Family-based therapy for treating eating disorders

What is family therapy?

Family therapy is a form of group therapy that involves people considered part of a family unit. This can include a wide range of family members and loved ones, including partners, siblings, parents, children, cousins, aunts, uncles, and close friends.⁸

Much like other types of group therapy, family therapy is facilitated by a mental health professional, though they will usually have specialized training in treating families. The idea is usually to treat the group as a whole, in order to improve overall dynamics or help educate the entire group on how to best help a member of the family.

The entire family doesn't need to be involved in family-based treatment, though they can be. Rather, this type of therapy focuses on those who could benefit most from receiving professional counseling around the issue at hand.

There are many different types of family therapy, all of which take different approaches. However, no matter which treatment plan for family therapy is used, the goals are similar:¹

• Improve family functioning
• Build stronger relationships
• Create a healthier home environment
• Solve family conflicts and problems
• Understand the unique issues of the family
• Improve communication
• Target dysfunctional family processes, such as overprotectiveness

What is family-based therapy for eating disorders?

When a child or adolescent is struggling with disordered eating behaviors, it's common for them to undergo family-based treatment for eating disorders.⁴ Though, this type of therapy can be helpful for people of all ages.

Some different types of family therapy for eating disorders include:^2,3

• Conjoint family therapy (CFT): CFT involves two or more family members meeting with a clinician in the same session. This type of family therapy is used when clinicians want to focus on working on the relationship between loved ones.
• Separated family therapy (SFT): SFT involves two separate meetings, one in which a younger person with an eating disorder meets with the clinician and one in which their parents meet with the same therapist. This type of family therapy may be used when there are concerns about parental criticism or hostility.
• Family systems therapy (FST): FST posits the idea of a family as a singular emotional unit. In other words, an individual's behavior influences the entire family unit, and the strength of the family unit can also serve to balance or support each individual within it. FST can be used to help identify and balance power structures within a family, or to address more specific problems.

Another popular type of treatment plan for family therapy is called the family-based approach, sometimes referred to as the "Maudsley method." This structured type of support involves different modules through which parents are educated and empowered to take over most food-related decisions for their child, then instructed, over time, how to return more autonomy to their child. Throughout, parents and child attend therapy together to help them work through other issues related to the eating disorder.¹⁰

Benefits of family-based treatment for eating disorders

• Teaching new coping strategies
• Offering understanding and insight into the family system
• Identifying challenges for the family
• Teaching strategies for dealing with conflict
• Improving communication skills
• Strengthening relationships
• Minimizing or changing the conditions that contribute to the eating disorder
• Teaching family members how to support their loved one with an eating disorder

Treating co-occurring mental health conditions with FBT therapy

Eating disorders often co-occur with other mental health conditions, trauma, or other life challenges, and family-based treatment can, in many cases, also help with these experiences. For example, family therapy may help those who experience or have experienced:

• The death of a loved one
• Divorce or marital issues
• Trauma
• Stressful life transitions
• Teen or child behavioral problems
• Conflicts in family life (e.g., between parents and children or siblings)

FBT therapy can help the entire group work on and move past these difficult experiences by involving the people closest to someone with an eating disorder.

FBT therapy for adults

Although family-based treatment benefits a child's eating disorder treatment plan, adolescents, and young adults, the benefits can also extend to older family members.

One study found that family based treatment helped treat many issues adults face, including mood disorders, anxiety disorders, alcohol misuse, psychosis, intimate partner violence, relationship conflict, and chronic physical conditions.⁵

While more research is needed into the effectiveness of family based therapy for adults, this development appears promising for treating eating disorders in adults, as well, given that many of the conditions FBT therapy can help with are experienced as comorbid—or co-occurring—issues.

How effective is family therapy?

This is important, as other common treatments for eating disorders, including cognitive behavioral therapy (CBT), have not been consistently found to help adolescents with anorexia nervosa.⁹

Another study showed that family therapy improved family functioning to help treat adolescents with various mental health conditions, such as eating disorders and substance addiction. Parents reported healthier parenting behaviors, greater perceived efficacy as a parent, and improved family cohesion.⁶

Lastly, another review found that family therapy was effective in treating eating disorders and healing from neglect or abuse, emotional issues, and conduct problems.⁷

However, professionals have acknowledged the limitations of this type of therapy and its lack of application to all families.⁴

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Should family-based treatment be combined with other therapies?

Typically, family therapy for eating disorders is combined with other treatment modalities, such as individual therapies like cognitive behavioral therapy (CBT) and other types of group therapy, to provide patients with a comprehensive treatment plan that comprehensively addresses their needs and challenges. 

Family-based treatment for eating disorders may be combined with:

• Interpersonal psychotherapy
• Cognitive behavioral therapy (CBT)
• Dialectical behavior therapy (DBT)
• Group therapy
• Support groups
• Nutritional counseling
• Medical care
• Meal support
• Adolescent-focused individual therapy

Family-based therapy at Within

At Within Health, we sometimes use elements of family-based treatment (FBT)—or, the "Maudsley Method"—in our treatment plans. Specifically, this focuses on psychoeducation, which teaches those involved in family-based therapy about eating disorders so a family unit, as a whole, becomes better prepared to understand and manage these issues.

In addition to these different types of family therapies, Within also offers a family partnership meeting, in which a clinician meets with family members and outlines a roadmap for treatment, skills, and strategies that may be helpful. 

Moreover, we offer groups where many families can talk about their experiences and provide each other with support, comfort, and encouragement. Knowing that other families may be struggling with similar problems can be helpful.

At Within Health, we think it's essential to provide our patients with integrated and individualized care that provides a high level of support and engagement. Enrolling in our virtual eating disorder treatment program gives you access to a team of compassionate and deeply caring treatment professionals invested in your recovery.