FBT tip #5 What is a therapeutic bind?

Professionals who use the FBT approach to treat adolescents with eating disorders can utilize this stance in the first session.  Experts in eating disorders identify the life-threatening symptoms and express alarm and compassion at the same time. Both sides of the coin are needed to orchestrate an intense scene.  This is referred to as a therapeutic bind.
 
The goal of this technique is to engage the family. Each family comes to the initial session with a unique level of confidence, anxiousness and understanding of illness. During the assessment the therapeutic bind can either propel paralyzed parents into action or ground overly anxious parents to get them focused on their role in weight restoration.  RDNs use this therapeutic window to move parents into action with acceptance and commitment to the role of feeding.  
 
This happens when professionals use the facts (collect these on the EDGE tool prior to the meeting) and their expertise in eating disorders to communicate.  RDNs are uniquely qualified to make the connection with the physical symptoms of the body and educate how malnutrition has caused a series of physical problems. The “Food Is Medicine” message can be heard more clearly when parents have experienced this intense scene.

One example of this is when I had a young lady in my office with her mom. She was clearly in need of hospitalization.  I educated the parent on the facts with a tone of urgency and alarm. I expressed my concerns over her daughter’s heart rate and rate of weight loss and risk of refeeding syndrome.  We talked about the need for a medical visit the next day and prepared the Mom to consider how she could ask her employer for Family Medical Leave Act (FMLA). Direct, urgent, honest and caring words helped the mother who was in tears know what to expect. Today her daughter is a doing well in high school. Without the FBT approach she still may be fighting a chronic eating disorder.

​Learn more about how to blend urgency with compassion. If you treat adolescent with Eating disorders  learn how to blend FBT informed treatment and sign up for coaching with Melanie Jacob, RDN today. Save your spot for the fall webinar series here.

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