Sssshh ….. What is the difference between FBT and CBTe? FAMILY INPUT Sssshh ….. What is the difference between FBT and CBTe?

is an individual, personalised treatment CBTe is an individual, personalised treatment which also involves family members in the support network

Parents and carers - a valuable resource as COACH / GUIDE Development of patient confidence and independence Parents and carers play an important role in encouraging recovery, maintain motivation To be a COACH- it is important that they are supported to gain information about the eating disorder programme and in general about eating disorders.

Family formulation Dr L to explain

Siblings- ACTIVITIES / NORMALISING RELATIONSHIPS Other family members Siblings- ACTIVITIES / NORMALISING RELATIONSHIPS Grandparents- COACH / GUIDE or SUPPORTER FOR THE COACH Not only parents but also other family members should be included – siblings and grandparents. Siblings - spending time on activities together - also information about the program for eating disorders, psychoeducation Grandparents - can be involved in assisted meals if helpful. May be involved in supporting a range of family members in different ways.

Relevance of the treatment in life stage Gives experience of adolescent autonomy and responsibility Progression to young adulthood Parents’ own development Adolescence is a launching/ transition stage of life - important for the adolescent patient not to perceive the family's participation as an intrusion or a threat to their autonomy. Parents will need to develop their own interests and review some of their involvement as parents.

What are the differences between family input with So .... What are the differences between family input with Family Based Treatment and CBTe? (Do parents have a less significant role than in Family Based Treatment? ) Family based : Cbte: Parents may take the view that they have a less significant role in their child’s treatment but they can contribute helpfully to meal management – acting in a guiding role and giving emotional support

Role of parents Externalise the problem Externalise the problem CBTe FBT Externalise the problem Meal table- encouragement and curiosity Diet plan- designed with patient Supported meals and assisted meals Guidance regarding use of Ideas from therapy sessions CBTe folder or self monitoring Collaborate with Therapy team Therapy team comprises patient, professionals (and parents) Externalise the problem Meal table- instructions and encouragement Diet plan- given to patient Supported meals Reflect on styles of parenting (boundaries etc) Family attitudes towards food Collaborate with therapy team Therapy team comprises of professional and parents

Reflection/ Discussion / Questions

Conclusion Continue the work with family Learn and help family learn about impact of eating disorder Build confidence for family Develop new ways to approach a problem