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December 20, 2005
Eating Disorder Treatment Option – Somewhat Controversal
The Maudsley Method / The Maudsley Approach
Defining It...
1. The first phase (Sessions 1-10) puts the parents in charge of the eating behaviour of the AN adolescent, making food the medicine to be administered to a patient. The first two sessions engage the family to determine their eating habits and assemble a picture of the AN impact on all family members. The therapist externalizes the illness by presenting the eating disorder as controlling the patient, freeing parents and patient from blame. The therapist then encourages the parents to find their own method to control the adolescent eating behaviours without using force or punishment, but rather through a system of creative measures that include functional rewards, such as "I cannot let you get your driving licence while you are too weak."
2. The second phase (Sessions 11-16) transfers the control of the feeding process back to the adolescent, and addresses related family problems.
3. The third and final phase of the treatment focuses on encouraging the processes of adolescent development that unfold as the AN wanes, and establishing new family relationships disentangled from the eating disorder.
Used appropriately, and as intended, the Maudsley Method is based on the foundation that where an Eating Disorder started matters little in it's treatment. This isn't to belittle the issues a sufferer may feel in relation to their [possibly dysfunctional] family... This is to stop playing the blame game, and instead, for all members of the family to accept responsibility in "fixing what is broken."
When sufferers often feel "invisible" in their families, this type of intense involvement may suddenly act as a psychological facilitator in improving the overall relationship. It may help to make the sufferer feel seen, to feel cared about and loved.
While it seems on the surface that the focus of the Maudsley Method is to treat just the symptoms of the disease (behaviors/eating), you could make a lot of arguments that the impact of such involvement in teen treatment carries many hidden psychological messages. Getting family members (ie., parents) this inherently involved in their child's treatment obviously carries many hidden psychological messages and lessons.
Theoretically, Anorexia caught in an early stage (during developmental teen years), in a manner such as this, that [slowly] establishes appropriate boundaries, shows an immense concern from the family, provides proper nutrition, emphasizes that there is no need for shame (from either family or patient), teaches appropriate control, and reestablishes positive family relationships (in phase 2 and 3), responds well to this treatment for a variety of reasons, and does encompass many of the aspects of what more "traditional" treatments try to (and do).
As stated, this treatment is meant for dependent teens. It is important to determine if this is the right treatment for your child. It is important to consider your entire family dynamic when making this decision.
Without sounding like it's appropriate to put the "blame" on anyone, I often hear from sufferers things like my parents don't care, my family doesn't get it, they don't understand, they get so mad about my anorexia -- the Maudsley approach puts patient and parents into a mutual place -- one to battle the Eating Disorder together -- in an understanding, caring, nurturing way that does address issues (again, phase 2 and 3). That isn't to say that this specific approach is for everyone. One simple example... a child with a particularly controlling parent may resent this type of treatment all the more.
"The treatment is not for everyone. Abusive parents are excluded from family therapy. The treatment is suitable only for minors living at home, where some degree of parental control is assumed. 'For young adult anorexics, individual therapy seems to work best,' says Dr. Loeb, an advocate of the method." (source: Columbia University)
Posted by Lisa at December 20, 2005 08:32 AM
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