The Vital Role of Family Support During Eating Disorder Treatment at Hidden River

It’s no secret that parents who admit a child to residential eating disorder treatment are under significant stress. Concern, fear, and even anger are noticeable in their face, demeanor, and voice. They often describe having conflicting beliefs. For instance, they may believe that their child can decide to stop the disordered eating behavior but also acknowledge that their ability to do so has been woefully ineffective thus far. Arguments in the home regarding meal planning and consumption are often intense. Parents recognize the irrationality of the situation. They have become baffled as to why the eating disorder is occurring when consuming food is a basic skill children learn at a young age. It is also common for the parents to argue with one another while feeling defeated by a mysterious and crafty opponent. On a personal level, parents describe having mindful struggles about loving their child deeply while simultaneously being overwhelmed with antagonistic frustrations caused by the irrationality of their child’s eating disorder

When a loved one enters Hidden River’s residential eating disorder treatment center, parents come with a list of concerns and many questions.

Their child’s safety is high on the list. To begin establishing a foundation for trust, a leading member of Hidden River’s multidisciplinary team meets with them to share the safety precautions the facility has in place. This education is designed to provide reassurance of how their child will be monitored while in residence, as there are several important environmental safety precautions throughout the facility. 

On the day of admission at Hidden River, parents will receive a tour of the grounds and buildings. A tour of the residential house shows its living quarters, bedrooms, bathrooms, group rooms, and dining areas as well as the therapist offices and nursing station. During the house tour, they learn about the security system, including cameras that are monitored by the Charge Nurse, the alarms on the doors and windows, and the electronic fob access. The parents also learn about the levels of observation used by staff to monitor their child over each 24-hour period as well as how our team addresses emergency events.  

Additionally, parents receive a thorough overview of the patient clinical handbook, daily patient schedule, group sessions, therapy sessions, the 5-Phase Program, and therapy assignments to support the patient’s recovery progress. The Hidden River therapy program uses evidenced-based curriculum – including cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT), communications therapy, family systems therapy, and exposure response prevention (ERP) therapy – as core foundations within the counseling approach. 

The Hidden River multidisciplinary team recognizes that the initial 14 days of residential treatment are often the hardest for the patient and her parents.

The lingering banter in parents’ minds – and all too often in the conversations with their daughter – centralize around pressure-filled bargaining from their child during the first couple of weeks of residential treatment. The parents are inundated with pleas to bring her home from residential care with a promise to stop the eating disorder. Parents describe such conversations as being emotionally taxing and highly confusing. The parents “wish” their daughter could commit to becoming healthy without the use of residential care, but her history shows otherwise. The conflict in parent’s minds coalesces around the wishful thinking that their daughter can “make the decision” to stop the eating disorder, but the chaos the family experiences is the factual basis of her history, which clearly illustrates that she cannot stop the behavior on her own volition. 

During the first weeks of treatment, parents are informed that they will receive a significant amount of supportive guidance from the Hidden River multidisciplinary team on how to manage this time. The Hidden River multidisciplinary team is highly experienced with the process that patients experience as they acclimate to the residential care environment. Helping the parents anticipate and navigate the emotional swings, bargaining, anger, and even desperate pleas from their child will benefit the whole family in the short-term and long-term goals of recovery.1

For the duration of the residential treatment program, the multidisciplinary team provides numerous communication opportunities for parents.

On a daily basis, the Charge Nurse is available to answer questions as needed. The Registered Dietitian provides one brief, weekly phone call with a nutrition progress report. The Primary Therapist provides two brief, weekly phone calls in addition to the weekly hour-long family therapy session. Additionally, the Clinical Director facilitates one “check-in” as a supportive measure every week. The multitude of contacts with the treatment team is intentionally facilitated to reassure parents that their daughter is receiving superior care. It also draws them in and establishes their participation as vital to the overall residential treatment process.2 

The Hidden River multidisciplinary team is committed to providing a safe, nurturing, and clinically-supportive environment to their patients. They have extended the focus of safety as a way to help parents successfully navigate the treatment process as well. Rightfully so, eating disorders promote high levels of concern on many fronts. Hidden River is focused on providing reassurance to the parents that their daughter will be treated with care from the moment she arrives on campus.

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1. Mitrofan, O. et al. (2019). Care experiences of young people with eating disorders and their parents: qualitative study. BJPsych Open, 5(1).

2. Accuroso, E.C. et al. (2019). Parents know best: Caregiver perspectives on eating disorder recovery. International Journal of Eating Disorders, 53(8), 1252-1260.


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