A Guide for Psychotherapists and Other Health Care Professionals

Statistics

5 to 10 million women and 1 million men suffer from eating disorders.

In the past 10 years, the number of males with eating disorders has doubled.

Eating disorders, previously diseases of adolescence, are now affecting kids between the ages of 9 to 12.

A U.S. Dept. of Health and Human Services task force reports the 80% of girls in grades 3 to 6 have bad feelings about their bodies, an issue diverting attention from schoolwork and friendships.

By age 13, 80% of girls are dieting to fight the natural changes in their maturing bodies. For adolescent girls, 20% of weight gained is in fat.

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

Recovery

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

Appendices

Taking an Eating Disorder to College p. 250-254
Resources p. 255-263

Psychotherapist Abigail H. Natenshon has specialized in the treatment of eating disorders with individuals, families, and groups for the past 37 years. She is the author of When Your Child Has an Eating Disorder: A Step-by-Step Workbook for Parents and Other Caregivers, Jossey Bass Publishers, San Francisco, CA. October 1999. Based on hundreds of successful outcomes, this book shepherds concerned parents step-by-step through the processes of eating disorder recognition, confronting the child, finding the most effective treatment for patient and family, and evaluating and insuring a timely recovery. A guide to eating disorder prevention, this book is useful to parents, health professionals and school personnel alike in countering the pervasive epidemic of unhealthy eating and body image concerns, and destructive media and peer influences. Her work can be reviewed further at her web site at www.empoweredparents.com. To order visit amazon.com.