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Hendrixt

Hi everybody. Haven’t posted for a bit but I’m still here listening and learning. I now I have a question. 

Has anybody had any experience of Family & Systematic Psychotherapy. 

14yrs old D has been AN since January - started refeeding in May, undergoing FBT in CAHMS in the UK. D is weight restored and eating well but only in the lower portions of her healthy weight range and still has a lot of ED behaviours which we are addressing but we seem to be coping this stage, just about. 

There are no particular problems with family dynamics/ relationships (other than ED of course), there is only me, my wife and D living together although we have 5 other adult children. We have a great relationship despite the strain of the ED.

Therapist has now offered some 'Family & Systematic Psychotherapy', which we had never heard of. This is to be carried out in addition to the FBT, which will continue alongside the Family & Systematic Psychotherapy (provided by a different therapist) and is supposed to give us additional help with family relationships within the home and outside the home. We are a bit puzzled as to why we have been offered this but have agreed to do a session just to discuss with the therapist how this might help. We’ve been told that we can just do it ourselves as a couple without our D being present, as she doesn’t engage much with therapy anyway, or we can do it with her being present but she doesn’t have to speak, or she can take part if she wishes. It’s up to us we’ve been told. 

At first I was worried that it might be similar to the old family therapy which was used before FBT came in but the therapist has assured us that it is nothing like that and doesn’t seek to find the root causes of the ED. 

Anybody had any experience of this type of therapy? 

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teecee

I’ve heard of multi systemic therapy which sounds similar if not the same. 

Basicslly the therapist works closer within the family observing and offering support and alternative ways of dealing with issues. They are contactable out of hours and will attend the family home in real time situations rather than reacting next day/week/ month. 


They work with parents....effectively upskilling you to deal positively with your child. 

 

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Hendrixt
teecee wrote:

I’ve heard of multi systemic therapy which sounds similar if not the same. 

Basicslly the therapist works closer within the family observing and offering support and alternative ways of dealing with issues. They are contactable out of hours and will attend the family home in real time situations rather than reacting next day/week/ month. 


They work with parents....effectively upskilling you to deal positively with your child. 

Hi Teecee - hope you're okay. What your describing sounds similar to how the therapist explained it [without the out of hours support] I just realised I used the wrong title on my post so had to edit it - the name of the treatment is actually Family & Systematic Psychotherapy.

 

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teecee

Yes we are ok thanks. Had a blip but seem to be moving forward again. I hope you are still moving forward. 

In my previous work I referred to the MST team and I have to say I got positive results however I’ve never heard of it for EDs. 

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Hendrixt
teecee wrote:

Yes we are ok thanks. Had a blip but seem to be moving forward again. I hope you are still moving forward. 

In my previous work I referred to the MST team and I have to say I got positive results however I’ve never heard of it for EDs. 

Sorry but what’s the MST team?

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teecee
Multi systemic therapy team
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Foodsupport_AUS
No experience at all of this, but a google search found this https://www.aft.org.uk/SpringboardWebApp/userfiles/aft/file/Research/Final%20evidence%20base.pdf

It does not seem to be specific for eating disorders in this form at least. I guess going to see them as a couple as an exploration could be worthwhile but it doesn't really sound like what you need from what you describe.
D diagnosed restrictive AN June 2010 age 13.5. Weight restored July 2012. Relapse and now clawing our way back. Treatment: multiple hospitalisations and individual and family therapy.
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Hendrixt
No experience at all of this, but a google search found this https://www.aft.org.uk/SpringboardWebApp/userfiles/aft/file/Research/Final%20evidence%20base.pdf

It does not seem to be specific for eating disorders in this form at least. I guess going to see them as a couple as an exploration could be worthwhile but it doesn't really sound like what you need from what you describe.


