The 411 on 504 Plans

imageIt is not uncommon for parents to be concerned about their child’s progress in school while seeking treatment for an eating disorder. Will my child have to take a leave from school?  Will he fall behind his peers? How will she have enough time to finish schoolwork when she is in program for six or ten hours a day? These are understandable fears and questions that a parent might have when considering enrolling a child or teenage into an eating disorder program.

Some schools are very understanding and are able to make accommodations while the child is in treatment, such as providing homework packets to be done at home or providing the option to do courses online.  If the school is not able to make the appropriate accommodations, parents have the right to ask for a Section 504 Plan because children with eating disorders meet the criteria for this service.

What is a 504 Plan? “Section 504 requires that school districts provide a free appropriate public education (FAPE) to qualified students in their jurisdictions who have a physical or mental impairment that substantially limits one or more major life activities, regardless of the nature or severity of the disability. Under Section 504, FAPE means providing regular or special education and related aids and services designed to meet the student’s individual educational needs as adequately as the needs of nondisabled students are met” (source: http://www2.ed.gov/about/offices/list/ocr/504faq.html). It’s important to note that private schools that receive no federal funding do not have to honor a 504.

What’s the difference between a 504 and an Individualized Education Plan (IEP)?  IEPs are generally reserved for specific conditions that affect academic performance and require special education or services such as speech pathology. As that is often not the case for children with eating disorders, a 504 is a more common and appropriate avenue to pursue.

Why might one make the effort of getting a 504? Parent mentor and educator Andree shares her thoughts: “I think many parents do not believe their child needs or qualifies for a 504 because they have students who excel. However, 504s can be temporary or long term and are often used for a range of illnesses (including eating disorders, anxiety and ADHD). For many families, the child’s school might be able to make every accommodation possible while the child is in treatment.  However if the school is not able to accommodate your child, a 504 will provide the necessary supports.” When you start the process in requesting a 504 plan, be sure to have a physician’s diagnosis paperwork with you as this will be critical in documenting that your child meets criteria.  

Can a 504 plan remain active when my child returns to school? The short answer is yes. As your child transitions back to school, consider every possible stumbling block and have a plan. From keeping food in the nurse’s fridge and scheduling accommodations that allow for afternoon appointments to non-cardio PE and eating lunch with a trusted adult, everything should be considered. Think about talking through every part of your child’s day with them to determine what fears might be lingering and work with the team to address it. As things change and new issues come up, know you can call a 504 meeting at any time to make an addendum or to add new accommodations to the service plan.

Another parent mentor adds his thoughts, “We have never used a 504 plan because we have dealt directly with school personnel who have been helpful and accommodating.  We have been fortunate – but, thankfully, the 504 does not depend on luck.  It puts the law on your side a critical point when dealing with a public that, by and large, misunderstands eating disorders.”

In general, making a verbal request to a counselor or administrator should be enough to get the ball rolling; a formal request should be made in writing if you sense any reluctance. If you are ever in doubt about information you are receiving from the school, ask them to cite the specific section of your state’s educational code where you can find the information.

Education is one piece of the often-overwhelming puzzle that comes along with treating and recovering from an eating disorder. A 504 can make sure all players on the same page and that your child’s school understands their obligations and role during your child’s recovery.

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Jennifer Denise Ouellette is a member of the Parent Advisory Committee (PAC) at the UCSD Eating Disorders Center. The PAC is a group of parents with children who have completed the UCSD adolescent eating disorders program and whose role is to support new parents as they enter the program. You can follow her on Twitter @jugglingjenn

Eating Disorder Treatment Worked - Why I Will March on Sept 30

This blog post was originally published on the M.O.M. (Mother and Others) March website. The M.O.M. March is an event that we are sponsoring and that is taking place on September 30th in Washington DC as an effort to lobby for eating disorder treatment and research. Please register for EDC Lobby Day and join us in making a difference.

