F.E.A.S.T's Around The Dinner Table forum

Welcome to F.E.A.S.T's Around The Dinner Table forum. This is a free service provided for parents of those suffering from eating disorders. It is moderated by kind, experienced, parent caregivers trained to guide you in how to use the forum and how to find resources to help you support your family member. This forum is for parents of patients with all eating disorder diagnoses, all ages, around the world.

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kas_US
How do you know if a therapist is good or not? whether they get it? My d was dx'd at 14, and I refed her at home all by myself, and she never had any therapy. Even though she didn't have therapy, we worked on a lot of "stress management" types of things over the years, and I thought she was doing better with things, but then her dad decided to walk out on us and that has thrown her for a loop and her weight has gone down pretty steadily since then. So now I believe she needs to be inpatient or residential, but she is refusing and because she is 18 she can. So, I am trying to find her a therapist to either help her or at least "convince" her to go to residential. BUT, how do you know if a therapist is a good one? I really have any extra money to waste, and I am afraid of bad care. One that I talked to seemed to think that my d is afraid to grow up and leave me and the eating disorder is her way of not leaving. She said other things that I agreed with, but that seemed way off. Another one I talked to said good things about "not listening to the eating disorder," but when I asked her if she involved families, she pretty emphatically said, "only if they are helpful." And at another point in the conversation she said something about unwinding the family tree. I'm not sure what that means. How am I supposed to know????
Weight restored/Phase II
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deenl
Hi kas_US,

Here are a couple of blog posts that might be helpful.

http://www.blog.drsarahravin.com/psychotherapy/how-to-choose-a-therapist/

http://www.blog.drsarahravin.com/eating-disorders/red-flags-how-to-spot-ineffective-eating-disorder-treatment/

http://edbites.com/2010/12/tip-day-picking-out-a-therapist/

Warm wishes,
D
2015 12yo son restricting but no body image issues, no fat phobia; lost weight IP! Oct 2015 home, no progress. Medical hosp to kick start recovery Feb 2016. Slowly gaining at home, seeing signs of our real kid.

May 2017 Hovering around WR. Mood great, mostly. Summer 2017 Happy, first trip away in years, food variety, begin socialising. Sept 2017, back to school FT first time in 2 years. 2018 growing so fast hard to keep pace with weight. 2020 Off to university, healthy and happy.
  • Swedish proverb: Love me when I least deserve it because that's when I need it most.
  • We are what we repeatedly do. Excellence Recovery, then, is not an act but a habit. Aristotle.
  • If the plan doesn't work, change the plan but never the goal.
  • We cannot control the wind but we can direct the sail.
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aboncosk
Deenl,

Thank you for posting the links.  We were essentially just "fired" from our therapist on Thursday.  She suggested our daughter take a "break" from therapy and just "live". While all that is fine and well and she does seem to be doing better - she still needs therapy.  This is truly one of the harder aspects of dealing with this illness.  Just because providers list on insurance that they treat eating disorders doesn't necessarily mean they are skilled with it.  Of course, the one therapist we did find who uses FBT and a Maudsley approach to treatment - is out of network.  As much as I hate to say it's not about the money - well all know how costly this illness is.  We are meeting with an adolescent doctor today who specializes in eating disorders and I will ask her for recommendations.  Just so hard to choose from the long list of providers that insurances gives us.

Anyone have any success fighting insurance in regard to adding an out of network provider?  The one we found is covered by our insurance (BCBS) but BCBS farms out behavioral health to a company called Beacon Health Services and she's not part of that. 

Anyway - the information you provided is certainly helpful!  Thank you [smile]
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hopefulmama
Kas - I know you are in FL, but don't know where.

Are you close to Dr Ravin?

http://www.drsarahravin.com/

She may have resources for you elsewhere in FL if shes not close.  So many, many therapists do not practice evidence based care. It really is worse than nothing at all.  It can be particularly difficult with a YA when they try to "empower" the YA to separate from you.
Enjoying my 23 year-old daughter's achievement of active recovery that was made possible by the resources and education I found on this forum.

Don't give up hope!
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Psycho_Mom
Hi,

Well, actually, you seem to have a pretty good idea of how to weed out bad therapists. Interviewing them first without d present is an excellent idea.


"I am afraid of bad care."

Very wise of you.  

"One that I talked to seemed to think that my d is afraid to grow up and leave me and the eating disorder is her way of not leaving."

Stupid!! Stupid old school idea!!!Run!!

"...when I asked her if she involved families, she pretty emphatically said, "only if they are helpful."

Run. It's the therapist's JOB to help the family support the sufferer.


"How am I supposed to know????
 "

Well, if you mention what area you live in, people on here may be able to recommend someone.

One of the first things our therapist said to my h and me, and one of the main reasons we chose her, was this: She said that we parents were in charge. That a good therapist can assist and provide advice and knowledge, but that parents do the actual work and parents know their child best. You want someone who's going to work WITH you.

Also, I think for ed sufferers, skills-based therapy is something to look for. Skills to help identify emotions, help identify ed-thoughts, CBT for anxiety, or possibly EFFT. Also, you could ask how many sufferers they've treated, how many are now in remission, how they define remission, what they see as the parent's role in recovery, what they think the main cause of eds is (very important and good way of weeding out old-school uninformed therapists like your first example.)

best wishes,


D diagnosed with EDNOS May 2013 at age 15, refed at home Aug 2013, since then symptoms gradually lessened and we retaught her how to feed and care for herself, including individual therapy, family skills DBT class, SSRI medication and relapse-prevention strategies. Anxiety was pre-existing and I believe she was sporadically restricting since about age 9. She now eats and behaves like any normal older teen, and is enjoying school, friends, sports, music and thinking about the future.
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