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Over 35 Years of Eating Disorder Specialty Practice
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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."
Abigail Natenshon

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 laboratory tests.
  • 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 aside.
  • 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

Recognizing Disease

  • 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. p. 92–110
  • 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, 232
  • 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

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