Nutrition Counseling within Family Based Treatment
Overview of FBT.
Family Based Treatment - or FBT - is a treatment model for adolescents with eating disorders that relies on parent and family involvement. This method was originally known as the Maudsley Approach as it was created at the Maudsley Hospital in London.
As a Registered Dietitian, my role is to empower parents and caregivers as they learn how to feed their child in the context of an eating disorder. As we work together I will communicate with the pediatrician, therapist, and any active providers on your team, and I will evaluate growth charts to determine whether weight restoration is needed. I will guide, educate, monitor progress, and provide feedback along the way.
Our work together will begin with an Initial Nutrition Assessment (60 minutes) to gather information and review the basics. During this assessment we will determine a frequency schedule for Follow Up Sessions (45 minutes) based on your families needs. These sessions are primarily held with the parents or guardians; adolescent age ranges accepted are 10-18 years old.
If you’re unfamiliar with FBT, there are 3 phases of treatment to be aware of:
Phase 1 - Weight restoration
We begin with interrupting behaviors and if needed, restoring weight to an appropriate range based on your child’s individual growth patterns. The focus now is on physical stability, and while an FBT trained therapist will be involved there isn’t a deep exploration of underlying issues or causes.
This is the primary phase where a Registered Dietitian can make an important difference in recovery and initial steps.
Phase 2 - Transitioning control over to the adolescent
When a consistent eating schedule has been established, weight has increased to a safe range, and there is more acceptance of regular meals/snacks without behaviors Phase 2 comes in. A gradual transition toward an age appropriate level of plating responsibility.
At this time, support from the Registered Dietitian naturally decreases. We would aim to meet once monthly until Phase 2 has been firmly established and you are comfortably maintaining adequate nutrition.
Phase 3 - Establishing a healthy adolescent identity
The final phase focuses on establishing a healthy adolescent identity that is free from the eating disorder.
