Family-based therapy (FBT) for eating disorders
Eating Disorders are serious mental health conditions that include disordered eating behaviours and body image concerns, which can affect people from all backgrounds.
Family-Based Therapy (FBT) is a leading treatment for adolescents and children with specific eating disorders. At Us Therapy, we have experienced therapists who will help guide families through this evidence-based collaborative approach.
When Are Eating Disorders?
Eating disorders are serious psychiatric conditions that involve disordered eating behaviours and a distorted body image. They frequently stem from complex biological, social and psychological factors and are associated with significant medical and psychological issues.
While eating disorders generally develop during adolescence, they can affect any age, gender or background, and can lead to severe consequences if left untreated.
Types Of Eating Disorders
- Anorexia Nervosa (AN): A disorder characterised by an intense fear of gaining weight, resulting in severe food intake restrictions leading to a significantly low body weight or lack of growth in children or adolescents.
- Bulimia Nervosa (BN): This disorder involves cycles of binge eating followed by compensatory behaviours like purging or excessive exercise
- Binge-Eating Disorder (BED): Recurrent episodes of eating large quantities of food to the point of being uncomfortably full, without purging behaviours. It is frequently accompanied by feelings of shame, guilt and loss of control
- Avoidant/Restrictive Food Intake Disorder (ARFID): Restrictive eating that is not related to body image concerns or an attempt to lose weight. It may be associated with sensory characteristics of food (e.g. colour, texture, smell) and fear of aversive consequences (e.g. vomiting, choking).
- Other Specified Feeding or Eating Disorder (OSFED): When individuals have symptoms that do not meet the full criteria for any of the above-mentioned disorders but still cause significant impairment and distress
What Is Family-Based Treatment (FBT)?
Family-Based Treatment is an evidence-based outpatient treatment used primarily for adolescents with specific eating disorders such as Anorexia Nervosa, Bulimia Nervosa and Avoidant/Restrictive Food Intake Disorder. The goal is to empower parents and caregivers to have an active and central role in restoring their child’s physical health and eating habits.
How FBT Works
Phase 1: Re-Feeding
- Focus on the rapid restoration of physical health
- Parents take full responsibility for meals and eating
- The therapist supports the re-feeding and finding ways to manage any resistance from the adolescent
Phase 2: Transitioning Responsibility Over Eating Back to the Child
- As the adolescent’s weight improves, we will work towards allowing your child to slowly have more control over eating
- The focus in the phases shifts to encouraging more autonomy and normal development in a gradual manner
Phase 3: Returning to Normal Development
- Explore age-based independence and emotional well-being
- Review of adolescent development and identifying upcoming developmental challenges
- May include supporting with a return to school, friendships and building identity
- Shift focus to relapse prevention and long-term strategies
FBT For Anorexia Nervosa
FBT is most effective for adolescents with Anorexia Nervosa. Parents take an active role in helping restore weight and normal eating in their child, aiming to support them through resistance and fear around food.
FBT For Bulimia Nervosa
For Bulimia Nervosa, FBT aims to help parents interrupt their child’s binge-purge cycles, build structure around meals, and support healthy coping strategies to reduce shame and secrecy.
FBT For Binge-Eating Disorder
FBT for Binge-Eating Disorders focuses on reducing loss-of-control eating by helping the families create regular meals, find emotional triggers, and support their child with healthy emotion regulation.
FBT For ARFID
FBT targets the fears or sensitivities causing food avoidance. Parents support gradual exposure to new foods and help reduce anxiety around eating without focusing on body image.
Who is FBT For?
FBT is an outpatient therapy designed mostly for children and adolescents with a specific eating disorder. It is most effective when:
- The patient is under the age of 18 (not necessary, it can be adapted for younger adults)
- The family is willing and able to have an active role in the treatment
- No current major medical and safety risks that require hospitalisation (eg, low heart rate, dehydration)
When To Seek Help?
Here are some signs when Family-Based Therapy can be beneficial for an individual with an eating disorder.
- Your child is losing weight rapidly or lacks developmentally appropriate weight gain
- There is a persistent avoidance of food or a change in eating habits
- An unhealthy preoccupation with weight and body shape, and size
- Social withdrawal, particularly around meal times
- Guilt or distress after eating
- Emotional distress linked to eating and body image concerns
How Can Us Help You?
Experienced Therapists
Our processes and quality assurance is led by Dr Emma Waddington, Senior Clinical Psychologist and Founder of Us Therapy, with over 20+ years of experience in helping individuals in Singapore.
Holistic & Personalised Approach
Our clinicians draw from various therapeutic models to create a holistic approach. At Us, we have seen hundreds of clients and we recognise that each individual is unique. Our approach is tailored to you but always includes customised treatment plans and integrative techniques.