In early 2012, my happy, healthy, bright and well-loved youngest-of-four 17-year-old daughter began to lose weight rapidly and experience a lot of stomach issues—the foods on her can’t-eat-this-it-hurts-my-stomach list quickly became longer than the list of what she could eat. Our pediatrician, a savvy and sensible woman, talked to my daughter about these issues over several visits and within a couple of months, after ruling out other possible causes, came to the conclusion the diagnosis was anorexia nervosa.

The doctor told us we would be going to the topnotch UCSD Eating Disorders Center for Treatment and Research. When I asked if Aetna would cover it, she said she would fight for it. She explained UCSD was the only local facility utilizing a Family Based Treatment (Maudsley) model and research showed that to have the best chance for success. Thankfully, Aetna quickly agreed to write a single-case agreement and treatment started within a week.

Recovering from anorexia nervosa is never easy; eating disorders are brutal, persistent and misunderstood by most of society.  You didn’t know they are genetic, biological, brain-based disorders thought to be triggered by a period of malnutrition?  You are not alone. Fighting stigma is hard when you are also fighting for your own or your child’s life.

My daughter had an early diagnosis, top-notch treatment and she still lost a semester of high school and one of college to her disease; she continues to be followed today to ensure her recovery stays solid. She fought hard to be where she is today (15 months of independent recovery and completing college out-of-state) and she and we are the lucky ones—we’ve had access to treatment that is evidence-based and that we can afford. 

I have an entire tab on my blog devoted to our journey that began with this post—my daughter encouraged me to share our story and I am happy to say our openness has helped others.  It is this openness that leads me to immerse myself in the world of advocacy and activism and use my experience with social media to raise my voice and help others raise theirs.

Our story is atypical. I’ve not spoken to anyone else whose path has been this direct. Most struggle with uninformed physicians which delays diagnosis. Most have to search, often fruitlessly, for a treatment program that is both evidence-based and accessible. Most have to battle their insurance company endlessly. Most have to follow paths far more rugged than ours (which was decidedly no walk in the park). 

I will march on September 30 in Washington DC because parent pioneers like Laura Collins deserve to know there are those committed to carrying on their work. I will march for the opportunity to recover my daughter had not to be an anomaly. I will march for the access to treatment every person affected by an eating disorder deserves. I will march because I know too many mothers who have lost their children and too many who face that prospect. I will march because the researchers who have taught us much in recent years need and deserve funding on par with what other diseases get. I will march so people will understand this disease has nothing to do with vanity or choice and everything to do with brain wiring.  I will march to ask my representatives to pass the FREED act. I will march because eating disorders are serious and there is hope.

On Sept 30 I will be marching in the first M.O.M. March in Washington, DC. We must also lobby on October 1 with the Eating Disorders Coalition (EDC) so our Members of Congress and Senators hear our voices. Changes to fund ED research and treatment start with Congress.  Our voices will be heard! Please register for EDC Lobby Day and join us in making a difference. 

 

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Jennifer Denise Ouellette is a member of the Parent Advisory Committee (PAC) at the UCSD Eating Disorders Center. The PAC is a group of parents with children who have completed the UCSD adolescent eating disorders program and whose role is to support new parents as they enter the program. You can follow her on Twitter @jugglingjenn

Back to School: Partnering with the School Nurse & Staff

imageIf your eating disorder treatment team has given the okay for your child to return to school, there are several steps you should take to make the transition successful. First, you need to let the school know about your child’s eating disorder, as you will need support. The reaction of teachers and administrators will vary, so don’t be surprised if you need to educate them, as some may have outdated knowledge.

It’s a good practice not to agree to anything immediately unless you are sure the school is operating solidly in the best interests of your child and his/her recovery. In a good situation, the school will be an important asset. You will need to meet with the school counselor or an administrator, and you may want to have a Section 504 or Individualized Education Plan in place to ensure your child’s physical, mental and educational needs are met.

One mother, Erika, explains: “Your child’s well being should be first and foremost while recovering from the eating disorder. Take your time to get a good foundation and be flexible when sending your child back to school. If there are setbacks it’s okay to adjust accordingly; communicate with the school and press on. “

How can the school help in your child’s recovery? Monitored meals and snacks and possibly rules surrounding bathroom usage and/or exercise are frequently needed; the health office or a sympathetic teacher can often be the one to provide supervision.

