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What to Expect When Your Child Starts Therapy for an Eating Disorder?

I think of eating disorder treatment as navigating a healing journey with a compass rather than a GPS. What I mean by this is that my expertise in eating disorders, along with your wisdom as a parent, and your child’s unique needs and strengths will guide the way and point us in the direction we need to go. Recovery is not a clear cut, step by step instruction manual that can be completed within a specific timeframe like a GPS offers. When your child and family are in crisis, I realize that the GPS coordinates sound far more alluring, but healing and recovery are far more complex and unique to each individual and family. We will work together to understand your child’s eating problem and find the right path for his or her healing so that he/she can move forward and thrive in their life.

 

Assessment and Consultation:

When working with minors, I meet with the parents alone for the first session. This allows for us to talk openly about your child’s development, strengths, and areas of concern that will be targeted in treatment. The following session, I will meet individually with your child to get to know him/her and further assess the eating disorder and mental health symptoms. From here, if we all feel it is a good therapeutic fit and clinically appropriate, we will move forward with therapy.

Therapy:

I generally meet with teens for individual therapy 1-2x per week for 45 minute sessions. Parents often worry that their child will be resistant to therapy or have a hard time opening up — I am intentional about finding creative ways to connect with teens and most come to enjoy having this safe space to talk about their world. Our conversations will not be limited to topics directly related to the eating disorder, but will encompass all aspects of his/her life. If we only focused on eating disorder thoughts and behaviors, we wouldn't be getting to the root of the underlying issues that contributed to the development of an eating disorder in the first place (examples include low self-esteem, perfectionism, social insecurities, disconnection from emotions or overwhelming emotions, depression/anxiety, etc).

Recovery is not a linear process. Anticipate your child to experience lots of “ebbs and flows” throughout this journey. My philosophy is that each “ebb” is just as important as the “flow.” The setbacks and stumbles will guide us in areas that need additional attention and strengthening. Eating disorder recovery is hard. It’s going to be hard for your child and it’s going to be hard for you, the parent. But it won’t always be this hard and it will be worth it.

 

Parent and Family Sessions:

In working with your child, it is important that I hold the integrity of the individual therapy, meaning there is limited parent contact to ensure the privacy and confidentiality of the teen. With that said, eating disorder teen therapy is tricky because as the parent, you are in the trenches navigating symptoms at home and need guidance and support yourself. As I get to know your family, I will have more clarity as to whether it would be appropriate for me to facilitate parent-support and/or occasional family sessions or whether it would be more appropriate for me to provide referrals to another therapist to facilitate this type of work.

 

Working with a Dietitian:

In addition to therapy, I generally recommend working with a dietitian who also specializes in eating disorders. As an eating disorder therapist, I am very comfortable talking about food, exploring the emotional component to eating, and challenging limiting food and diet beliefs, however a dietitian is able to provide direct guidance on nutritional needs and meal planning to help stabilize eating patterns.

 

Medical Monitoring:

Depending on the severity of your child’s symptoms, a medical doctor is often an important part of the team. I recommend a complete physical at the start of treatment so that we can have a baseline and ensure that your child is medically stable. From there, the doctor will determine the frequency of checkups based on the current symptoms.

Levels of Care:

Outpatient therapy, (the level of care I provide) is the lowest level of care when treating eating disorders. One of the things that I will be assessing for and discussing with you is the recommended level of care. When making recommendations, I take into account current symptoms, co-occurring mental health or medical issues, current life stressors, and motivation for recovery. Again, each person is unique in their needs and we will work together to figure out the right path for your child.

 

Intensive Outpatient Therapy (IOP): The individual participates in a treatment program that is usually 3 hours/day, 3-6 days per week. Treatment combines group therapy, individual therapy, nutrition counseling, and meal support. IOP is typically held in the afternoon/evening so that participants can attend school/work during the day.

 

Partial Hospitalization Program (PHP) aka “Day Treatment:” The individual lives at home with their family, but attends a treatment program that is usually 7 hours/day, 6 days per week. Treatment combines group therapy, individual therapy, family therapy, nutrition counseling, and meal support. Your child would need to take a temporary leave from school - most students enroll in a home studies program through their school district while in PHP.

 

Residential Treatment (RTC): The individual resides at the treatment facility so that he/she can receive 24 hour staff support. The idea of residential treatment is often daunting for families to think about, but most that I have worked with end up having a positive and healing experience. RTC is generally a 1-3 month stay before stepping down to a lower level of care. RTC programs include an educational component so that students can keep up with school.

 

Inpatient Hospitalization: Inpatient hospitalization is required if the individual is not medically stable. Treatment is short-term, typically around 3 weeks. Though patients receive some therapy and psychological treatment while in the hospital, the focus is on medical stabilization.

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I will work closely with you in figuring out what is best for your child and I will be honest and direct with you in my recommendations. It is important to me that you have all the information so that you have a clear understanding of what treatment could entail, resources available, and are informed in making decisions.

Many parents express worry that an eating disorder is a lifelong illness that their child will have to endure — it does not have to be. Your child can achieve full recovery. In my experience, many people who recover from an eating disorder actually develop a healthier and more nurturing relationship with food and their body than the general population, in part because of the hard work they do in therapy.

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