My daughter has been struggling with Anorexia for 3 years and has been in both acute care and long term residential programs on an ongoing basis. She developed the illness at age 13 and is now 16. Although she received treatment early on and has been in some reputable programs, the illness has progressed and has quite a hold on her. She has come close to death.
It seems that from the research compiled that Maudsley has been most successful with adolescents who are not yet entrenched in the illness. Are there success stories related to individuals who are further along in this disorder? Given the duration and severity of my daughter’s illness, would it be recommended to pursue this approach and if so, do you have any recommendations for clinicians who are formally trained who are in the NYC/Dutchess/Westchester county area?
Kara Fitzpatrick, PhD responds:
We always want to intervene as early as possible when someone has anorexia nervosa. In fact, the research suggests that family-based treatment is most effective when patients are under 18 and have a short duration of illness. That being said, we know that this approach has been successful with some young adults and those who have been ill for longer periods of time. Indeed, in my experience, this approach has worked well when residential, acute care and other intensive programs have not been successful. In part, this is because return to health happens in the home and in the very environment that your daughter needs to learn to thrive in.
Obviously, as with any illness, the longer the course, the more likely that the illness has begun to interfere with areas other than simply food/eating/shape and weight. The longer AN is present, the more likely that adolescents will be moved off of their normal “developmental curve” – in other words the illness can begin to interfere with social and friendship development, learning independence skills and being able to manage more challenging emotions without returning to restriction and eating disordered behaviors. This is again another reason why an approach that works to keep your daughter in her environment can be useful, as it allows her to work on social development and independence skills in addition to just changing eating patterns. Ultimately, full recovery from AN happens when food, shape and weight concerns are replaced with normal, healthy relationships and the home environment is often the best place to allow this simultaneous progression.
You can find a listing of therapists trained in family-based treatment here.
Kara Fitzpatrick, PhD
Dr. Fitzpatrick is a psychologist working with Eating Disorders at Stanford University/Lucile Packard Children's Hospital and serves as clinical advisor to Maudsley Parents. She is widely trained in a variety of models for treatment and performs research in applied clinical treatments for adolescents and neuropsychological factors associated with eating disorders.