The nurse is an important person to partner with as your child transitions back to school.

Erika advises utilizing the school nurse in many ways: “The school nurses are not a replacement for your duties as a parent. They are there as a support person for all of the children in the school. School nurses will keep things noted in your child’s school file, which will remain confidential. Always keep in contact with the nurse to notify them of any medications that your child is taking and/or changes that have been made to medications throughout the school year.  

This will help if there are any changes with your child that should be communicated to you immediately. The school nurse can also provide a safe place for your child to go if at any time they are feeling overwhelmed, anxieties are high or support is needed when it comes to lunch and snack. Keeping lines of communication open with the school nurse will be extremely beneficial for both you and your child.”

Andree echoes Erika on enlisting the nurse: “I spent a lot of time behind the scenes talking to the health clerk, nurse and counselor to give them specifics about my daughter’s needs. I gave them brochures and info to read, but they needed to know what was going on with my daughter specifically. With the nurse and health clerk, we worked out a system of keeping multiple meals and snacks in the health office refrigerator. She could go in there and meet with them, no questions asked. All I asked of the nurse was that, if my daughter came in, just talk about normal teenage things and distract.”

School can be a source of great anxiety for children with eating disorders. They, and we, need all the help we can get. You have the right to expect good support and the responsibility to ask for it. If your school isn’t knowledgeable about eating disorders, print our Ten Things Parents Wish Educators Knew About Eating Disorders Post.

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Jennifer Denise Ouellette is a member of the Parent Advisory Committee (PAC) at the UCSD Eating Disorders Center. The PAC is a group of parents with children who have completed the UCSD adolescent eating disorders program and whose role is to support new parents as they enter the program. You can follow her on Twitter @jugglingjenn

Ask the Expert: Eating Disorders in Young Children

In this blog post, Dr. Jessie Menzel addresses two commonly asked questions about eating disorders in young children.

Why are more and more young children getting eating disorders?

imageEating disorders are now being diagnosed at a higher rate in younger children. While it is rare to find eating disorders in children as young as 5, cases have been identified in children between 6 and 12 years old. A study published by the Canadian Government reported that children younger than 12 made up 4% of their hospitalizations for eating disorders between 2005-2006 – a 119% increase from 1999-2000. While the rate of new eating disorders is considerably lower in younger children compared to adolescents, the risk of developing an eating disorder increases with age. For example, the rate of new eating disorders in children who are 12 years old is about 45 times higher than in children who are 6 years old.

Unfortunately, it is unclear as to why the rate of eating disorders is rising in younger children. What we do know is that historically, eating disorders in younger children were often misdiagnosed. Children are less likely to report being dissatisfied with their bodies, a major eating disorder symptom seen in adolescents and adults. The effects of an eating disorder also may not be as apparent in younger children; younger children might not lose a significant amount of weight as a result of restricting their diet but rather may just not grow. Finally, some older diagnostic criteria for eating disorders, such as missing menstrual cycles, often just do not apply to children.

As awareness of eating disorders has grown, it is likely that pediatricians and mental health professionals now are better at recognizing eating disorders in young children. Furthermore, as our diagnostic criteria have improved, many eating disorders that would have been “missed” in young children are now being properly recognized. Using the latest edition of the Diagnostic and Statistical Manual of Mental Health Disorders, the number of eating disorders recognized in children and adolescents has jumped as much as 50%.

How is eating disorder treatment different for younger children compared to teenagers?

The primary treatment for a child with an eating disorder, particularly anorexia, is the same as that for a teenager. Family-Based Treatment, also known as the Maudsley Model, is the most effective treatment for a child with anorexia, no matter the age. This approach empowers parents to take an active role in their child’s recovery by helping their child restore weight and return to normal, healthy eating patterns.

