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WORKING WITH FAMILIES

I aspire to continually work to understand and hold space for the complexities and intersectional (Crenshaw, 2010) ways in which we bring our multidimensional identities and experiences into all different spaces—including this one. With that, biases and blind spots are with us—please let me know if you have feedback.

Identities and positionality: Bringing awareness to and action around the layers of oppression—systemic and interpersonal—that infiltrate the work. Acknowledging the harmful impacts of white supremacy, integrating gender-affirming relationships and care, recognizing the aspects of our systems that contribute to trauma, etc..

Awareness of and naming the ways that external and systemic messaging about bodies, weight, diet culture, and more impacts young people and families.

Interpersonal relationships as vehicle for health and recovery journey 🡪 relational reframing rooted in the identities we carry and the experiences we bring into our interactions.

No one size fits all: Holding space for non-linear (if this🡪then that) pathways toward recovery. Multiple pathways can and do exist simultaneously. Leaning into what works for the humans in front of us. Recognizing the importance of, strengths, and limitations of current research, which holds its own biases and blind spots. We can and should be more expansive.

Jatlow, D. & Barron, M. (2018)

Adapted from Centerpoint’s Multidimensional and Multimodal Model of Support for Parents, Families, and Caregivers

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WORKING WITH FAMILIES

All needs, challenges, and presentations are understood as opportunities for growth and change and recognizing the vulnerability in engaging in change processes. Recognizing different stages, acuity, and variability throughout the work.

Complementary expertise: Family as expert on their experiences. Dismantling expert stance towards collaborative, co-constructed, and multi-directional understanding and assessment that is continuous and ongoing. Recognizing when ED volume is turned up and how to co-explore staying the course, shifting the course, or changing the course.

Teaming: You don’t need to know or provide everything with collaborative teaming. There will always be things we know, things we don’t know, and things we “don’t know we don’t know”. Building in highly intentional consultation and supervision within and across disciplines can be powerful, efficient and highly effective.

Strengthening relationships is, of course, central. Building in time and space during each session to fortify trust and connection honors the work (both visible and invisible) that families have already been doing prior to this “chapter” and encourages the integration of dynamic, creative, playful, joy-filled experiences.

Understanding how people experience their interactions with others. Nurturing a compassionate environmental and interpersonal space for all to promote healthy risk. Staying close to all communication, beliefs, values and ideas from each person so they feel heard and seen in the room. Learning about self in relation to others as a foundational meaningful skill.

Understanding defensiveness and other presentations (worry, control, fear, avoidance, etc.) as protection. Acknowledging, naming, and addressing the harder parts with curiosity to lower the “threshold” for engagement. Knowing when to slow down or pause to do in vivo coaching or mindfulness and when to engage more actively in co-thinking through the ED’s stronger hold and trajectory (not simply a point in time, but also a more broad focus, with team input).

Jatlow, D. & Barron, M. (2018)

Adapted from Centerpoint’s Multidimensional and Multimodal Model of Support for Parents, Families, and Caregivers

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WORKING WITH FAMILIES

Multiple perspectives exist simultaneously—this is expected. Enhancing developmentally-matched understanding and communication honors different viewpoints and approaches with the family empowered to navigate through with their touch and the family worker bringing a “light touch”. This work is focused on whole family health and wellness with a concurrent focus on supporting the young person towards recovery.

Engaging with the whole human: Reconnecting to the parts of each family member outside of the ED can re-ignite strengths, passions, interests, and successes. Identity development work outside of the ED has health promoting properties.

Multidimensional needs require compassion, love, tenderness, patience, warmth & creativity.

Transparent positioning of continuous improvement for all: What’s working, what’s not working (and for what reason), and how to move forward, navigate, and make decisions in best interest of health and wellness.

What comes up for us as providers when working with a family impacted by eating issues and how might we work through that? What questions, curiosities, needs or supports are coming up for you as you think about this work? How might we hold hands as an interdisciplinary provider community around issues that feel complex, overwhelming, or that carry risk? Let’s connect, share, and learn together. Please be in touch!

Jatlow, D. & Barron, M. (2018)

Adapted from Centerpoint’s Multidimensional and Multimodal Model of Support for Parents, Families, and Caregivers

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REFERENCES

Crenshaw, K. W. (2010). Close encounters of three kinds: on teaching dominance feminism and intersectionality. Tulsa Law Review, 46(1), 151-190.

Pullmer, Rachelle, Jennifer S. Coelho, and Shannon L. Zaitsoff. (2019). "Kindness Begins with Yourself: The Role of Self‐compassion in Adolescent Body Satisfaction and Eating Pathology." The International Journal of Eating Disorders 52.7, 809-16. Web.

Rienecke R. D. (2017). Family-based treatment of eating disorders in adolescents: current insights. Adolescent health, medicine and therapeutics, 8, 69–79. https://doi.org/10.2147/AHMT.S115775

Scarborough, J. Understanding Gendered Realities: Mothers and Father Roles in Family Based Therapy for Adolescent Eating Disorders. Clin Soc Work J 48, 389–401 (2020). https://doi-org.ezproxy.uvm.edu/10.1007/s10615-019-00706-2

Sepulveda, A.R., Lopez, C., Todd, G. et al. An examination of the impact of “the Maudsley eating disorder collaborative care skills workshops” on the well being of carers. Soc Psychiat Epidemiol 43, 584–591 (2008). https://doi-org.ezproxy.uvm.edu/10.1007/s00127-008-0336-y

Tagay, S., Schlottbohm, E., Reyes-Rodriguez, M. L., Repic, N., & Senf, W. (2014). Eating disorders, trauma, PTSD, and psychosocial resources. Eating disorders, 22(1), 33–49. https://doi.org/10.1080/10640266.2014.857517

Tinker, C. & Brown, C., Eds. (2019). Hope for Recovery. Brown Writing and Editing LLC.

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