About FBTSCM
During FBT, the family is actively involved from the start of therapy in order to support the child's refeeding and long-term recovery within the familiar home environment. FBT helps parents to help their children. It focuses on the resources that every family has, even in times of crisis. Ideally, the entire family, including siblings when possible, participates in the therapy sessions. The FBT sessions take place weekly at the beginning of treatment. As the therapy progresses, the time between sessions increases.
FBT is a standardised, manualised approach in which all therapists follow the same principles and procedures, while taking into account the individual needs of each family. FBT is broadly divided into three phases:
Phase 1
Refeeding: In this phase, the parents take responsibility for their child's food intake, with guidance and support from the FBT therapists.
Phase 2
Handing responsibility back to the child: Once sufficient weight has been gained and the patient is better able to separate themselves from the eating disorder, the parents gradually hand back the responsibility for eating to their child in an age-appropriate manner.
Phase 3
Focusing on the individual issues of the affected child: When the patient is able to hold responsibility for eating again (to an age-apropriate degree), the family can begin to address the individual goals of the child/adolescent at the end of therapy.
Close family cooperation and regular session attendance are essential throughout the entire course of therapy.
The FBTSCM treatment team
FBTSCM treatment is carried out by a multidisciplinary team that is responsible for a variety of tasks: the FBT therapist conducts the therapy sessions together with the family, the FBT clinician monitors the patient's medical stability and is also responsible, where applicable, for managing the medication of co-existing mental health disorders or addressing other physical or psychiatric needs.
The study examinations are carried out by the FIAT study team, which includes conducting interviews and handing out tablets with electronic questionnaires, as well as recording height, weight and other physical parameters. The entire FIAT multidisciplinary team meets weekly for joint consultations and supervision.
FBT as a stepped-care model (FBTSCM):
For the FIAT study, the FBT method originally developed in the USA was adapted to the German healthcare system. Since the FIAT study is intended to treat patients with severe AN for whom inpatient treatment is intended, according to treatment guidelines, an adequate safety net is important. If weight does not increase adequately, the risk of chronicity (i.e. long-term illness with potentially more harmful consequences) also increases. In the FIAT study, FBT is therefore applied within a stepped care approach, with gradual intensification up to short-term inpatient stabilisation if progress is lacking.
If an inpatient stay longer than six weeks is necessary, or if weight loss continues after a short inpatient stay, the patient is transferred to standard inpatient treatment. This means the treatment with FBT is ended, and the patient continues to receive inpatient treatment followed by regular outpatient care. As a result, the risk of prolonged illness is minimised and all patients receive the type of treatment best suited to their individual needs.
"FBT enabled me to stay in my familiar environment and still feel well supported by my therapist and doctor."
Feedback from a patient who received FBT at the Charité - Universitätsmedizin Berlin