Guidelines for the treatment of eating disorders emphasize, though, that treatment approaches for children need to be modified to be developmentally appropriate. Many eating disorder programs are currently designed for adolescents. Some professionals feel that it is important for younger children’s eating problems to be addressed separately from those of adolescents.

At UCSD, our Pediatric Program is designed specifically for this younger age range. Our program takes into account the developmental stage of younger children by using therapy groups and materials specifically designed for younger children and by gearing therapy topics toward younger childhood issues. Our PHP and IOP programs frequently incorporate games and allow extra time for keeping up with school work. Everything from our kid-friendly meal plans to our heavy emphasis on parent involvement is designed with younger children in mind.

 

Dr. Jessie Menzel is a postdoctoral fellow at the UCSD Eating Disorder Center for Treatment and Research and is the Pediatric Program Manager. Dr. Menzel has extensive treatment experience working with adults, adolescents, and children with eating disorders at all levels of care. She is also involved in conducting research and providing family and group therapy at the Pediatric Program.

References:

Peebles, R., Wilson, J., & Lock, J. (2006). How do children with eating disorders differ from adolescents with eating disorders at initial evaluation? Journal of Adolescent Health, 39, 800-805.

Pinhas, L., Morris, A., Crosby, R., & Katzman, D. Incidence of age-specific presentation of restrictive eating disorders in children. Archives of Pediatric Adolescent Medicine, 165, 895-899.

Ornstein, R., Rosen, D., Mammel, K., Callahan, T., Forman, S., Jay, S. et al. (2013). Distribution of eating disorders in children and adolescents using the proposed DSM-5 criteria for feeding and eating disorders. Journal of Adolescent Health, 53, 303-305.

 

Parenting a Child with an Eating Disorder: From Panicked to Proactive - Part 4

imageOnce the initial battles with meals are over, and your child is nearing weight-restored, you settle into a familiar routine—an exhausting routine, but a routine nonetheless. Whether your child struggled with restriction, purging or other destructive behaviors such as self-harm, you are used to having all eyes on your child to prevent actions.

As recovery progresses, it’s time to see if you are able to avert your eyes now and then. This is called Phase 2 of Maudsley/Family Based Treatment (FBT). The point of Phase 2 is to transition away from 100% supervision and return control back to your child.

Phase 2 is characterised by the balance of parents gently and gradually letting out enough rope to encourage their teen to take independent steps of managing their ongoing recovery, whilst not letting out too much rope. Parents should ensure that any challenges be met with full support. An equally important focus of this phase centers around encouraging independence around normative teenage behaviors which may have been disrupted by the eating disorder, such as exercise, social events and schooling.

Generally, if parents have any regrets during this phase, it is usually due to moving too quickly—eagerness to return to a “normal” life can sometimes backfire with a full-blown relapse. Careful and gradual return of independence around food, exercise and unsupervised time to your child is the best approach.

One father shared his experience of Phase 2 with his daughter: “After seven months in treatment, we tried to transition from Phase 1 to Phase 2 for the first time. We progressively turned over meal decisions to our daughter, starting with snacks. We had no idea how much anxiety even small decisions would trigger. She would restrict whenever she was unsupervised or when we were more lax. We later realized that when she made the food decisions, she had to face the eating disorder alone…it was too difficult for her and she had a major setback.

“The next time we tried Phase 2, after several months back in Phase 1, we continued to supervise her as she made food decisions. We were also there to help her stare down her eating disorder. As she gained more confidence, we were able to turn over more decision-making to her and eventually cut down on meal supervision. Phase 2 is all about watching the subtleties of letting your teen take back non-eating responsibilities and slowly taking on food-related responsibilities. It is not to be done too quickly.”

Another mother described her family’s progression: “We started out letting our daughter choose snacks out of a bag of prepackaged snacks we chose. Once she ate through most of those, we replaced them with new ones. Then we progressed to letting her choose her own snacks out of the pantry. After that we let her make her own breakfast or lunch. We would make suggestions on things for her to make and appropriate amounts, such as, ‘You need to have two sandwiches with some sort of meat on them.’ We would always check the amounts, and that went on for a very long time. It was a scary time, and for us it was the first time our daughter lost weight. Assess and adjust constantly. Some days will be easy, and some days you might need to step in a lot. Our daughter can now feed herself well if we are not around. We have left her at home when we have gone away and she has been fine.”

