FBT / Maudsley
Core Mechanism
Empowered parents take charge of refeeding; externalization separates illness from identity; control gradually returns to adolescent
Ontology
Anorexia as an illness requiring parental intervention (agnostic about cause); adolescent cannot recover alone
Therapeutic Voice
"Your job right now is to make sure your daughter eats. This isn't about blame — it's about her survival."
View of the Person
An ill adolescent who cannot recover alone — parental empowerment is necessary and non-blaming
Evidence
NICE: recommended for adolescent anorexia (NG69)
10+ RCTs
Multiple meta-analyses
Gold standard for adolescent anorexia. Very strong evidence.
Conditions
Epistemology
Blind Spots
Requires highly involved parents; etiology-agnostic stance can frustrate families seeking understanding; narrow to eating disorders
Contraindications
Families unable to participate in meal supervision, active domestic violence in the home, patient with severe comorbid conditions requiring separate treatment (e.g., active psychosis), families where the eating disorder serves a protective function in family system
Training
FBT training workshop (2-3 days) + supervised cases. Comfort with families and ED medical monitoring required
Various training centers; no single body
16-24 hrs + supervised cases
$1K-3K
Equity & Cultural Adaptations
Philosophical Roots
Pragmatism (agnostic about etiology — just refeed); family systems (externalization); medical model (anorexia as illness requiring parental intervention); anti-blame stance
Related Modalities
Clinical Vignettes
See how FBT / Maudsley formulates these cases:
Test Yourself
What is 'agnostic about cause' in FBT?
Show answer
Deliberately avoids blaming families — focuses on empowering parents to refeed.