Family-Based Treatment (FBT) for Eating Disorders

It’s a rare gift when a child has a serious illness and parents can deliver the cure…

Family-Based Treatment, also known as FBT or the Maudsley Method, is the leading evidence-based outpatient treatment for anorexia and bulimia in young people.  FBT uses education and training to empower caregivers with the skills and confidence needed to take a central, directive role in their child’s recovery. 

What is FBT and how does it work?

Family-Based Treatment for children and adolescents with eating disorders has proven to be the most effective intervention for sustained recovery from Anorexia Nervosa.

Parental empowerment is at the core of FBT. The treatment charges parents with the critical role of restoring their children back to optimal mental and physical health. FBT requires the commitment of at least one primary caregiver, but other close family members or friends may be central supports as well.

Families participate in weekly sessions with a trained FBT therapist. For a malnourished person with anorexia, food is the primary medicine. Given the 35-42 (3 meals and 2-3 snacks per day) doses of nutrition your child will require weekly to successfully be re-fed and avoid hospitalization, he/she will require intensive “medication” management. In this process, every bite counts as a step back to the healthy child you once knew.

The 3 Phases of FBT

  • Phase One

    In Phase One of treatment, you bring much needed relief to your child when you take control of their food choices. You will be given the support and skills necessary to do this effectively. With your intervention, your child will quickly begin to show signs of returning health — physically, emotionally and behaviorally.

  • Phase Two

    You will carefully transfer feeding responsibilities back to your child after you’ve reestablished a solid foundation for them. Phase Two is about maintaining weight with normalized eating and gradual return to more age appropriate independence.

  • Phase Three

    In Phase Three, we will work together to restore a more normal lifestyle and relationships between family members, with particular focus on addressing gaps in development, which eating disorders often leave behind.

FBT at Columbus Park

At Columbus Park, we see remarkable success with our FBT families, and in almost all cases of childhood/adolescent anorexia or bulimia, we will recommend FBT as the intervention of choice.

Columbus Park’s FBT program is spearheaded by our Founder and Clinical Director, Melissa Gerson, LCSW, who is a Certified Family-Based Treatment Therapist.

  • FBT has proven to be the most effective intervention for sustained recovery from Anorexia Nervosa. Increasingly studies are showing similar success in recovery from Bulimia Nervosa.

  • Residential and hospital stays can be helpful in moving your child forward out of crisis; however, these settings are only the first leg of the journey. It’s essential for parents to have the skills and confidence to support the transition home and the continuation of the recovery process which can extend for many months. Parents are also central in ongoing monitoring and prevention of relapse. FBT is designed to support the patient in their movement to increased independence as they demonstrate the ability to feed themselves adequately. FBT also provides a structure for improving communication, increasing family harmony and addressing underlying issues that might have left the child more vulnerable to developing an eating disorder in the first place.

  • All Columbus Park services are delivered via telehealth. Currently, our team serves clients in New York, California, Connecticut, and Pennsylvania.

  • Eating disorder recovery starts with nourishment, the only way to correct the energy deficits in the body that are exacerbating symptoms of anxiety, depression and obsessive focus on food, weight and related concerns. When in physical crisis from anorexia or bulimia, no amount of talking and deep emotional therapy can heal the issues that are arising as a result of calorie and nutrition deficits in the body. In FBT, as parents exert their authority to block the eating disorder and support renourishment, we see dramatic improvement in all domains: social, emotional, cognitive, and physical functioning. Much of the eating disorder recovery happens simply from getting re-nourished and stabilizing weight. Once we see this stability, remaining concerns, if any, are addressed through targeted psychotherapy.

  • If you or your loved one are interested in learning more about FBT, please arrange a consultation call here. We can address questions and help you establish if FBT might be right for you.

Frequently Asked Questions About Family-Based Treatment

  • We see great benefit in avoiding hospital, residential, and other intensive treatment programs for our youngest patients; unless there is immediate medical complication, we believe it’s in the child’s interest to recover in the least restrictive setting possible, surrounded by family support, protection, and encouragement. FBT can be a robust intervention, appropriate even for the most severe eating disorder presentations; we just need to ensure that the patient is medically stable and that there is at least one trusted adult available to create structure around food procurement and monitoring.

  • Resistance is to be expected; if it was so easy for your child to eat, you wouldn’t be reading this right now! FBT is designed to treat even the most aggressive eating disorders. Parents are given the skills necessary to outsmart the eating disorder and ensure consistent and adequate nutrition. We treat food like medicine in FBT; every dose is required, and the child cannot move on to the next activity until they have completed the medicine in its entirety. As needed, we create behavioral plans designed to encourage eating and implement natural consequences for food refusal (for ex, we don’t move on to pleasurable activities until the meal or snack is complete). Parents typically find that within a few weeks, they’re able to get into a groove and the feeding gets easier. The patient begins to show signs of returning health — physically, emotionally, and behaviorally.

  • We encourage families to keep their child engaged at school and other activities while doing FBT; we just have to figure out together how to get each and every meal and snack supervised. We have creative strategies and methods for navigating school and various other demands on the child and the caregiver[s].

    Especially considering that FBT is robust enough for the most severe eating disorder presentations, it’s remarkably efficient. Parent[s] attend one weekly sessions with their FBT therapist. The child/patient may attend these sessions alongside their parents, but it can also be as effective – in some cases, more effective – for parents to have alone time with the provider as they strengthen their skills and confidence in managing the illness. As needed, this weekly session can be supplemented with an individual supportive therapy appointment for the child – but it’s not required.

  • FBT is appropriate for medically stable individuals with a diagnosis of anorexia or bulimia and living at home with at least one caregiver who can be available for weekly sessions and for the supervision of most meals and snacks. Single and divorced parent[s] are among the most effective FBT parents. FBT is a great option for patients coming out of the hospital or other programs; it’s ideal for caregivers to have the skills to build on the foundation of healing achieved before return to home. FBT teaches parents the very specific and critical skill of parenting a child with a current or past experience of anorexia or bulimia. Savvy caregivers can not only help the child achieve stabilization but they can provide the necessary oversight and support to prevent recurrence in the future.

    If you’re considering FBT, we encourage you to contact us. After an initial phone intake, we can decide together if it makes sense to move forward with an assessment. The assessment involves obtaining a full history and a clear snapshot of the current challenges. We will provide a diagnosis and will outline the targets of treatment along with a thorough recommendation for a treatment course. We have specific criteria to guide whether FBT will be the treatment protocol of choice or if another treatment would be more appropriate. An initial assessment will give you a great deal of information about the nature of the problem and the best strategy to address it.

  • If eating was easy for your child, you wouldn’t be reading this right now! FBT understands that getting your child to eat is no easy feat. Your FBT provider will set you up for success with strategies for ensuring compliance with the feeding plan. Parents learn how to set and hold limits as they relate to food and eating. They become skilled at navigating emotional outbursts and remaining steady and resolved in the face of food resistance. The treatment bolsters parents with calm, loving, determination to lean in to the hard moments in service of successful eating and weight stabilization.

Take the first step

If you are interested in learning more about starting FBT with Columbus Park, please book a free consultation call with one of our clinicians.

Contact Us

Please schedule your complimentary 15-minute informational intake or fill out the form below and we will respond within one to two business days.