As the mother of a daughter who died of anorexia nervosa, I would like to write about a program that I feel, considering my experience, holds new hope for the victims of anorexia and bulimia. The therapy is family-based and called the Maudsley Method or Approach.
The Maudsley Method was created by child psychiatrists and psychologists in London, and it is now practiced from one end of the United States to the other: Columbia University, Mt. Sinai School of Medicine, Duke University, The University of Chicago, Stanford University, and the University of California at San Diego, according to the Maudsley Parents website, maudsleyparents.org .
But what exactly is The Maudsley Method? Dr. Cris Haltom, a licensed psychologist and a Cornell University Ph. D., explains that “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 twenty sessions or six months in duration. It is conventional wisdom that recovery is best achieved when eating disorders are treated in the earliest stages, in order to prevent long term, chronic illness.” There is a huge difference in the Maudsley Method compared to other forms of therapy.
The difference is that unlike so many eating disorder therapies, the Maudsley Method does not demonize parents, but after instruction by a trained eating disorder professional, actually puts the parents in charge of re-feeding their own child.
My daughter was eighteen and in college when she became anorexic so ineligible for the Maudsley Method. Yet every time she came home from college for the summer we re-fed her. The semester we took her out of college because of anorexia we re-fed her. When she moved to another state for work and needed help, I lived with her and re-fed her. She went to a psychologist as well, but the family was not included. I realize this is anecdotal information, but considering my experience, I also believe the Maudsley Method’s position is right: families can re-feed their own children especially when trained and included in therapy.
This parental instruction and re-feeding or in the case of bulimia, eliminating the binging and purging behaviors are part of the first stage of treatment. There are definite ground rules for this stage: parents may not use force or punishment to get their adolescent to eat in a healthy way. But instead, they must draw on their deep knowledge of their own child for what they intuitively know will work.
But make no mistake; this will be an intense experience since a parent must be with the anorexic adolescent for breakfast, lunch, dinner and two snacks to make sure she eats. And the parent of a bulimic adolescent must endure hours of standing guard to prevent binging and purging.
What the Maudsley Method calls “functional” rewards are used. For example a parent might say, “I’m afraid something will happen to you if you go out to the movies in this weak condition,” rather than the parent saying, “You didn’t eat your dinner so you can’t go to the movies.” This keeps the focus on the disease not on child. The first stage also includes family meetings with the therapist to check re-feeding progress and to receive advice and encouragement.
In part 2, we’ll be discussing stage two and three of the Maudsley Method and research results.