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

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mec
I'm an educator and when a student is struggling an SAT is put in place. This stands for Student Assistance Team. The team comes together to do an analysis of why the student is struggling and creates a plan for how to help him/her succeed. There are 3 tiers of intervention. Tier 1 is a general analysis of all students or  assistance for an individual student within the classrooms setting, Tier 2 is supplemented targeted assistance and Tier 3 is highly individualized assistance to meet specific needs.

I've been thinking about this in terms of Eating Disorders, our journey with my dd and all of our children in general, and came up with my own SAT Plan for sustained remission.

The three elements are:

Support
Accountability
Timing

My d has been in remission for 6 years+. We have had to implement various Tiers of intervention during this time. We started with the highly intense interventions (Tier 3) during Stages I and II to moderate support during Stage III and IV (Tier 2) to being in a state of observance (Tier 1) for much of the past 2-3 years where I consider that she has been in solid remission.

What I have realized is that our d needs a certain degree of SAT support in order to continue in recovery/remission. For the last couple of years, dd has primarily needed indirect support by having a family that cooks meals, shops for food and has a fridge full of food. At other times, she has needed accountability where she knows that people around her will step in if she is not eating enough. But, I think the KEY to her success in staying in remission has to do with Timing. Timing is crucial because parents and/or significant others have to learn when to step in and increase accountability and support. After 6 years in remission stepping in too soon, sabotages allowing our d to learn how to manage life without ED independently. But, the opposite case scenario is even more troubling. Stepping in too late, could mean her being deep into a relapse. Timing is tricky because at times she can go for days without sufficient nutrition due to health issues (wisdom tooth surgery, etc) and bounce back without any problems. But, at other times, a perfect storm may be brewing inside her head and 2-3 days of low nutrition due to an illness with fever can put her in a danger zone.

 I think that all of our children need an SAT not only while they live with us but also when they go off on their own. To see how quickly they can spiral down - within a matter of days - explains why SO many kids relapse in college. I like the idea of a contract but that contract needs to have built in interventions that can happen within days, not weeks or months.

We just had to put in place an SAT Plan for our d (Tier 2) and almost immediately saw things turning around. If we would have let our d continue with sub-par nutrition for a couple more days, we would be looking at a much different scenario. Instead, she is almost back on track where she was before the perfect storm started brewing inside her head.
21 year old daughter who was DX with RAN at 9 years old. The work of recovery is ongoing. 
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WeNWinning
You're right Mec that the intervention needs to be quick and swift to get back on track.
In the relapse prevention plan we had, that was all spelled out who would do what and when. (signs of slipping).  If there was a couple pound weight loss under her range, there was an intervention if she couldn't get back in her range within a short period of time.

There were also signs that we are very clear are ED symptoms - that others could observe in her - either friends, the boyfriend, parent when visiting, etc.

Yellow light signs were those that came pretty early and quickly.  
Red light signs were relapse (5 pounds under her accurate range)

Because we know our children and they often know what their symptoms are you can work on it collaboratively.  

So this Tier system sounds pretty much as our relapse prevention plan.




WenWinning (formerly wenlow) - a Mom who has learned patience, determination, empathy, and inner strength to help her young adult daughter gain full remission after over a decade of illness and clinician set inaccurate weights
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mec
Amoma,

Definitively agree with you on the life skills. We are furiously working on those right now and we have the PERFECT excuse to do it, not because of an ED prevention plan but because she is engaged. Of course, it works as ED prevention too but we don't have to call it that.

So, I am teaching her everything that she has been uninterested or unwilling to learn during all of these years, from learning how to wrap gifts, to cooking, keeping house, managing her checking account, etc. Up until now, chores were done begrudgingly and not well. But now, she is actually interested in learning all of these like skills.
21 year old daughter who was DX with RAN at 9 years old. The work of recovery is ongoing. 
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