Why I can't do the Maudsley approach

  1. My kid is too strong-willed.
  2. I don't want my child to hate me.
  3. I tried making her eat before and it didn't work.
  4. He has to want to change.
  5. Her therapist doesn't believe in it.
  6. His illness isn't that bad.
  7. Her illness is far too serious for that.
  8. No one told me about it.

I've heard it all.

  1. Your child's ILLNESS is strong-willed. The stronger your child was, the more the ED has to use against your child, the stronger YOU need to be to protect the patient.
  2. I see lots of former patients who hate their parents, but they aren't the ones who got successful Maudsley therapy.
  3. It isn't 'making them eat,' it is a treatment approach that helps you support your child in ending malnourishment and ED behaviors.
  4. No one wants swimming lessons when they're drowning. Insight and motivation are results of successful treatment, not a prerequisite.
  5. FBT/Maudsley is not the Tooth Fairy. It is a well-established model of care with more research to support it than any other approach. Not believing in it says more about the clinician than the method. Most therapists do not receive training in the causes and evidence-based treatment of eating disorders. Your child deserves one who has.
  6. Pregnancies, government programs, and infections start small, too. Early intervention offers the best chance of full recovery.
  7. Maudsley therapy isn't a self-help program. It is done with a trained treatment team and under medical supervision with full knowledge of the medical and psychological seriousness of the illness.
  8. It isn't your fault that no one told you, but now that you know you can act. Find evidence-based care, and put everything else - including regret - aside. When your child is well, join the activists out here trying to improve things for all families faced with an eating disorder.


  1. i could change this to active words about why others think we can't or shouldn't do MT. I really appreciate your responses written out so eloquently.... I am going to memorize them so I will have quick responses when faced with these same discouraging or questioning words.

  2. So effectively spoken! ED finds ways to overcome barriers that stand in it's way therefore it is our responsibility to the people that we love, care for, treat to do everything and anything to stop ED and promote healing and recovery point blank!

  3. This is really helpful and something I'll point care-givers and treatment professionals to. Very concise, to the point, and direct.

  4. We did the Maudsley Method as that was the only treatment available here in Canada. I followed the requirements to the letter. My daughter continued to worsen. I quit a job I loved to devote myself 24/7 to helping her beat this illness. As she got worse I continued to step up my efforts. I viewed the ED as the invisible bully that was harming my child and I refused to let it continue. One day in April 2010 she told me that she couldn't eat. As instructed I told her that not eating was not an option. After 5 hours where she didn't eat one bite of food she pushed passed me screaming "I hate you" and ran to her room. I was shocked and after a few minutes went to her room. I am glad I did as I discovered her suicide attempt. We rushed her to the hospital for the first of what would become many many admissions.

    When she was in hospital I lived there. I slept in a chair and provided 24 hour a day monitoring. I did nothing but monitor, support and read how to help your child beat an eating disorder as well as everything else I could. I didn't see friends or spend anytime doing anything other than trying to help my daughter. Everytime her doctor and therapist said that I had to do more I did more. I begged them to help but they had no help to offer.

    Thankfully after months of hospitalizations that brought her weight up only to see it fall again, she was approved for out of country treatment. If she hadn't gone I know that I would have lost her. I am now unemployed as I have mental health issues stemming from the constant stress and lack of sleep during those 2 and a half years. I developed serious sleep issues, PTSD and severe depression. I am now being treated and am hopeful that I will be able to overcome and go on to live a productive life.

    I can see from your post that you are a strong supporter of Maudsley and yes the treatment model can be a very effective one but there are times when it fails no matter how much a family does. I know that there was nothing more that I could have done to help and in spite of all the effort I and the rest of our family made her illness was too serious.

    My only issue with Maudsley is in the application. In our case it was used as a cop out for a health care system that would rather see a parent wear themself down to the breaking point than provide a more costly treatment. My child was on a feeding tube with her heart at risk of failure and that was the only reason we got help. Due to my experience I am not a fan, I would never want to see anyone have to do what I did. It was way beyond too much.

    My daughter is on the mend. She is grateful for all that I did and has told me that I saved her life. No matter how much damage was done to my mind body and soul, her recovery is worth it. I just wish that there was more help and that I and my family didn't have to go through this alone

  5. Anonymous, you have my complete sympathy and my complete agreement. FBT/Maudsley should not be the only option and if a patient is not progressing in a short time with the approach of course it needs to be changed. Parents should not have to carry the entire burden unsupported and there should always be hospitalization or respite available as needed.

    Making sure parents are given this option and supported fully is my goal -- not to have parents ONLY get this option. FBT/Maudsley isn't a panacea or a magic formula.

    I think of it more as an antibiotic: to be administered carefully and monitored - and changed to a stronger or different formulation when appropriate. If the program isn't working we wouldn't just stick with doing the same thing, but we don't consider the antibiotic the problem.

    Parents who are given the "go feed your kid" without assistance and without an alternative aren't being offered appropriate FBT or ED care.


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