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

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mtkmbc4
When our d was seeing a FBT at a very well respected (on this forum and internationally) children’s hospital, she didn’t really do anything but tell us what we already knew and agree with the weight and calorie goals we had. For whatever reason, she gave our d permission to return to sports and gave her a fair bit of leeway in choosing her own food rather early in the process. Because we had to drive 90 min one way, because our pediatrician was monitoring her and because d refused to engage with the therapist and because she had made excellent progress reaching the weight goal, we quit going.

I’m wondering what what exactly your FBT says at each appointment. Good job, keep it up? Do they meet alone with your child?

H and I know full well how many calories d needs to eat and I know how to cook with extra calories. We know how to make behavioral contracts, employ LSUYE, etc.

So I’m wanting to know what happens at your FBT appts so I can figure out if there’s any reason to go back to the one we saw before or perhaps go to UCSD intensive family program or if what we have going on at home is as good as it gets.

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scaredmom

hi mtkmbc4,

Our FBT therapist said what yours did. She would agree to what I was doing to help with weight gain. She stressed that parents knew best. She has been helpful to give me strategies to help D sit when she would stand all the time. She would sometimes introduce a fear food challenge for the week that D would  need to eat a few times, that was helpful. 

Now my D is WR for 1 yr or so and now I find the therapist (social worker) helpful to tackle some of the perfectionistic stuff. Also she see D alone for half hour or so I don't know what is discussed but had forewarned the T to discuss a few things with D like bullying at school, academics and sports. At the beginning I felt the therapist was there for me to help to re-feed and help me with my emotions. D only went for weight and height checks. Now I take D to discuss handing back some control and the school issues that I see popping up. 

I also am very open about what I need from the team (doctor included) and spell it out prior or during the appt. Not sure if you do that or if you feel you need to do that too and how receptive your team would be. 

No one can predict if your FBT team or UCSD Or going it at home alone is going to be the best for you. Would the UCSD program be affordable to you? It has such a good reputation and maybe that is worth a try? It may be helpful?
Hard to know, such an individual personal decision to be made based on your own concerns/issues.
All the best,
XXX

 
Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
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debra18
This is an interesting thread for me to read because I did everything on my own and I am still trying to figure out if my daughter is missing out on something by not going to a therapist.
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mtkmbc4
We are very fortunate in that what our insurance doesn’t cover, we can probably afford if we go to UCSD.

H and I need to reach a solid decision about San Diego. I understand that we will have a phone interview prior to the week, so I’m hoping that their admissions counselor will be able to help us know what they can offer us.

If the week would help garner some cooperation from d or help her develop some insight into whatever is driving her restrictive eating, then it would be worth it, in my opinion. Additionally, if her evaluation by their providers would help us to know what the drivers are behind her restrictive eating are (primarily anxiety or OCD) then it would be helpful.

D expressed frustration about her thin body habitus, acknowledges that she is very conscious that her friends are filling out and getting normal curves while she is not. She voices wanting to gain weight, denies any fears about gaining, yet displays resistance to eating the volumes or types of food needed at times.

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edengirl
We recently did the week intensive at UCSD. It was definitely a turning point for us. We have very limited resources where we live with no FBT therapist in our state at all. This week of being surrounded by families going through the same torment as we are enduring helped us feel so not alone. They do a very good job of really helping the parents understand what is going on with their child- emotionally and physically. They spend a good deal of the week with the kids in separate group time from the parents. I think our d also benefited from spending time with kids who really could understand what she was dealing with.

A word of caution though- at the time we went, our d was eating fairly well. A good bit of time there is spent with meals and snack time being observed by the UCSD team. They coach the parents and kids through the process. Since we had already made a ton of progress on our own with this, we spent a good deal of this time eating in the cafeteria or on our on. We quickly realized that our d being around the kids struggling to eat actually set her back some- almost like the ED was telling her she should be doing the same. This resulted in nightly panic attacks from whole the entire week we were there. She also began telling us that week that we were trying to “make her fat.” She has never said anything like this before. I suspect she picked that up from group time from the other girls. Mid week I was getting nervous we made a bad decision by attending.

The team is excellent and looking back I see it was a great decision for us to attend. It was rough but once returning home we could see the impact it had. It strengthened my h and me and really helped my d come to terms with what we were dealing with. We are light years from where we were prior to attending. D had a terrible exercise compulsion. The team were adamant that we had to get it under control or she would need outpatient care. We took them at their word, took their advice on how to tackle it and have come a long way in getting it under control. Also, once home for a couple days, the new habits d picked up from group time seemed to go away thankfully along with the nightly panic attacks.

All in all, I can’t say we learned anything that I had not already found through the hours of forum and book reading, podcast listening...etc that I spend so much time on. However, being surrounded by their expertise and having their acknowledgment/approval of the plan we had in place gave us great confidence to continue to tackle this on our own at home. Well worth the time and monetary investment- highly recommended.
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mtkmbc4
Thank you so much to sharing your UCSD experience! That was very helpful!
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edengirl
Glad to help. Feel free to email me directly if you need more in-depth info. I will be happy to answer any questions I can that might help you decide your next steps.
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tina72
mtkmbc4 wrote:
When our d was seeing a FBT at a very well respected (on this forum and internationally) children’s hospital, she didn’t really do anything but tell us what we already knew and agree with the weight and calorie goals we had. For whatever reason, she gave our d permission to return to sports and gave her a fair bit of leeway in choosing her own food rather early in the process. Because we had to drive 90 min one way, because our pediatrician was monitoring her and because d refused to engage with the therapist and because she had made excellent progress reaching the weight goal, we quit going.

