), but that’s often only when the challenges of treatment and recovery truly begins.  These challenges generally don’t occur in the treatment center, but only through the experiences of living life itself.

I think it’s really important that we reevaluate our perspective on eating disorder treatment and recognize that treatment centers represent an opportunity to learn new tools, but they are not the complete solution.

You can take your child or loved one to a treatment center or program and they will generally learn behavioral tools, stabilize their disorder, and begin their journey towards recovery.

The healing, however, has to continue when they come home.

The healing has to continue for life.

I also think it’s important to balance the need for a child or adolescent to begin their “recovery” in the context of their developmental needs. That is, they need to become “their own person.” When parents push unwilling children into treatment centers against their will, children will often push back. As a result, it can be very frustrating, and economically difficult, for parents who are in this situation – spending hundreds, if not, thousands of dollars getting their loved one treatment. They are desperate to help their children, and often financially commit themselves to their loved one’s recovery even though their child might resist their efforts.

There is no easy answer or solution for eating disorder treatment and recovery. I think it’s very important for family members, including the child, to talk these ideas through with someone who is qualified to provide them with an honest assessment of where their child is in their disorder and recovery, what the child and family’s options are for recovery, and what is realistic to expect from a treatment center, program, therapist, group, and/or other approaches to recovery.

I recommend that parents focus on providing a consistent, safe and secure environment where recovery can take place, and strive to empower their child to continue a healthy life while pursuing recovery. This is really difficult, and I encourage parents to learn not just about the eating disorder behaviors, but also about the underlying triggers and situations that can lead to eating disorders.

For example, it is very important for parents to learn how to set limits, but also how to praise and encourage their child both during and after treatment. Kids don’t get better if they don’t have hope; and fundamental to hope is the belief that recovery is possible and likely in a caring environment.

A lot of parents think that the baby and toddler years are hardest, but I believe that later years, such as ages 10-18, are when kids may need the most intensive parenting. This isn’t any longer about watching them learn to safely walk, eat and crawl. Now it is about the child learning about their life while being in an emotionally safe environment. It’s not as obvious, but children need just as much care throughout adolescence as they did during infancy. They need a safe, consistent environment so they can take the next step in their life.

As a therapist, I am grateful and honored to the individuals and families who have allowed me to enter their lives and be part of their recovery. In my approach, I focus on treating all eating disorder patients and their families with kindness and hope. I believe, and have found, that generally people get better over time in the context of a good healthy human interaction; which I believe effective therapists offer families who are going through eating disorder treatment.

John L Levitt, PhD, CEDS, FAED, FIAEDP, is the coeditor of the book, Self-Harm Behavior and Eating Disorders: Dynamics, Assessment, and Treatment, and is on the Editorial Board of Eating Disorders: The Journal of Treatment and Prevention. Email: Phone: (847) 370-1995