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The National Council of Psychotherapists

Est. 1971

Family Therapy is Cutting Edge Treatment
for a Family Disease
By Abigail Natenshon

Eating disorders are family diseases.

  • When young children, teens and young adults who live at home become afflicted with an eating disorder, everybody who comes in contact with that individual suffers - including parents, siblings and grandparents.
  • Parents tend to be the primary diagnosticians of an eating disorder in their child. This is because eating disorders predominantly show up around kitchen tables, and in family bathrooms, rarely in the doctor&Mac226;s office. In addition, their presence is typically silent in laboratory tests.
  • Recovery too, happens at home, over time, alongside parents and siblings, throughout the course of daily living; this is particularly the case in the face of the limited services provided through managed care these days. Patients typically spend 45 minutes a week with their therapist or doctor. For the rest, 24/7, kids live out their recovery at home, or at school.
  • In research carried out at the Maudsley Hospital of London England, it has been proven that family treatment is more effective than individual psychotherapy for anorexics living at home that have been ill for less than 3 years.
  • The nature of parental involvement will vary widely with the age and needs of the child, the skills and capacities of the parent, and the nature and quality of the ever-changing parent/child CONNECTION.

Family Therapy is the most effective way to treat everyone’s needs.

Parents and siblings are deeply affected by the presence of an eating disorder within the family system. Family members need an outlet to understand the disease and recovery processes, a forum to communicate their concerns and needs with the patient and with each other, and the opportunity to learn how best to support the recovery process. They often need personal support and bolstering in the face of what typically tends to be an extended, convoluted and at times discouraging recovery process for the afflicted individual. Family therapy provides that vehicle.

The individual child's efforts to make recovery changes are facilitated and enhanced not only by a family that understands the recovery process, but by family members who make their own parallel personal changes to accommodate the needs and requirements of the changing child and family system.

Eating disorder psychotherapists are responsible to "grow" the relationship between parent and child, for that is where the greatest and most effective capacity for healing lies. Therapists must demonstrate respect for the power of the family system in eradicating (or possibly sustaining) disease.

The potential for the family unit to bring about constructive change is far greater than the sum of its parts. Kids get far better, far faster when families can be involved in constructive ways. Not only that, kids who learn to function better with family members carry these valuable interpersonal skills over into their other relationships as well, and life gets to be a healthier, happier place to be.

Appropriate parental involvement is an enhancement to recovery, despite the warnings of misguided health professionals who may imply that eating disorders are caused by parental involvement (interference) in their children's lives, that the disordered adolescent requires autonomy and independence from parents in order to get well and separate healthfully from the family. Such a professional might exclude the child's parents from the psychotherapy process in order to protect patient/therapist privilege (confidentiality rights). This kind of advice would indicate that the professional is unaware of the unique needs and requirements of eating disorder treatment, the benefits of conjoint family treatment for the child who lives at home, or the power of the family system to support the child&Mac226;s recovery. It might also indicate a therapist who is either untrained or inexperienced with eating disorder treatment or is otherwise uncomfortable facilitating family treatment.

Loving one’s child is not enough. Parents need to act on the knowledge they acquire. Parental involvement may vary from providing:

  • On-going and unconditional support day in, day out.
  • Nutritious meals which they prepare and sit down to eat together with the child.
  • The monitoring of food intake and symptom management,.
  • Involvement in family treatment to support the child and recovery process and to resolve underlying emotional issues that may be driving the dysfunction


Psychotherapist Abigail H. Natenshon (MA, LCSW, GCFP) has specialized in the treatment of eating disorders with individuals, families, and groups for the past 31years. She is the author of When Your Child Has An Eating Disorder, A Step-by-Step Workbook For Parents And Other Caregivers, Jossey-Bass, 1999. Based on hundreds of successful outcomes, this book shepherds concerned parents step-by-step through the processes of eating disorder recognition, confronting the child, finding the most effective treatment for patient and family, and evaluating and insuring a timely recovery. A guide to eating disorder prevention, this book is useful to parents, health professionals and school personnel alike in countering the pervasive epidemic of unhealthy eating and body image concerns, and destructive media and peer influences. Abigail is also a Guild Certified Feldenkrais Practitioner.  Her work can be reviewed further at and and her book is available through



Abigail H. Natenshon, MA, LCSW, GCFP
Author of "When Your Child Has an Eating Disorder:
A Step-by-Step Workbook For Parents and Other Caregivers"

A Family Approach to Healthy Eating,
Positive Body Image and the Prevention and Healing of Eating Disorders







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