One of my fellow parent mentors explained this process succinctly:

“1. Maintain your standards, but temper your expectations.

2. Try to reset your perception of your child to that of a ‘normal’ child, and view their behavior through that lens.

3. Don’t be afraid to restore boundaries.”

It is helpful not to view boundary-setting during Phase 2 as a failure. Perfectionism plays a huge role for many with eating disorders, so it is advisable for parents to accept some level of backsliding without too much angst.  

Phase 2 is analogous to the first years of a child’s life. While with you in a room, your toddler, curious about the surrounding toys and people, may briefly waddle away from you. At some point, she may freak out that she has wandered off too far and return for comfort. The process of becoming independent around food, exercise and behaviors works in much the same way.

It cannot be stressed enough that this is a gradual process and one that can take months. According to Dr. Stuart Murray, a clinician at UCSD, one year is the most conservative timeline for recovery, so it is important for families to adjust their expectations to fit that reality.

Personally, I am famous among my cohort for saying that we were staying in treatment long enough that it would be a “once and done” experience. It turns out it wasn’t, but that’s okay. A year after she left treatment the first time, we recognized that it was time to go back for more helpand now she has 15 solid months of recovery behind her.

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Jennifer Denise Ouellette is a member of the Parent Advisory Committee (PAC) at the UCSD Eating Disorder Center. The PAC is a group of parents with children who have completed the UCSD adolescent eating disorders program and whose role is to support new parents as they enter the program. You can follow her on Twitter @jugglingjenn

Ten Things Parents Wish Educators Knew About Eating Disorders

image 1. Eating disorders are “real” and deadly illnesses and having one is not a choice. Your reaction, as an administrator or teacher, to a disclosure of an eating disorder should be the same as if you were told a child had leukemia. Facts: certain eating disorders have a mortality rate as high as 20%, eating disorders are up to 80% genetic, and they are biological in nature. Treatment has to be the number one priority, and the medical and psychological needs of the student should drive how school absences, attendance and other issues are handled. Be aware that boys get eating disorders, people of color get eating disorders, and it’s happening in younger and younger children.

2. Parents want to work with you, not against you. We understand that most of society is not educated about eating disorders and many myths persist. We don’t blame you if you are not initially well-informed, but once we share our knowledge and provide resources, we expect you to bring your knowledge up to date so you can best serve your students.

3. Parents and families don’t cause eating disorders. It used to be the medical “truth” that “refrigerator mothers” (cold, unfeeling, non-bonded) caused autism. We now understand that parenting has nothing to do with autism developing. As with autism, families don’t cause the disease of eating disorders, but how they manage them is very important to a child’s well-being. We need your support and understanding as we fight to save our children.

4. One of the most challenging aspects of an eating disorder is anosognosia (a term meaning that the patient truly does not know he/she is sick). Eating disorder sufferers may perform at very high levels academically, athletically, and in other extracurricular activities. You cannot tell just by looking at someone whether or not he/she has an eating disorder. One can have very serious medical and psychological issues and not be stereotypically thin as you might imagine.

5. Talking about dieting or weight in front of your students can be extremely detrimental since they often look up to and emulate their teachers. Be body-positive, “exercise-is-fun,” “everything-in-moderation” role models. Please do not give assignments that involve reading food labels, counting calories, and keeping food diaries. Recent studies show that nutrition education, anti-obesity campaigns, and BMI testing do not have a positive impact on obesity and tend to have unintended negative consequences in terms of promoting disordered eating, which can in turn trigger an eating disorder in those who are genetically vulnerable.

