“FBT considers the family as an adolescent’s greatest resource, so it’s designed to boost their confidence and maximize their strengths,” explains Senior Eating Disorders Therapist Alison Locklear, MSW, LCSW, CEDS-C. “With the guidance, support, and insight of the eating disorders treatment team, this approach in turn makes the family the treatment team.”
While FBT was created as an outpatient program, Princeton Center for Eating Disorders has developed an FBT model that provides components and structure for this approach in the inpatient setting so that families have a foundation for continuing progress after discharge. This includes:
- In-depth nutrition education with a dietitian that empowers parents to practice coaching, plan menus, bring in prepared or take-out meals, and provide in-person or virtual mealtime support during their child’s inpatient stay
- Daily update/coaching calls with therapists
- Regular family meetings with therapists and psychiatrists
SPACE Training
The Princeton Center for Eating Disorders FBT model also incorporates weekly training in Supportive Parenting for Anxious Childhood Emotions (SPACE). This treatment was first developed by Eli Lebowitz, PhD, Associate Professor at the Yale Child Study Center, for parents of children with OCD or severe anxiety. SPACE gives parents tools to identify and adjust what they may have accommodated in the past along with dialogue to validate feelings and convey boundaries in ways their child can understand.
“There’s an evolved predisposition for parents to respond instinctively to a child in distress, but it doesn’t always work in their favor,” explains Locklear, who is a certified SPACE trainer. “When parents swoop in to solve issues, the child doesn’t gain the confidence in their own ability to handle challenges.”
In the eating disorders setting, an example might be no longer swapping out a food that a child wants to avoid, as removing that item only maintains it as a fear food. The child can choose whether or not to eat that food, but the message no longer implies that the parent lacks confidence in the child’s ability to overcome that fear.
Many families of patients at Princeton Center for Eating Disorders have shared their gratitude for these resources, noting an increase in confidence and decrease in anxiety.
“We know eating disorders, but families know their children best,” adds Locklear. “By working together closely and consistently, we’re helping to ensure the best path forward.”