At Union Square Cognitive Therapy, we offer an individualized, family-based approach to treating adolescents with eating disorders that combines the core principles of Family-Based Treatment (FBT) with individual therapy. Our approach recognizes that parents play a critical role in helping their child recover from an eating disorder, while adolescents can also benefit from developing the skills needed to manage distress, challenge eating disorder thoughts, and build motivation for recovery.

Family-Based Treatment (FBT), also known as the Maudsley Approach, is the leading evidence-based treatment for adolescents with anorexia nervosa. FBT empowers parents to take an active role in their child's recovery, particularly in restoring adequate nutrition and supporting weight restoration.

Our approach builds on these principles by providing adolescents with individual therapy while simultaneously working closely with parents through weekly coaching sessions. This allows us to support the entire family throughout the recovery process, addressing both the nutritional and psychological aspects of the eating disorder.

How Our Approach Works

Unlike traditional FBT, which primarily involves sessions with the adolescent and their parents together, our modified approach includes two complementary components:

• Individual therapy for adolescents: Adolescents meet individually with their therapist to develop skills for managing eating disorder thoughts, emotions, and behaviors. Drawing from Enhanced Cognitive Behavioral Therapy (CBT-E), Dialectical Behavior Therapy (DBT), and Acceptance and Commitment Therapy (ACT), treatment focuses on increasing motivation for recovery, challenging rigid beliefs about food and body image, developing distress tolerance skills, and reducing behaviors that maintain the eating disorder.

• Weekly parent coaching: Parents meet separately with the therapist to receive education, guidance, and practical strategies for supporting their child's nutritional rehabilitation. Drawing from FBT principles, these sessions help parents understand the eating disorder, respond effectively to resistance and distress around eating, establish appropriate expectations and boundaries, and take an active role in helping their child achieve weight restoration.

By working with adolescents and parents concurrently, we aim to create a collaborative treatment environment in which parents feel equipped to support recovery and adolescents receive the individualized therapeutic support they need.

Empowering Parents to Support Recovery

Eating disorders can leave parents feeling overwhelmed, uncertain, and unsure how best to help their child. A central principle of FBT is that parents are not to blame for their child's eating disorder. Rather, they are an essential resource in helping their child recover.

Through weekly coaching, we help parents develop the confidence, knowledge, and practical skills necessary to support their child's recovery. Depending on the family's needs, this may include:

• Understanding the eating disorder: Learning how malnutrition and eating disorder symptoms can affect thinking, emotions, and behavior, and why nutritional rehabilitation is an essential first step in recovery.

• Supporting adequate nutrition and weight restoration: Developing strategies to help their child complete meals and snacks, increase nutritional intake, and make consistent progress toward recovery goals.

• Managing resistance and distress: Learning how to respond to anxiety, avoidance, negotiation, and other eating disorder-driven behaviors with a combination of empathy, consistency, and firm boundaries.

• Separating the eating disorder from the child: Recognizing how eating disorder thoughts and behaviors can interfere with their child's ability to make recovery-oriented decisions.

• Gradually restoring independence: Helping adolescents regain age-appropriate autonomy around food and eating as they make progress in recovery and demonstrate readiness for greater independence.

Supporting Adolescents Through Individual Therapy

While parents take an active role in supporting nutritional rehabilitation, we recognize that adolescents can also benefit from individualized therapeutic support throughout the recovery process. Recovery often involves confronting deeply rooted fears around food, eating, and weight gain, which can provoke significant anxiety and emotional distress.

Individual therapy provides adolescents with a space to work through these challenges while developing skills that support recovery. Using CBT-E, DBT and ACT informed interventions, we help adolescents identify and challenge eating disorder beliefs, increase flexibility around food and eating, manage difficult emotions, reduce body image distress, and strengthen motivation to make recovery-oriented choices.

Our goal is not only to help adolescents achieve nutritional and medical stability, but also to help them develop a healthier relationship with food, their bodies, and themselves.

Is Our Family-Based Approach Right for Your Family?

Our approach may be appropriate for adolescents struggling with anorexia nervosa, bulimia nervosa, or other eating disorders who would benefit from parental involvement in restoring adequate nutrition, stabilizing eating patterns, and supporting recovery.

We recognize that every adolescent and family is different. Treatment is tailored to the individual's clinical needs, developmental stage, and family circumstances. Effective eating disorder treatment often requires a multidisciplinary approach, and we work closely with physicians, registered dietitians, and psychiatrists, as appropriate, to ensure coordinated, comprehensive care throughout the recovery process.

Interested in learning more?

Schedule a free consultation with Union Square Cognitive Therapy to discuss whether our approach may be a good fit.

We offer FBT for adolescent eating disorders in our New York City office and via telehealth.

Credit: Emma Hart, LMSW