6. Pay attention to your students, and if you notice something amiss, alert the parents. This includes throwing lunches away, bringing treats for friends and not eating any, new or intensified moodiness and social isolation, and indications of self-harm. These signs, especially in a student who is a high academic performer, are red flags. Parents may not notice the symptoms or may be in denial; please don’t let the feeling of discomfort prevent you from having a conversation and following up. This can be a matter of life and death. Approach parents in a way that doesn’t put them on the defensive, such as, “I am concerned about your child’s health …” Having resources to share with a parent can be very helpful; there are links at the bottom of this page.

7. At all levels, recognize that social isolation is a symptom of the disease, and reintegrating into the social sphere is both a sign of recovery and can be very difficult to navigate. Work with parents on 504 plans, Individualized Education Plans, independent contracts, and other accommodations to allow students to come back to school and participate in activities as their health allows. Would you tell a student who missed three months for chemotherapy that he/she couldn’t go to prom or walk at graduation? This is the same thing - please don’t push our children out because they are inconvenient for the school’s schedule. Recovering only to find you have no life to return to is cruel; due to social stigma and ignorance, this happens too often to children with eating disorders.

8. Support our children’s return to school with the appropriate meal-monitoring and modified schedules that their treatment team suggests. A supportive school environment can make all the difference in a child’s recovery and we will be so grateful for your help.

9. Address bullying whenever and wherever it occurs. More students will feel confident about sharing the nature and details of their illness if they understand that the school culture is one of warmth and support versus gossip and bullying. Our children should not have to feel fear or shame about disclosing an eating disorder any more than if they disclosed any other serious illness. Reinforce the idea that good friends seek out trusted adults to share concerns with; many kids are hesitant to “tell” on a friend for bullying because they are not confident that their concerns will be appropriately or confidentially handled, and they fear backlash.

10. Know the signs of a possible eating disorder:

• Fear of certain foods—especially fats and carbs

• Anger at others if pressed to eat something

• Avoiding situations where communal eating is expected

• Dieting

• Assigning moral value & rigid distinction to foods (“clean/dirty”, “good/bad”)

• Social withdrawal

• Reports others are newly judgmental or “not connecting”

• Inability to describe emotions

• Spending a lot of time in the bathroom

• Exercising intensely but without pleasure

• Exercising to compensate for eating

• Signs of self-harm

With a lifetime prevalence of as high as 1 in 30 people, the odds are great that you will encounter more than one student with an eating disorder in your career. Your knowledge and empathy can positively impact precious lives and help families. 

This list was inspired by “Ten Things I Wish Physicians Would Know About Eating Disorders” written by Edward P. Tyson, M.D.

Thanks to the dedicated Warrior Mamas of Mothers Against Eating Disorders (MAED) for their assistance in compiling this Top 10 List. The group’s support can be accessed via a closed Facebook Page. MAED welcomes all to join our Advocacy and Activism page 

Further information can be found at: 
• Families Empowered and Supporting Treatment of Eating Disorders (F.E.A.S.T.): http://www.feast-ed.org/
• The Eating Disorder Coalition website: www.eatingdisorderscoalition.org
• The Alliance for Eating Disorders: www.allianceforeatingdisorders.com

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Jennifer Denise Ouellette is a member of the Parent Advisory Committee (PAC) at the UCSD Eating Disorders Center. The PAC is a group of parents with children who have completed the UCSD adolescent eating disorders program and whose role is to support new parents as they enter the program. You can follow her on Twitter @jugglingjenn

Parenting A Child With An Eating Disorder: Social Media…A Pandora’s Box

The use of social media is a hot topic in eating disorder parent circles.  In recovery, online recovery communities can be a source of great support and a way to connect with others who understand the journey. One, however, has to get to recovery first before it can really be used in a positive way.  

Before a patient is in solid recovery, social media can indeed be full of peril. Comparing oneself to others is often part of the personality profile of those who suffering from an eating disorder, and the internet provides 24/7 opportunities to do that. The number of “pro-ana” (pro-anorexia), “pro-mia” (pro-bulimia) and “thinspo” (thinspiration) communities on Tumblr will make you cry.  Social media can also expose your child to ignorant and harmful comments about eating disorders.  The other day on Twitter, this tweet leapt at me: “Eating disorders aren’t really a thing. It’s like just eat, lol”.

