Tuesday, July 31, 2012

Anorexia Nervosa and the Maudsley Approach to re-feeding your starving child

The Maudsley Approach is applied to adolescents 18 and under who are living with their families.  It is designed to intervene aggressively in the first stages of illness and is a short term model as short as 20 sessions or six months in duration.

The Maudsley Approach builds on evidence that family therapy approaches are superior to individual therapy approaches with younger patients.  This approach involves the family from the outset of treatment and relies heavily on patient involvement in the re-feeding of the child with an eating disorder.
Parents are empowered to help their adolescent recover from this life threatening illness, rather than having them watch passively from the sidelines.  This treatment involves compassion, yet persistent and firm expectations that your adolescent eat an amount of food that can reverse the state of starvation his or her body is in and help them to gain weight.

In the first stage of treatment, the therapist plays an active and key role in helping parents separate their child from the child’s illness.  Parents are given the task of re-feeding and removing the illness from the child.   
Re-feeding the patient begins as the patient usually has just been hospitalized and is medically compromised.  This phase focuses exclusively on the re-feeding of the patient and other psychological issues are not explored.  Parents are encouraged to set their own goals regarding their child’s weight and health, with the emphasis on physical appearance and menstruation in girls as an indicator rather than precise weight goals.

Attia, E., & Walsh, B. T. (2009). Behavioral management for anorexia nervosa.New England Journal of Medicine, 360(5), 500-506.

Couturier, J., Isserlin, L., & Lock, J. (2010). Family-based treatment for adolescents with anorexia nervosa: a dissemination study. Eating disorders,18(3), 199-209.

Wallis, A., Rhodes, P., Kohn, M., & Madden, S. (2007). Five-years of family based treatment for anorexia nervosa: The Maudsley Model at the Children's Hospital at Westmead. International journal of adolescent medicine and health,19(3), 277-284.

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