Professionals who treat adolescents with eating disorders need to expect resistance, denial and caregivers with a limited understanding of the illness.
Young clients with eating disorders will present in your office with denial that there is a problem. Parents vocalize obvious signs and concerns including restrictive food patterns, weight loss and narrowing of food choices. The irrational food beliefs are often accompanied with related physical symptoms like stomachaches and cold intolerance and loss of menstrual periods in girls. It is very common to experience this resistance. Your patients will be resistance to talking in session, resistance to accepting recommendations and overall resistance to treatment and goals for nutrition.
Anosognosia means denial of illness. Clients who present with restrictive eating disorders do not believe they are sick and do not see their need for help. Professionals need to be prepared for this type of resistance and solicit the help of parents. Family-based treatment (FBT) utilizes the parents to help implement nutrition restoration, which helps to side step the resistance and denial that is present in the starved clients. Waiting for the young person to have insight and readiness to change may put them at risk for delaying treatment and contributing to chronicity.
Parents must become experts on eating disorders very quickly. Professionals should offer a number of resources and encourage outside reading. The faster the parents become educated consumers the greater the opportunity for progress and recovery. One new book just released should be a great supplement to any professional who treats eating disorders. This book written is by Lauren Muhlheim, PsyD When Your Teen Has an Eating Disorder: Practical Strategies to Help your Teen Recover from Anorexia, Bulimia & Binge Eating New Harbinger publications. There are ten chapters filled with step by step guidance, sample scenarios and practical tools that can be accessed on line as a supplement to the book.
Melanie Jacob RDN is a seasoned eating disorder professional that found her niche in treating adolescents with eating disorders. When the FBT research surfaced in 2006 she transitioned her approach to follow the evidence.