Thanks foodsupport - I'll have a good read at this. I've also found some stuff in Eva's book which suggests it could be as effective as FBT especially with patients who have OCD, which I think our D has. Either way we will be continuing with FBT and the therapist as assured us the 2 treatments can run alongside each other 
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sandie
Interesting article. Suspect we have started something along these lines with psychologist where H and I are being encouraged to think of each other as a resource..... I find challenging! As ED has put such a strain on family relationships. Will take a certain amount of digging deep and being open to benefit. But worth a shot here I think. I think we need to rebuild the family to support ongoing recovery. 
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Hendrixt
sandie wrote:
Interesting article. Suspect we have started something along these lines with psychologist where H and I are being encouraged to think of each other as a resource..... I find challenging! As ED has put such a strain on family relationships. Will take a certain amount of digging deep and being open to benefit. But worth a shot here I think. I think we need to rebuild the family to support ongoing recovery. 


Hi Sandie. Was this therapy provided by CAHMS?
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sandie
Yes, they have not called it that - just H and I starting new programme of mtg with psychologist, apparently will sometimes be with D also. H has not engaged previously in sessions with family therapist and has distanced himself from refeeding and I end up being the baddie in the house. I think they are keen to try anew. We have just had one session but the article seemed to be describing what was happening at session. I am no expert!!! 
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Hendrixt
sandie wrote:
Yes, they have not called it that - just H and I starting new programme of mtg with psychologist, apparently will sometimes be with D also. H has not engaged previously in sessions with family therapist and has distanced himself from refeeding and I end up being the baddie in the house. I think they are keen to try anew. We have just had one session but the article seemed to be describing what was happening at session. I am no expert!!! 


Hope it goes well Sandie. We’re going for an introductory session to find out what it’s all about. They haven’t said why they’re offering it. That’s why I’m a bit puzzled. Maybe the therapist had identified something which needs ‘fixing’. Suppose we’ll find out 
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teecee

Hi Hendrixt
i think I remember saying to you that before ED we were a loving family spending lots of family time together like you.

Since ED we found out that our D felt closer to us and felt far able to communicate her feelings and thoughts towards us - even though we thought there was no issue as we’ve always parented by being open with each other and resolving any issues quickly.

The one thing I am grateful to CAMHS for was helping us really ‘listen’ and hear what she was struggling to communicate. 

She said to us recently (which raised a smile in me) that it’s important we all sit down to discuss a particular issue so everyone’s in the loop and there’s no misunderstandings!! That would have never happened before 😂

Hopefully you will get something positive out of it even if you don’t think you are...like I did (without realising).

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Hendrixt
teecee wrote:

Hi Hendrixt
i think I remember saying to you that before ED we were a loving family spending lots of family time together like you.

Since ED we found out that our D felt closer to us and felt far able to communicate her feelings and thoughts towards us - even though we thought there was no issue as we’ve always parented by being open with each other and resolving any issues quickly.

The one thing I am grateful to CAMHS for was helping us really ‘listen’ and hear what she was struggling to communicate. 

She said to us recently (which raised a smile in me) that it’s important we all sit down to discuss a particular issue so everyone’s in the loop and there’s no misunderstandings!! That would have never happened before 😂

Hopefully you will get something positive out of it even if you don’t think you are...like I did (without realising).




Hi Teecee - Hope you’re keeping well. It sounds like you did really well with this therapy. Our problem Is that our D will not speak to us or anybody, including the therapist,  about ED or school or any of her problems. She clams up and gets angry as soon as you get anywhere near having a decent conversation. Maybe CAHMS  have identified that problem with communication and think the therapy may help. We are having an introductory section, just myself and my wife, so we can explore exactly what issues it might address. Sounds positive from what you say, but I’m just a bit wary as the food side of it is going really well, she is 104% weight for height and eating really well.  The FBT therapist doesn’t agree with us having her at that weight, she says it’s not necessary, but has agreed not to say anything to our D about her views. It’s a different therapist who will do the systemic therapy and I  don’t want her going into the area of food and giving any messages  that the weight gains are not necessary.  
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tina72
Hendrixt wrote:


