Background: This presentation will provide an overview of FBT across levels of care, including how to preserve the role of parents within a treatment team of professionals on an inpatient medical unit, residential treatment center, and a partial hospitalization or intensive outpatient setting. A number of innovative interventions will be discussed.
l. Overview of FBT at various levels of care: Walter Kaye
a. Neccessity of theoretical consistency and adherence to the FBT model
b. Discusssion of how to determine levels of care and minimize length of treatment stays using FBT
c. Rationale for starting FBT during inpatient medical stabilization
ll. Integrating FBT into a multilevel treatment program: Anne Clarkin
a. Family therapy sessions, meal coaching, behavioral contracting and novel family interventions
b. Multifamily meals, multifamily therapy groups, including innovative experiential group interventions
c. Intensive family week: FBT Boot Camp
lll: Peer to Peer Parents Support: Roxanne Rockwell
a. How to make parents active and important members of the treatment team at all levels of care
b. Why and how to create a parent mentor support group
b. Using the unique expertise of skilled parents of recovered teens to empower anxious parents of newly diagnosed teens.
It has been clearly established that in treating adolescents with AN, early intervention results in lower mortality rates, reduced illness chronicity and greater symptom remission (Steinhausen, 2002). Research focused on adolescent presentations of AN shows that family-based treatment (FBT) is the gold standard outpatient treatment for adolescents with medically stable AN (Lock et al, 2001; 2013; Murray & Le Grange, 2014). In clinical practice, however, many adolescents with AN require treatment at a higher level of care at some stage of their treatment trajectory. Since recent findings underscore the critical importance of theoretical consistency across treatment providers and levels of care in promoting the therapeutic effects of FBT (Murray, Griffiths & Le Grange, 2014, Murray et al., 2012; 2014), the incorporation of FBT at higher levels of care is essential for treatment integrity. We will demonstrate how the theoretical underpinning of FBT may be applied across varying levels of patient care, addressing the challenges of ensuring theoretical fidelity to the core tenets of the model.
The primary premise of FBT is that parents are empowered to be the agents of change in their child’s recovery, providing ongoing insistence that the child eat and restore weight. Preserving the primary role of the parents within a treatment team of professionals on an inpatient medical unit, residential treatment center, partial hospitalization or intensive outpatient setting is complex, but also provides opportunities to enhance the efficacy of FBT. Advantages include providing temporary respite for exhausted and burned out parents, and providing individualized support and coaching so that the parents may be more successful, facilitating quicker weight restoration and recovery.
In this presentation, we will describe how the FBT model has been integrated into an inpatient medical stabilization unit, a 6 day partial hospitalization program, an IOP and an intensive family (Boot Camp) treatment week. We will describe a number of innovative interventions, such as multi-family meals, multi-family experiential groups, and a unique parent peer mentoring program.
Dr. Kaye has an international reputation in the field of eating disorders and is the author of more than 300 articles and publications. He attended Ohio State Medical School, trained in neurology at the University of Southern California and trained in psychiatry at the University of California, Los Angeles. As Director of the UCSD Eating Disorders Center, Dr. Kaye and his clinical team are treating anorexia nervosa and other eating disorders with an innovative, intensive program that approaches the problem on multiple levels, including medical, psychological, psycho-educational and counseling of the family as key support group.
Dr. Roxanne Rockwell is Associate Director of the UCSD Adolescent Eating Disorders Service. She was one of the founding members of the UCSD Eating Disorders Program in 2005, and has been integrally involved in its development and expansion. Dr. Rockwell played a primary role in devising and building the innovative individual and multi-family Intensive Family Therapy (IFT) programs and the adolescent day treatment programs. As a certified Family Based Therapist, she provides training and clinical supervision in the pediatric and adolescent eating disorder programs.
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Anne Clarkin, LCSW
Anne Clarkin has been working with eating disorders for over 25 years. She has designed and directed both inpatient and outpatient eating disorder programs in San Diego hospitals and has specialized in treating adults, teens and families dealing with eating disorders in private practice. Anne has written a chapter on the treatment of eating disorders for Psychiatric Mental Health Nursing, a nursing textbook. Anne is working in the Day Treatment program at UCSD.
