Family Based Treatment (FBT)
Family Based Treatment (FBT) is a treatment for adolescents and young adults with anorexia nervosa. It is one of the few eating disorder treatments available that has demonstrated efficacy in controlled clinical trials and is recommended in international treatment guidelines as the first line of treatment for this age group. The distinguishing characteristic of this treatment is that parents are recognised as the key resource to facilitate recovery of their child. While clinicians may be experts in eating disorders, in FBT the parents are identified as experts in their children and are empowered to re-establish their footing as parents in the recovery process of their child. FBT takes an agnostic view of the development of eating disorders and is non-blaming of parents or families. It has the distinct advantage of involving all family members and recognising that each member can play an important role in the recovery process.
Treatment duration on average is about one year and is divided into three distinct phases..
Phase 1: Parental management of weight restoration and extinction or eating disorder behaviours with parents co-operating on finding ways to re-nourish their child. The therapist’s support and encouragement is crucial for both patient and parents.
Phase 2: Parents gradually reduce their management of their child’s eating and weight recovery, gradually allowing them to increase their own responsibility for food and eating. This phase also places strong emphasis on normalising all food and eating related activities (e.g. eating socially, eating with flexibility and spontaneity).
Phase 3: Once eating disorder symptoms have resolved, and full weight recovery achieved, the focus shifts to addressing any developmental issues of the adolescent as in preparation for completion of treatment.
Although targeted originally to the treatment of anorexia, FBT has also been shown to be effective with clients presenting with bulimia nervosa.