Family involvement significantly enhances the effectiveness of eating disorder treatment. Understanding the complex nature of eating disorders and fostering open family communication is crucial in supporting the recovery process. As a therapist, I have worked with numerous clients, highlighting the importance of involving families in the treatment of children who, through various means, restrict their food intake, leading to malnutrition and both mental and physical distress.
Family participation in eating disorder treatment is essential for several reasons. First, during a time when children's decision-making abilities are underdeveloped and affected by neurological changes due to illness, the proximity of stable adult role models becomes critical. Second, parents are often in the best position to interrupt eating disorder behaviors. Finally, when children face challenges related to their eating habits and body image, the relationship between parents and daughters is often strained and needs repair.
I have had the opportunity to work with many mothers, fathers, and their children, encouraging all family members to attend therapy with the affected child for optimal outcomes. However, studies show a notable discrepancy in fathers' participation in family therapy sessions compared to mothers', despite recommendations for both parents to be involved. This trend has been linked to adverse effects on the outcomes of eating disorder treatment.
While it's essential for fathers to be involved, their limited presence or absence can be understandable. Social expectations dictate that mothers are to be ever-present and available to their children, while fathers are often more removed and tasked with supporting mothers. Furthermore, the nature of caregiving responsibilities can overwhelm families, and fathers may find themselves preoccupied with increased duties resulting from their child's illness. They might take on additional household responsibilities due to redistributing parental time and resources toward the affected child. Regardless of the reasons for the father's presence or absence, the therapeutic journey must proceed, and the family must navigate the challenges of eating disorder treatment together. This often results in mothers and daughters taking on an unequal amount of the therapeutic responsibility.
Possibly ingrained sexism and assigned gender roles give mothers a priority seat in treatment with their young daughters. The same-sex connection between mothers and daughters certainly contributes to mothers' special place in treatment. Shared societal pressures on women and girls to derive their self-worth from body size and shape create a common understanding, further influencing the mother-daughter bond in therapeutic settings.
Despite modern culture promoting more involved fatherhood, research on the division of labor between heterosexual parents indicates that mothers continue to occupy the primary caregiver role. That is not to suggest that fathers are absent or not in a shared primary role in many families. Even in a secondary role, fathers often plan meals. When that is the case, fathers are particularly crucial to family-based eating disorder treatments. The importance of parents preparing and serving balanced meals is often emphasized in treatment because normalizing eating is key to treatment success.
I encourage both mothers and fathers to actively participate and remain committed to their children's eating disorder treatment for the best possible outcomes.