Empowering Parents: Strategies for Supporting a Child’s Eating Disorder Recovery

Emotion-focused family therapy (EFFT) sees caregivers as having a key role in their child’s recovery.

Looking for moments of freedom with a child sitting on ther parents shoulder during eating diosrder treatment.

Parents of children with eating disorders can feel overwhelmed about how to support their child’s recovery. Since eating disorders are complicated illnesses that affect children both mentally and physically, it can be challenging for parents to know their role in the treatment process.

Many parents fear they will “make things worse” or “say the wrong thing”. These fears can leave parents feeling ill-equipped to support their child’s recovery. They may even conclude that their child’s treatment is best handled by a team of professionals.

However, research has shown that parents play a vital role in their child’s eating disorder recovery. Children have an established emotional connection with their parents that treatment professionals don’t, and this can be a supportive, and even crucial, asset in their child’s healing.

Dr. Adele Lafrance, who developed emotion-focused family therapy, has helped caregivers tap into their healing power. She gives parents clear tools on how to effectively support their children. Through Dr. Lafrance’s research, she has created easy-to-follow steps for parents and caregivers to take when supporting their child with an eating disorder.

Two Core Ways to Help in Your Child’s Recovery

Dr. Adele LaFrance has created clear ways for parents to support their child’s eating disorder recovery. The next two sections of this article will walk parents through two of these treatment tools.

The tools are emotion coaching and recovery coaching. Both interventions are broken down into simple steps to give parents a specific direction and plan to fall back on when their child’s recovery feels overwhelming.

Emotion Coaching

Emotion coaching is a tool that parents can use to emotionally connect with their child who is recovering from an eating disorder. This doesn’t only apply to eating disorder behaviors or thoughts but can be used anytime your child is struggling. The three parts of emotion coaching, which are outlined below, teach caregivers how to effectively validate their child’s emotions while also offering practical support. 

Steps of Emotion Coaching

1. Validate.

The first step in emotion coaching is to validate your child’s experience. It is crucial to start here. Providing your child with reassurance without validation will be ineffective, even though you might feel pulled to do so. If you validate your child’s experience first, reassurance is more likely to have an effect.

So, how do you validate? The most important thing to remember when validating your child is to swap out the word BUT for BECAUSE. For example, your child tells you they feel sad about missing band practice to attend therapy appointments. Typically, parents will want to lead with this response:

“I can understand why you might feel sad BUT your recovery is more important.”

Rather than jumping to this response, parents need to pause. Imagine why your child is sad about missing practice. Then, when you have some ideas about why your child might be feeling this way express your understanding by swapping the BUT for BECAUSE.

“I can understand why you might be sad BECAUSE you’re missing out on spending time with your friends.”

By trying to understand your child’s experience, even when you don’t agree with it, you can have a soothing effect on your child. Dr. Lafrance’s research has shown that for this tool to be most effective parents should try to use three “becauses”. This might look something like this:

“I can understand why you might feel/think/want (______)  BECAUSE…” (x 3)

“I can understand why you might be sad BECAUSE you’re missing out on spending time with your friends, and BECAUSE you have a big performance coming up, and BECAUSE going to therapy has been a hard thing to do.”

2. Emotional Support.

Once your child feels validated, you can then move on to the second part of emotion coaching, which is offering emotional support. The most important aspect of emotional support is to recall the emotion you identified within your child’s experience and then ask yourself what that emotion might need. You might not know this, but every emotion has a specific need.

For example:

  • Sadness needs comfort, such as a hug.
  • Fear needs safety, such as a parent to sit beside them.
  • Anger needs protection, such as boundaries or space. 
  • Shame needs compassion, such as a nonjudgmental, listening ear.

Once you identify the emotion, you can offer some words of support. Examples you may use are:

  • “We’re in this together,” is a comforting statement when your child is sad.
  • “It’s going to be okay,” is a safety statement for fear.
  • “Why don’t I give you a few minutes and we’ll try again,” is a way to support anger.
  • “I understand and hear you,” could be used for shame.
3. Practical Support.

Finally, you can move into problem-solving, which is commonly the step where most parents want to start. It is important to follow these steps in order. To problem-solve, or reassure, without first validating your child’s experience will commonly be met with resistance to your efforts. Your child first needs to feel understood in their experience before problem-solving techniques will feel supportive, rather than dismissive.

