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Phase 1: Restoring the adolescent's
weight. Treatment is focused on the eating disorder
symptoms and includes a family meal. Families are encouraged, with
guidance from the therapist, to work out for themselves how best
to restore weight for their anorexic child.
Phase 2: Handing control over eating
back to the adolescent. The start of the second phase
of treatment is usually signaled by the adolescent's acquiescence
to the demands of the parents to increase her food intake and a
positive change in the mood of the family. Symptoms remain central
in the discussions, while weight gain with minimum tension is encouraged.
All other issues that the family has had to postpone throughout the
first phase of treatment can now be brought forward for review.
Phase 3: Discussion of adolescent development. The
third phase is usually initiated when the adolescent has achieved
and maintained a healthy weight and self-starvation has abated.
Central to the discussion for this part of treatment is the establishment
of a healthy relationship between the adolescent or young adult
and his or her parents. That is, this relationship is no longer
characterized by the illness constituting the basis of interaction.
Adolescent developmental issues are also now brought to the fore.
Phase 1: Reestablishing healthy eating. Treatment
aims at empowering parents to disrupt binge eating, purging, restrictive
dieting, and any other pathological weight-control behaviors. It
also aims to externalize and separate the disordered behaviors from
the affected adolescent to promote parental action and decrease adolescent
resistance to their assistance.
Phase 2: Helping the adolescent eat independently. Once
abstinence from disordered eating and related behaviors has been
achieved, the second stage of treatment begins when parents transition
control over eating and weight-related issues back to the adolescent
under their supervision.
Phase 3: Adolescent developmental issues. The
focus here is on ways the family can help address the effects of
bulimia nervosa on adolescent developmental processes, both on the
adolescent and the family as a whole.