Sunday 18 December 2016

Let's try FBT first - it's a no-brainer!

As I say in my last blog post: I am not saying that FBT (Family Based Treatment) is a 'magic bullet', nor that it suits everyone. But there appears to be more evidence for FBT than AFT (Adolescent-Focused Individual therapy). And, when faced with an illness that could kill your child, I'd bet my back teeth that any parent would want to try the treatment method for anorexia with the most evidence of success? It's a no-brainer, really. Like, why in a million years would you choose to initially go for a treatment model that didn't have as much evidence to support it? Especially when, with an illness as deadly as anorexia, your child's life could be at stake?

Yes I know that FBT (Family Based Treatment or the Maudsley Approach) doesn't work for everyone; eating disorders like anorexia are notoriously difficult to treat. This is why, as I understand it, those eating disorder services in the UK that have adopted FBT as first line treatment for girls and boys with anorexia also offer other treatment models.

Just in case, I guess.

Things change so quickly in the world of eating disorders. Which is why, back in February 2010, when my son and I sat in front of our new CAMHS team, we weren't offered FBT. Instead we were offered the more traditional Adolescent-Focused Individual therapy (AFT) for adolescents with anorexia nervosa. Or it might have been a kind of hybrid eating disorder treatment; it was never clear what the treatment model was, but it did include some CBT (Cognitive Behavioural Therapy).

This is one of the reasons why we clashed. I was advocating FBT because I was learning about the emerging evidence while they were insisting on AFT (or whatever it was) because they believed it to be the most successful model for them, to date.

Our views were diametrically opposed which was never going to be a good mix.

The Good News is that our local CAMHS and eating disorder services have spent the past year getting ready to roll out FBT as first line treatment for young people with anorexia. So if Ben and I were to sit in front of the same treatment team today or other treatment teams in the UK who have adopted FBT as first line treatment for anorexia, I expect we would be offered FBT.

As a result I would have been heavily involved in the treatment process rather than being viewed as interfering, instructed not to talk about eating and to 'back off' and take a back seat.

I strongly believe that the outcome for my son could have had the potential to be more successful - and he could have achieved full weight and mind restoration rather than "settling for good enough".

And there would have been none of the implied finger pointing and blame.

OK, FBT might not have worked for us. But I would have darn well liked to have given it a go! Why the heck wouldn't I? Why the heck would I have said "Oh no, actually I prefer the other method, the one with less evidence of sustained success"?

As a first line treatment model for adolescent girls and boys with anorexia, choosing to try FBT is a no-brainer, surely?!

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