A Treatment Guide for Psychotherapists, Physicians, School
Personnel and Nutritionists
to Using When Your
Child Has An Eating Disorder
By Abigail Natenshon
When Your Child Has An Eating Disorder: A Step-by-Step Workbook for
Parents and Other Caregivers has
been included with StudyCredit.com in
a resource bibliography for professionals seeking online Continuing
Education Credit Units.
It takes an empowered child to recover from an eating disorder….
It takes an empowered parent to raise an empowered child. ………
None but an empowered professional can enable the entire family to
grow closer, communicate more effectively, and to heal optimally
through the experience of their child’s eating disorder recovery."
Eating disorders are family diseases.
Eating disorders are more likely to show up in kitchens,
bathrooms and bedrooms than in doctor’s offices or through
Scientific research out of the Maudsley Hospital research from
London, England confirms that children living at home who have
been anorexic for less than three years recover most effectively
and lastingly through family, rather than individual, therapy.
Through a family systems approach to eating disorder recovery and
the guidance of the child’s professional team, the enlightened and
appropriately proactive parent has the capacity to become a mentor
and advocate to the child, to the eating disorder recovery process,
to the treatment team, and to the therapeutic process.
In this age of managed care, the options for access to both
inpatient and outpatient professional services are minimal. In some
instances, parents have little choice but to become symptom managers
for their very ill and/or very young children.
The benefits of a family systems focus
Therapeutic change happens most efficiently when parallel
changes occur simultaneously within the wider family system.
Effective family treatment is the key to substantive
interaction, but to an exchange of information without the risk
of breaching confidences or making inappropriate disclosures.
Parents. . . with the exception of those who are chaotic,
without boundaries, overly critical or abusive. . . want to do
what is best for their child. As consumers of their child’s
mental health services, they deserve to be taught how by their
child’s health professionals.
It is simply impractical to separate parents from children
struggling with eating disorders, their treatment and recovery.
Nothing is more conducive to a child’s emerging autonomy,
independence and healthy separation than providing the child the
opportunity to bond with family, substantively and securely.
Problems or issues that exist within a family system need to be
confronted and resolved before they can be effectively put
In addition, where the out-of-control eating disordered child
cannot assume responsibility for himself, parents need to take
charge and to take up the battle against disease in order to
enable the child to achieve self-control and the developmental
tasks of childhood and adolescence.
Professionals have found this book to be a helpful aid in setting goals
and keeping the focus in the work. Others have found it to be useful as
an adjunctive tool to be used by patients either during the treatment
session or at home as “homework” between sessions, to supplement and
enhance the growth process. The exercises, when executed by both parent
and child, provide a perfect “jumping off point” for dialogue and
learning at home and within the treatment milieu.
The following is a directory to a discussion of specific issues that
are of particular interest to patients and parents:
Understanding eating disorders
Dispelling myths and misconceptions p. 4-7
What eating disorders are and what they are not p. 7-26
Causes and Triggers p. 26-36
Seeing beyond smoke screens p. 40-49
Helping parents to help their children p. 49-56
Confronting the child confronting disease
Dealing with resistance p. 72
Listening for feelings p. 76-81
What do I say, when and how? p. 83
Becoming educated: The body’s infinite wisdom p. 211
Rethinking power struggles p. 89-91
Understanding treatment options
What happens in treatment. Demystifying the treatment process.
Understanding treatment approaches and philosophies p. 110-117
Treatment modes p. 117-127
The Medication Alternative 123-127
Treatment Milieus p. 128-132. Hospitalization v. outpatient therapy
,day treatment programs
Working with the professional team 140-151
What kind of therapist do I need? p. 140
What to look for in a nutritionist. p. 144
Insurance coverage. Getting the most out of the system p. 139 163,
Parents as members of the team p. 162
What recovery is about p. 171-193
What recovery and change looks like p. 95, 208
What should happen in the first session? p. 165
Parental limit setting is okay. p. 232
Parental influence on disease onset p. 214
Overcoming Recovery Setbacks
Measuring progress p. 207-210
Facilitating, troubleshooting a stalled recovery p. 210-238
The choice to remain ill p. 238-242
Taking an Eating Disorder to College p. 250-254
Resources p. 255-263