Hope it goes well Sandie. We’re going for an introductory session to find out what it’s all about. They haven’t said why they’re offering it. That’s why I’m a bit puzzled. Maybe the therapist had identified something which needs ‘fixing’. Suppose we’ll find out 


Here in Germany I would be very careful with therapy named that but from all that you wrote I really think that they call phase 3 of FBT that way there. And that is something totally harmless and has nothing to do with underlying issues and is only to help you to get your family together again (if needed, you do not sound as if you need that at all).
Will your d be there for that first talk? I would think about doing it just with you and without your d in case something is said there that you find inappropriate...
Keep feeding. There is light at the end of the tunnel.
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Hendrixt
tina72 wrote:


Here in Germany I would be very careful with therapy named that but from all that you wrote I really think that they call phase 3 of FBT that way there. And that is something totally harmless and has nothing to do with underlying issues and is only to help you to get your family together again (if needed, you do not sound as if you need that at all).
Will your d be there for that first talk? I would think about doing it just with you and without your d in case something is said there that you find inappropriate...



Thanks Tina. Hope all is well with you. Yes we are doing the first couple of appointments as a couple without D so we can be assured that nothing will be said to, or in front of, D which might compromise our success with eating 
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tina72
Hendrixt wrote:

Thanks Tina. Hope all is well with you. Yes we are doing the first couple of appointments as a couple without D so we can be assured that nothing will be said to, or in front of, D which might compromise our success with eating 


Thanks for asking, Hendrixt, all well here 🙂. In year 3 there is no worries every day any more (only now and then from overreacting mum) and that is really nice. Normal family life. Never thought this could ever happen again but here we are.

Sounds all great, if you go there as a couple see what they offer and take it or leave it. You have nothing to lose I think.
Keep feeding. There is light at the end of the tunnel.
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teecee

Anything that helps her to understand her own feelings and communicate her emotional needs to you is to be embraced I suppose. 

Our CAMHS dietician was happy to overshoot - isn’t it ironic? I suppose different people have different ideas but YOU are the expert in your daughter. I know they do get concerned about AN morphing in to other EDs like Bulimia however as long as she is eating regularly and a wide variety then that’s great. Just because they may binge sometimes due to the effects of the starvation does not mean they have other disordered eating. I know my D was so frightened of not being able to stop eating and somehow becoming a binge eater....
you’re doing great...don’t let others place doubt in your mind. 

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Hendrixt
tina72 wrote:


Thanks for asking, Hendrixt, all well here 🙂. In year 3 there is no worries every day any more (only now and then from overreacting mum) and that is really nice. Normal family life. Never thought this could ever happen again but here we are.

Sounds all great, if you go there as a couple see what they offer and take it or leave it. You have nothing to lose I think.


Yes you're right Tina (as usual ðŸ˜) we've nothing to loose by going without D and we're educated and aware enough to be able to spot it is going to to be disrupted
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Hendrixt
teecee wrote:

Anything that helps her to understand her own feelings and communicate her emotional needs to you is to be embraced I suppose. 

Our CAMHS dietician was happy to overshoot - isn’t it ironic? I suppose different people have different ideas but YOU are the expert in your daughter. I know they do get concerned about AN morphing in to other EDs like Bulimia however as long as she is eating regularly and a wide variety then that’s great. Just because they may binge sometimes due to the effects of the starvation does not mean they have other disordered eating. I know my D was so frightened of not being able to stop eating and somehow becoming a binge eater....
you’re doing great...don’t let others place doubt in your mind. 



Thanks Teecee. Wish our CAHMS were more enlightened about weight recovery. I mentioned the 2019 research which discovered the 8 genetic indicators that suggest ED is both metabolic as well as psychiatric. I said this during a parents group meeting when one mother was questioning whether she herself was at fault for her daughters ED. The therapist facilitating the discussion cut me short, saying “well they don’t really know that do they” and moved the discussion on🙄
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tina72
These therapists should be fired...so sad.
Keep feeding. There is light at the end of the tunnel.
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