Families who are just commencing FBT can benefit from the wisdom of carers who have gone in their steps before them!
- There are the Family Matters Tips Sheets developed for clinicians to provide families in services in Victoria and they can be found in the Resources and Links section of CEED website
- F.E.A.S.T has the Hall of Fame which is a collection of posts from its Around the Dinner Table forum that families and carers have found particularly helpful.
And we have one of our own members top tips
One of our mums in NSW, undertook FBT with her 16 year old daughter and here are some of her tips on how to survive. Her daughter is doing very well in recovery.
- You prepare meals
- Do not allow your child in the kitchen during meal prep
- Your child should not go grocery shopping
- Toilet before meals and no toilet for at least an hour afterwards
- If purging is suspected, use an open door policy in the bathroom, or have them count or sing whilst in there. And no flushing
- Do not negotiate – whatever you serve has to be eaten
- Use whatever leverage you have – phone, Internet, TV – whatever they hold dear is to be removed if they refuse to eat, until they have eaten. If they’re older and are not financially independent, this is your leverage
- Separate the two – Your child is not the ED
- Detach yourself from the situation during meals. Do not get drawn into emotional discussions. THIS IS NOT UP FOR NEGOTIATION
- Remember that your child wants to recover – the ED is stopping them
- Your child needs your permission to eat. They need you to stand up to ED as they do not have the strength to do so themselves
- 3 meals and 3 snacks per day (supervised) – do not deviate from this. Add time limits to the meals (as a guide/goal!). Ours (and the hospitals) was 30 mins for meals and 15 mins for snacks. In the early days this could extend A LOT. I made my daughters meal times the same as they’d be at school so that when she transitioned back to full time it would be easier and less anxiety provoking.
- High calories are needed throughout refeeding with lots of full fat dairy. Some need as much as 6000 cals with hyper metabolism, but the norm would be minimum 3500-4000 cals (for you to track, not your child)
- When they know you will not negotiate, I promise you will see the weight lifted from their shoulders… If only for very short periods
- BE THE CAGE that keeps ED away from your child
- When food is eaten be mum / dad again and have cuddles (if they’ll let you)
- 24/7 supervision – I slept with my daughter for 4 months – this will protect against them purging through vomiting or exercise. Many patients will exercise alone at night for hours on end when nobody else is awake
- All sport may need to stop in the early stages, and for those who compulsively exercised this could be long term
- Be consistent, consistent consistent!
- Don’t congratulate them after a meal or say ‘well done’ – just cheer inwardly! Likewise when (for girls) their period returns!
- Learn from others. I found this website with stories of other parents journey through recovery to be extremely helpful – http://www.maudsleyparents.org/familystories.html
- Recommended reading: ‘Brave Girl Eating’ by Harriet Brown
- Be prepared for resistance, and lots of it! You will find your own way to manage this, but NEVER back down. Any compromise is a win for ED. Remember, you have to see the beast to slay beast!
- Sometimes distraction helps during meal times. That can come in the form of games,TV, music. Whatever it is you control it and it only continues with eating.