Thorough Assessment
At Us, we pride ourselves on our comprehensive assessment processes. We will undergo a thorough assessment process with you in your first sessions before we come up with a plan for your therapy.
Our Therapists
Here are the therapists who work using this model
What To Expect
Our therapists will support you and your partner through the following process:
Initial Consultation – A Space to Be Heard
The first session is all about getting to know you. It is a conversation—one where you can share what is been on your mind, what has been feeling difficult, and what you would like support with. Your therapist will ask questions about your background, experiences, and goals, but there is no pressure to answer any questions—just a safe space to begin.
Questionnaires & Onboarding Surveys – Understanding the Full Picture
To help tailor therapy to your needs, you may be asked to fill out some brief questionnaires before or after your first session. These can give insight into things like mood, stress levels, relationship patterns, or coping strategies. They are not tests—just tools to help your therapist understand how best to support you.
Individual Therapy Sessions – Your Journey at Your Own Pace
Each session is a step forward in your journey. Therapy is not just about talking—it is about discovering new ways to navigate life’s challenges, make sense of emotions, and feel like you are getting the most out of your life. Depending on your needs, sessions may focus on:
- Exploring patterns of thought and behavior
- Understanding past experiences and their impact on the present
- Developing practical coping tools
- Strengthening emotional resilience
Feedback Sessions – Reflecting and Adjusting
After the first few sessions (or after assessments), a feedback session provides space to reflect on how therapy is going. This is a chance to talk about what has been helpful, what you would like more of, and how therapy can continue to best serve you.
Intervention – The Heart of Therapy
Intervention is where meaningful change happens. Every therapy journey is unique, and the approach will be shaped around what works best for you. Some common approaches include:
🌱 Cognitive Behavioral Therapy (CBT) – Helping to identify and shift unhelpful thought patterns, reduce anxiety, and develop healthier ways to cope and new patterns of behaviour.
🧠 Schema Therapy – Deep, transformational work to uncover long-standing patterns that might be keeping you stuck, often rooted in early life experiences.
💙 Acceptance and Commitment Therapy (ACT) – Learning to handle difficult emotions with self-compassion and move towards what truly matters in life.
🌊 Eye Movement Desensitization and Reprocessing (EMDR) – A powerful approach for healing trauma and distressing memories, helping the brain reprocess them in a way that feels less overwhelming.
🧘 Mindfulness-Based Approaches – Building self-awareness, grounding techniques, and ways to manage stress and emotions with greater ease.
Fees
Individual Counselling Rates
Clinician type
Fees and Duration
Clinic Founder
$310
Principal Psychologist
$290
Senior Clinical Psychologist
$262
Educational Psychologist
$262
Clinical Psychologist
$236
Counsellor
$170
Expressive Arts Therapist
$170
Associate Psychologist
$130
Phone calls / Emails
Clinicians rate pro-rata (10 Mins)
FAQ
What therapy is most effective for eating disorders?
The most effective therapy depends on various factors, including the type of eating disorder, age, available support, and the needs of the individual. Here is a general idea of what usually works best:
- Adolescents with Anorexia Nervosa: FBT involves parents taking an active role in supporting their child in recovery
- Adults with Eating Disorders (AN, BN, BED): Cognitive Behavioural Therapy – Enhanced (CBT-E), which involves targeting unhelpful thoughts and behaviours around food, body image and control
- ARFID: CBT, FBT and exposure therapy are often used to increase the types and variety of foods consumed.
No single approach works for everyone. Early intervention and care based on the needs of the individual are important in recovery!
How to deal with a family member with an eating disorder?
- Stay calm and non-judgmental: Avoid commenting on weight, food, or appearance. Focus on how they’re feeling
- Educate yourself: Learn about eating disorders so you can understand what your loved one is going through
- Encourage professional help: Gently suggest seeing a therapist, dietitian, or doctor. Offer to help them book appointments or to go with them.
- Be patient: Recovery takes time, and relapses may happen. Show love and consistency, even when it’s tough.
- Seek help: Caregivers can attend support groups or caregiving workshops to help them better support the individual.
Is FBT only for Anorexia Nervosa?
No, while it was initially designed to treat adolescents with Anorexia Nervosa, it has been adapted for other forms of eating disorders such as Bulimia Nervosa and Avoidant/Restrictive Food Intake Disorder. Your child’s suitability will be discussed at their intake session.
Is my child involved in sessions?
Yes, they are expected to attend every session, together with the family.
Do parents have to take full control?
In the beginning, yes (Phase 1), as the model relies on encouraging caregivers to override the disorder with the clinician’s support.
