The Maudsley Method: A No-Blame, Family Treatment Approach for Anorexia

The Maudsley method is a relatively new approach to anorexia treatment. Some methods focus on the roots of eating disorders, trying to find causes and address them. The Maudsley method does not. It simply sees anorexia as a serious illness that must first be addressed by the consumption of more calories. The entire family gets involved to help the person with anorexia get the nutrition she (or he) needs.

The feature of the Maudsley method that makes it most unique is its use of the family of the person with the eating disorder. The child is considered separate from the disorder. No one is blamed for anything, including parents. Quite the contrary: Parents are empowered to think differently and find their own systems for helping their children to eat. This might include creating healthy consequences when they do not comply with eating plans. The idea is to join the parents and their child in the common goal of dealing with the eating disorder.

The Maudsley method wisely focuses on weight gain as the first priority. This has a number of benefits. It gets things moving; immediate action must occur for the person with anorexia to begin the process of eating differently. Further, and more importantly, the body and mind of one who is underweight generally are not working well. Helping her to gain weight, and thus improve the functioning of physical and mental processes, will help her to deal with other counseling issues much more effectively.

As described above, the first phase of treatment helps the child to gain weight. Parents are encouraged to avoid force and punishment and instead use a rewards system based on the child's ability to function. If she is too weak physically to participate in sports, this would be an opportunity for the parents to draw a line -- participating in sports might require reaching a certain weight or strength level, for example.

The second phase of treatment entails transferring control of eating back to the child. The child must demonstrate good weight gain to begin to assume responsibility for her own eating.

The third phase begins when the child can maintain a weight of 95% of her target weight without significant supervision from parents. At this point she can begin individual therapy. This is the time to address issues of childhood and adolescence that may have been relatively untreatable prior to weight gain.

The strength of the Maudsley method is high family (particularly parental) involvement. Because those with anorexia are often very resistant to changing eating patterns, parents must make a big time and energy investment to see the plan through. Also, any parental differences must be set aside to join in the common struggle against the eating disorder.