What Parents and Teens Should Know About Eating Disorder Treatment
By Christy Zender, MSW, LICSW, The Emily Program Site Manager, Woodbury & Toogood (Adolescent Outpatient Services, St. Paul)
Let’s start with a quick analogy.
Eating disorders and icebergs are more alike than one might think. Picture an iceberg floating in a vast ocean: You can only see the tip of the iceberg and have no idea of what is under the surface of the water. Most people look at an eating disorder the same way, only seeing what is on the outside, above the water. This generally represents the behavioral parts of an eating disorder – weight, size, shape, purging, excessive exercise, and so on – the things that you can see, measure, and quantify.
The biggest issues with an eating disorder (and iceberg) are what you cannot see, that which is under the water. After all, that is the part of the iceberg that sunk the Titanic. Below the water level of an eating disorder is the mental preoccupation, the mental “noise,” the fixation, and distress that is going on in his or her mind. Parents sometimes say, “Well, she gained her weight back or stopped bingeing, so she must be better.” Unfortunately that is not usually the case. Despite looking better on the outside, this young person often still cannot even think straight and sometimes you do not even know it. We can help with that.
Eating disorders, like icebergs, are deceiving because the parts you can see are just a small fraction of the underlying problem. You can look like you do not have an eating disorder, but the underlying issues are there, and can be deadly.
So, what does this mean for parents and teens? It means there is no known quick fix for this illness. Eating disorders are tough, but we understand them and how to help people get better.
We have the ability and commitment to individualize services: To look different for every family that walks through The Emily Program’s doors. Our adolescent services staff is trained specifically to work with the families and developmental needs of adolescents. We have experience and the understanding to work with the different developmental stages of a 12 year old, 14 year old…even a 20 year old.
There are a lot of differences between working with adults and adolescents in treatment. The biggest one is that with adults, the treatment is voluntary. Those individuals are walking through the doors because it was their decision to do so (well, most of the time). On the other hand, adolescents are usually seeing us because they have been told they need to by a parent or other adult in their life.
Our adolescent specific providers work on building rapport, meeting adolescents and parents where they are to get the best treatment plan and approach in place. We work collaboratively with families while providing psycho-education and the innate ability to straddle both worlds – the involuntary teenager and the often scared parents who are trying to get their child the best treatment possible.
Why choose The Emily Program?
We can personalize your experience and care by integrating your knowledge of your family and self with our expertise in treating eating disorders. We offer a wide-spectrum of interventions, from Family-Based Treatment (FBT) to Dialectical Behavioral Therapy (DBT skills), so if one thing does not work we are going to try something else. I tell people we have tenacious clinicians here, and our persistence and depth of commitment to helping kids recover is unmatched.
We need help, now what?
The first step you will do is to set up an appointment for your child to complete a diagnostic assessment, sometimes referred to as an intake. This is a comprehensive assessment to explore what brought you to making the call to us so we can make a clinical diagnosis and treatment recommendations.
I want to emphasize that getting an initial assessment is not a commitment to treatment; it is simply an opportunity to get a professional opinion. We integrate the family’s perspective and any outside providers with whom you allow us to collaborate. Anyone is welcome to come for a second opinion or to leave to go somewhere else for another perspective. I’m a mom, too, and if someone told me my kid had a life-threatening illness, you better believe I would get a second (or third) opinion. Eating disorders are serious and sometimes fatal, so get as many opinions as you need to feel comfortable with your treatment direction.
What’s going to happen during and after the diagnostic assessment?
The diagnostic assessment is a number of psychological tests and an interview with a trained clinician who will make initial recommendations. The diagnostic assessment always involves a teen’s parents or primary guardians. We also request to involve additional resources (external therapists, primary care physicians) so that we can give you our best professional opinion upfront. We can diagnose whether this is an eating disorder, or if you are in a prevention stage, or maybe there is something else going on. Our goal is to help you and your family make the best decision about the kind of treatment you want.
After your first session, you will walk out with recommendations about treatment options or recommendations to not get treatment. You will be offered a second session to go through the psychological testing results and get answers to any questions that may surface after your initial meeting. Many people feel really overwhelmed with the amount of information provided, so the second session is used to help sort through any questions and determine next steps.
Attention Teens: Your parents want you to be seen – here’s what you should know:
We know that coming here as a teenager is rough. No adolescent wakes up in the morning and says, “Woo-hoo, I get to meet with a therapist who is going to tell me what’s wrong with me!” You do not want to be here and we understand that. We know you do not want another adult telling you what to do or not do. We also know that eating disorders kill people and we want to work with you to figure this out. It is not our goal to make you fat or make you miserable. We just want to figure out how your body’s needs can be met in a way so that you don’t have to come here.
What I (and the rest of our staff) know is that if you have an eating disorder, you have mixed feelings. You don’t really want to be here, and yet there is a part of you that is really unhappy. You want to believe you have control over this, but this thing has gotten too big to deal with on your own. I don’t blame you and it’s not my place to judge you. It’s not your fault. You didn’t choose this. We get it and we can help.
Almost all eating disorders start out as something “healthy” and then swing into something out of control. I don’t want to take healthy and good things away from you - I just don’t want a cupcake to make you cry. And I understand your preference may not be for a cupcake per se, but you will be exposed to cupcakes for the rest of your life, and I don’t want that to ruin one moment of your life. That is the difference between being healthy and having an eating disorder: We both eat the cupcake and you are going to be upset about it all night long, I am not. That is what an eating disorder is, that is the part under the water.
I know treatment does not seem like fun, but neither are eating disorders. We can help you get back to just being you.
We are more than happy to answer your questions, so feel free to give us a call 1-651-645-5323 or 1-888-EMILY77. There is no need for parents or their teen to do this alone. We have the experience and resources that can help guide you through this journey.