Practical support is exactly what it sounds like. It is the time to offer suggestions to your child that will help them move through their struggle effectively. Examples of practical support options include:

  • Distractions – “Let’s listen to your favorite song on the way to therapy.”
  • Problem-solving – “Let’s see if your therapist can meet at another time so you don’t have to miss any more practices.” 
  • Setting limits – “We need to go to at least four therapy appointments.”
  • Taking over – “I am going to check in with your therapist at the beginning of your session to request that you two discuss your feelings around missing practice.”
Freeing doves for peace and recovery when struggling with parenting and child eating disorder.

Recovery Coaching

Recovery coaching is another skill parents can learn that allows them to interrupt their children’s eating disorder behaviors in a supportive way. Once the behavior is interrupted, the parent’s role as a recovery coach will be to help their child replace the symptom with recovery-focused behaviors. 

Parents may feel overwhelmed at the idea of interrupting their child’s eating disorder behaviors for fear of “making it worse”. The eating disorder serves an emotional purpose, so of course when it is taken away there is going to be resistance. Luckily, there are five steps parents can follow when recovery coaching feels overwhelming.  

Steps of Recovery Coaching

1. Do a check-in with yourself.

Are you calm? Is your expectation reasonable?

2. Connect with your child for at least 2 minutes. 

For example, notice a drawing they’ve been working on or ask them what’s been happening in a show they’re watching.

3. Make your request.

Deliver your request in a clear, concise way and with a calm, but confident tone. Try to avoid giving a list of reasons why your request is necessary.

Say: “Please do X,” instead of, “Can you do this?”

4. Validate your child’s emotional reaction.

You learned about validation above and you can use the same script. Be prepared to be met with resistance and lean into the child’s resistance. This will be the content that you can validate.

“I can understand why you wouldn’t want to ________ BECAUSE…BECAUSE…BECAUSE…”

4. Make the request a second time and set a limit if necessary.

“You need to come to the table and sit with me for 15 minutes.”

Recovery Coaching Example

Let’s use this example to practice recovery coaching. Pretend your fourteen-year-old daughter named Mara is struggling to try a new fear food.

1. Check in with yourself.

Are you calm? Is your request reasonable?

2. Connect with your child by supportively observing the situation.

“Mara, I can see you haven’t picked up or taken a bite of your pizza. It seems like a lot is coming up for you during this meal.”

3. Make the request.

“Mara, please take a few bites of your pizza.”

4. If you’re met with resistance, validate your child’s emotional experience.

“I can imagine you might not want to try the pizza BECAUSE you’re afraid of what the food might do to your body, and BECAUSE you feel overwhelmed about what we are having for dinner today, and BECAUSE pizza is a food you haven’t allowed yourself to have in a very long time.”

5. Make the request again.

I know you are trying your best, but I need you to try the pizza. Afterward, we can watch a movie together to take your mind off of the meal.”

6. If your child still isn’t able to comply, set a limit or communicate a consequence.

An example of a consequence might be 10 more minutes at the table and then supplementing for the calories your child was unable to consume.

Conclusion: The Healing Power of Families

Eating disorders are complicated mental illnesses that can interrupt families and leave parents feeling disconnected from their children. This makes sense and you aren’t alone if you are a parent who is feeling this way. Eating is a large part of the family experience as it is a way of connecting and sharing memories.

Even though it can be scary and overwhelming, willing parents and caregivers can be a big asset to their child’s recovery. If you are a parent of a child with an eating disorder and are interested in more resources for how to support your child’s recovery, visit Dr. Adele Lafrance’s website where you can find lists of workshops, books, and articles on these topics.

In addition, Hilltop Behavioral Health takes a family-based approach to treating children with eating disorders. If your child needs a therapist who can support them in their recovery, you can reach out to Hilltop’s team, and they can offer further insight into which therapist would be a good fit for your family.

References

Dolhanty, J., & Lafrance, A. (2019). Emotion-focused family therapy for eating disorders. In L. S. Greenberg & R. N. Goldman (Eds.), Clinical handbook of emotion-focused therapy (pp. 403–423). American Psychological Association. https://doi.org/10.1037/0000112-018

Stillar, A., Merali, N., Gusella, J., Scarborough, J., Nash, P., Orr, E., Henderson, K., Mayman, S., Files, N., & Lafrance, A. (2023). Caring for a child with an eating disorder: Understanding differences among mothers and fathers of adolescent and adult children. European eating disorders review : the journal of the Eating Disorders Association, 31(1), 87–97. https://doi.org/10.1002/erv.2935