Comments on: Therapists are like Starbucks Drinks

By: Jane

Jane — Tue, 31 Mar 2009 17:55:39 +0000

Actually, FBT has been looked at in randomized controlled trials, which are specifically designed for “apples to apples” comparisons. The exclusion criteria for these studies was not especially stringent. No active suicidality, medically stable enough for OP treatment, no parental abuse. That’s it. You might want to take a look at the research yourself before you criticize the methodology.
http://maudsleyparents.org/bibliography.html

Excluding families that have struggles seems like a really bad idea to me. These families are especially likely to benefit from good family treatment IMO. Parents should be aware of treatment choices and make their decisions, rather than let someone else decide for them whether they’re “good enough” or not. Once in a while I hear the opinion that FBT isn’t suitable for single parent families, but single-parent families were just as successful as intact families in helping kids with BN using FBT.

By: greythinking

greythinking — Fri, 20 Jun 2008 02:05:20 +0000

Harriet –

I’m not sure exactly which studies you’re referring to… but I doubt that you’re comparing apples to apples. The criteria for using FBT seems pretty stringent — you need supportive family, they need to be available, your home environment needs to be a safe place, monitoring all meals must somehow be possible, and the ED individual must be young enough that the family member can exert control. What if your parents has a serious addiction? They can’t always be responsible. What if your family has no interest in participating in treatment? Or, since the genetic component of EDs is so strong, what if your mother is still really struggling with an eating disorder herself?

I’m not arguing that FBT isn’t effective; just that the participants in all the other studies probably don’t have the continuous support system and other advantages as do those in your FBT study.

One more question… what defines “long-term”? 1 year? 5 years? 20?

(P.S. – As always, I appreciate your contributing your perspective).

By: Harriet

Harriet — Thu, 19 Jun 2008 17:07:34 +0000

Actually, for adolescents who have been sick for less than three years, family-based therapy has absolutely been proven to be the treatment of choice for anorexia. Long-term outcomes are between 80 and 90 percent recovery, compared with recovery rates of between 30 and 50 percent for all those other kinds of therapy.

For more information on FBT, check out http://www.maudsleyparents.org.

By: Niika

Niika — Thu, 19 Jun 2008 11:20:01 +0000

Here’s my opinion. Thinking about someone’s mode of therapy, while important, is a little like reading the back and front covers of a book. It will highly influence your decision about whether to take on this therapist or not… but once you accept the therapy, if the therapist is GOOD, there will be so much more than you ever expected or predicted within that book. Much more depth, a lot of work, a lot of growth and change.

I really also believe that, if the therapist is good and you really bond with him or her, the “mode” of therapy can be almost superficial. What will matter more, later on, is the connection you have with the therapist, and how this connection in combination with the therapeutic techniques helps to both heal the mental illness and strengthen you as a person.

Honestly, therapy is mostly an art. Every person is different, and is going to need different things from the therapeutic relationship. Bad therapists are the ones who blanketly apply CBT, then blink in confusion when it doesn’t work for you. Good therapists are the ones who see what techniques work and don’t work, and carry further with the ones that do work, and ask you about YOU, and, yes, dig deeper into your personal life so that they’re actually dealing with the real issues and not the superficial outsides.

Sorry about the novel, also!

By: vicky ann

vicky ann — Thu, 19 Jun 2008 09:08:32 +0000

I have my first appointment for ed treatment next week, I presume we’ll discuss the different types of therapy they offer, I wonder which one it will be! Maybe like Starbucks it’s worth trying new flavours.