Evidence Based Treatment is Flexible and Compassionate: DBT and FBT for Eating Disorders

The most fundamental question in treating eating disorders is “What works?” Eating disorders are so painful and can be so fatal; we want to use the treatment that has the best chance of giving our clients their lives back.

We live in a time when empirical observation can be used to answer this question as more and more research studies examine the effectiveness of various interventions.

Family-Based Treatment (FBT), sometimes referenced as the gold standard for treating eating disorders, is a manualized treatment that gives parents the responsibility for restoring their child's weight and managing eating behaviors. Critics of FBT are concerned that in cases where a parent is abusive, neglectful, or psychologically unstable, this type of parental involvement may increase family dysfunction and in some cases enable a child’s abuser. Others are concerned that FBT addresses only the eating disorder behaviors without understanding the underlying psychosocial dynamics.

In this episode, Abby Sarrett-Cooper discusses her experience combining Dialectical Behavior Therapy (DBT) with FBT to help clients achieve tangible improvement, while also navigating theirs and their families’ emotional realities.

Abby shares her history of struggling with an eating disorder while in an unstable family environment during a time before targeted, evidence-based treatment was available. She speaks about how now she navigates complicated family dynamics and uses FBT and DBT to help parents support loved ones.

Abby challenges the assumption that evidence-based treatment is rigid and distant, and talks about how individualized, client-centered care is a key component of evidence based intervention.

Abby is a Licensed Professional Counselor in New Jersey and Pennsylvania and a Certified Eating Disorder Specialist. She has been in private practice for 20 years, focusing on evidence-based, Health at Every Size (HAES)-informed approaches to treating eating disorders. Her postgraduate training includes certification in FBT and intensive training in standard DBT, DBT for adolescents (DBT-A), DBT for families, and DBT for eating disorders. Abby is an early adopter of FBT in community private practice, and of integrating DBT with FBT to empower families and manage the dysregulation common in treatment.

Outside her practice, Abby served on the psychology faculty at Caldwell University in New Jersey for 10 years, teaching Child Development, Adolescent Development, and Psychopathology, and designing the university’s first Positive Psychology course. Throughout her career, she has been a vocal advocate for evidence-based treatment that is nonjudgmental, stigma-reducing, and myth-challenging. Abby is a member of the International Association of Eating Disorder Professionals and has been active in the Academy for Eating Disorders for 15 years, currently serving as co-chair of its Special Interest Group Oversight Committee.

This is our second time recording this episode so to begin, we briefly reflect on our first time recording and what we'd like to shift this time around.

One of the challenges in the current digitized climate, is that the things we say become so solid and permanent, while as humans we are constantly evolving. I cringe inside when I look at so much of what I’ve written or produced in the past. And I hope that we approach this episode, and all the others, with flexibility and forgiveness, recognizing that each of us is perpetually reflecting, growing, and changing.

To work with Abby, visit https://partnersincounseling.net/meet-the-partners/

For Elka's binge eating recovery program, visit https://elkacubacub.com/