I’m wondering what what exactly your FBT says at each appointment. Good job, keep it up? Do they meet alone with your child?

H and I know full well how many calories d needs to eat and I know how to cook with extra calories. We know how to make behavioral contracts, employ LSUYE, etc.

So I’m wanting to know what happens at your FBT appts so I can figure out if there’s any reason to go back to the one we saw before or perhaps go to UCSD intensive family program or if what we have going on at home is as good as it gets.



I think like always there are people who do their job better and others who so their job less. In our case looking backwards the FBT therapist also did introduce phase 2 a bit too early and we had to go back to phase 1 with some parts. The decision about returning to sports and introducing phase 2 should be done together with the parents and not in front of the sick child I think.
We had time with the therapist alone and our d had time with the therapist alone and we had time together. As it was needed in the stage we were in.

Between the lines I read that you think it is not that helpful any more to drive that far. To be honest we came to a point we needed to stop FBT after 4 month because our therapist went to maternal leave. I was very afraid of going on alone but in fact at this time we knew what to do and did not need her any more. If you feel the same, then leave it. You are the captain of that ship. If it is not helpful or wasted time, then leave it.
Keep feeding. There is light at the end of the tunnel.
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evamusby_UK
For me at the time it felt like the FBT therapist was supporting me to work out what to do next (but unconventionally, most of that work was done in private phone calls before sessions). It seemed like a formality to take my child along to sessions - though a few were instrumental in the therapist being there while we announced changes (e.g. we will stop weighing your food). When treatment ended my D said to me that she didn't need the therapist because my husband and I were the ones who knew what to do. I reckon this means the therapist had done a perfect job of empowering us, both in our own minds, and in the eyes of our daughter.
If you wanted to double-check what is supposed to happen in sessions, the  Lock and Le Grange FBT treatment manual give all that in detail.

Eva Musby, mother, author, produces lots of resources for parents at https://anorexiafamily.com and on YouTube https://www.youtube.com/user/EvaMusby/playlists
[comp]
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Torie
tina72 wrote:
You are the captain of that ship. If it is not helpful or wasted time, then leave it.


Agree.  Professional help is not always worth it.  If things are progressing well at home, if both parents are on the same page, if there are no "special issues" you need help with ... why go?  xx

-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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tina72
Just wanted to add, maybe you feel you do not want to have a hard cut as you do not know where the journey takes you and FBT therapists are rare...
you could think about telling the therapist, that you would like to try it on your own for some time x now and have the next appointment in for example 2-3 months and so slowly stop therapy there with bigger gaps between appointments. Just an idea.
Keep feeding. There is light at the end of the tunnel.
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scaredmom
evamusby_UK wrote:
For me at the time it felt like the FBT therapist was supporting me to work out what to do next (but unconventionally, most of that work was done in private phone calls before sessions). It seemed like a formality to take my child along to sessions - though a few were instrumental in the therapist being there while we announced changes (e.g. we will stop weighing your food). When treatment ended my D said to me that she didn't need the therapist because my husband and I were the ones who knew what to do. I reckon this means the therapist had done a perfect job of empowering us, both in our own minds, and in the eyes of our daughter.
If you wanted to double-check what is supposed to happen in sessions, the  Lock and Le Grange FBT treatment manual give all that in detail.



This is how I "used" the FBT therapist. Also I asked/demanded for what I thought I needed at the time. I kept communication open and was very specific about my/D's needs. 
XXX
Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
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scaredmom
Just wish to add, that I hope some of these discussions here on the forum, help to empower parents/carers not just in a way to take care of your child, but to empower, with knowledge, and confidence the ability/strength to speak to the professionals. No one should feel that their "voice" is not enough, and that the professionals are always the only ones that are "right". Remember these people are just people, ask for what you want and need. That is true advocacy.
XXX
Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
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tina72
Nothing to add, scaredmom.
I think we often forget that these people are there to help US and WE pay for their work and so we should be allowed to ask for what we need.
Keep feeding. There is light at the end of the tunnel.
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scaredmom
I think it is more than just that we pay them. Here I don’t pay for ED services at all. I can see the FBT weekly or daily as well as the doctor at no personal cost to me. The thing that is common to Carers and professionals is the health and wellbeing of the child and  that we focus on that and help each other be the best each of us can be for the child, then we are all winners especially the child. Our goals need to be aligned, we need to work collaboratively, we need to communicate and  we even need conflicts. Conflicts shape us, and change us and that is where the greatness lies where our better selves are. 
I get what you are saying Tina, yes as we pay both money and time and concern and emotions we are not just allowed to ask, we are charged to ask. I wholeheartedly agree. This is not different at all to what you said.🙂
XXX
Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
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mtkmbc4
Thank you all for your replies. They have been very helpful.
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