Furthermore, if your child is having peer issues and participating in the the drama that inevitably unfolds on social media, that can be too much for them to handle on top of fighting the eating disorder.

Regardless of whether or not you decide to limit your child’s access to social media, it’s important to keep it on your radar.  If the terms above are not familiar to you, do some research. Your kids are likely using social media so you familiarize yourself with all of the popular platforms:  Facebook, Twitter, Snapchat, Ask.fm, Tumblr, Instagram, etc.  You may find yourself doing some detective work online, which can yield important information about your child’s mental health.

Andree shares how access to technology was managed in her home, “When my daughter was at her sickest, the phone didn’t matter and that signaled our scariest time ahead. So when she started to be more nourished and had more skills, the desire for the phone came back and we used that to our advantage. It was a part of our contract – the phone was the first thing to go when she didn’t follow through on her end. I am also an avid believer in keeping an eye on social media. It usually tells me where her head is … if I see it going the wrong way, I know to jump in with conversation, distraction or motivation.”

Erika and Michael found access to social media to be a double-edged sword. Because they understood its power, they were able to leverage it to help their daughter. “We used this to our advantage to use as a reward for reaching her goals in treatment.  We had an extremely strict schedule and monitoring during this phase.  For a time, it was just another way for the eating disorder and its detrimental ways to fester and interfere with our daughter’s treatment.  Of course when she was noncompliant in her treatment, those privileges were taken away until she resumed progress.

She had an iPhone and we exchanged it for just a regular phone so she had no access to the Internet, yet could text and have contact with her friends and family.  As time went by, she was allowed to earn free time on the computer by building trust.  We did have a few setbacks, like looking up inappropriate information and trying to delete her history, and she had to earn back that trust.  We didn’t go to extremes when setbacks happened since we were aiming for progress, not perfection.  ‘If at first you don’t succeed, try, try again’ was our motto. “

If you feel, as many parents do, that access to social media is hindering treatment, you can easily purchase blocking software for both computers and phones.  Since nighttime can be a scary and difficult time, it may be best for your child to surrender technology at bedtime.

Like many of the things that you have to do as a parent of a child with an eating disorder, handling access to technology and social media can feel very counterintuitive especially with an older teen. Discussing your fears and your new rules in family therapy and putting parameters in a contract can alleviate your fears and let you make peace with doing what you have determined is best to save your child’s life.

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Jennifer Denise Ouellette is a member of the Parent Advisory Committee (PAC) at the UCSD Eating Disorders Center. The PAC is a group of parents with children who have completed the UCSD adolescent eating disorders program and whose role is to support new parents as they enter the program. You can follow her on Twitter @jugglingjenn

HOW DO WE KNOW WHAT KIND OF TREATMENT WE NEED?

HOW DO WE KNOW WHAT KIND OF TREATMENT WE NEED?


imageIf you suspect that your loved one has an eating disorder, it is important to seek diagnosis and treatment right away. Evidence shows that early recognition of symptoms and early intervention are correlated with improved treatment outcomes.

The type and level of care that your loved one needs will depend on many factors including: age, physical and behavioral symptoms, medical stability, psychiatric state, and length of illness.

It is important for the patient to receive complete medical and psychological evaluations by providers familiar with eating disorders before a treatment plan can be put in place.

As different providers may recommend different treatment plans, it is essential that caregivers become familiar with the various treatment options, diagnostic criteria, and current clinical guidelines so that they can make informed decisions about the care being offered. Every patient has unique needs and multiple treatment options should be considered.

As part of our services, the UCSD Eating Disorders Center offers a free intake assessment to help patients & families determine the appropriate level of care. Please call us at (855) 824-3050 for more information. To learn more about levels of care, you can visit:http://bit.ly/1lknZ93

Excerpted from FEAST Family Guide, March 2014.http://bit.ly/1lj2Pnl