Recovering At Home: Understanding the Benefits and Challenges
Creating a nurturing home plays a pivotal role in recovery. Family involvement in eating disorder recovery leads to higher success rates and stronger resilience. Whether or not an individual goes to a hospital treatment program, eventually they have to come home. Creating a strong foundation in the home, and within the family dynamic is a key pillar for lasting recovery, and for many families, this can be implemented from the start of the recovery journey.
Let's make home a foundation of healing.
Our programs are designed with a supported FBT approach. The family is involved and a vital component of the care team; the difference we provide is full support along the way. The family or caregivers are not expected to know how to do recovery at home - we provide the structure, the map, the monitoring and the supervision required to successfully heal in the home environment, with help from the family.
Clinical Advantages of Family-Based Treatment
Higer Rates of Recovery:
Research indicates that FBT leads to higher rates of full remission from anorexia nervosa compared to traditional hospital-based treatments. Studies have found that approximately 40-50% of adolescents treated with FBT achieve full remission at the end of treatment, compared to around 20-30% with traditional treatments. There have been less studies for other types of eating disorders, however, at The Holistic ED Recovery Center we have seen great success with bulimia and EDNOS recovery too.
Lower Relapse rates:
FBT has been associated with lower relapse rates compared to hospital-based treatments. Long-term follow-up studies have shown that a significant proportion of adolescents who receive FBT maintain their recovery even several years after completing treatment.
This is in part due to decreasing the risk of the “boomerang effect” that happens to a lot of patients who have been in a highly structured, very clinical and completely monitored environment, and upon discharge, experience an almost whiplash-like change in their daily routine. Many hospital programs focus on weight restoration, symptom interruption and physical stability, but lack appropriate transitional care. A patient leaves treatment and returns to the environment that facilitated the eating disorder. The family is not always equipped or properly educated or supported on how to keep moving through recovery in the home environment.
Reduced Treatment Duration:
FBT is typically a shorter-term treatment compared to hospital-based treatments. While the exact duration of treatment may vary depending on individual circumstances, FBT often lasts for around 6-12 months, whereas hospital-based treatments may require longer periods of hospitalization and intensive therapy. This is a guideline, as each person has their unique journey to recovery, however, being in the home environment allows recovery and life to happen simultaneously - the patient learns how to LIVE recovered, rather than recovering and then having to learn how to apply and maintain recovery in the “real world”.
Family Involvement:
FBT emphasizes the importance of family involvement and empowers parents to take an active role in their child's recovery. By focusing on refeeding and restoring weight within the family context, FBT aims to address the underlying dynamics that contribute to the eating disorder and strengthen family relationships.
Benefits Of Home-Based Recovery for the Individual
Protective Factors:
Being in the home environment for the recovery process offers a protective factor; a safe "known" in a journey of unknowns for the individual.
Recovery is hard, and often very scary for the individual. They may not even believe it is possible. Surrounding the person with as many protective and motivational tethers as possible greatly increasing the probability of treatment adherence (ie: sticking with it, even when it gets really hard).
Protective factors are characteristics associated with a lower likelihood of negative outcomes or that reduce a risk factor's impact. Protective factors may be seen as positive countering events, and can help people more effectively manage stressful events, and strengthen other characteristics that minimize the risk of mental health challenges.
Together, protective factors and coping skills can bolster resilience – a person’s ability to “bounce back” or overcome adversity. Resilience involves behaviors, thoughts and actions that can be learned and developed in anyone over time.
Reduce "Boomerang Effect":
We believe that recovery that happens IN your life instead of being removed FROM your life allows the individual and family unit to heal together right from day one. Instead of treatment happening in isolation, removed from the home and removed from their everyday life, our philosophy is to integrate recovery into life immediately.
It is said that "genetics load the gun, environment pulls the trigger", so to expect lasting change and health in an environment that once facilitated the eating disorder is often an unrealistic expectation. Working together as a family means everyone is in recovery - not just the individual with an eating disorder. The entire family may need to learn new communication styles, or work through their own bias and beliefs about health, body and food in a way that supports lasting recovery.
You Know Your Child Best:
Parents and caregivers know their children best.
You are the best resource to establish meaningful patient-centered treatment outcomes. Parents and caregivers are often well-suited to observe change over time that may not be acknowledged by patients in the grips of the disorder or readily detected by others, such as clinicians.
We like to say that “parents are the experts in their child, and we are the experts in ED Recovery”, and together, this makes a powerful team where the child is able to still feel like themselves, not simply a patient, while still receiving the appropriate type of care required to heal.
Enhanced Quality of Life:
Family involvement can contribute to improved overall well-being and quality of life for individuals recovering from eating disorders. Having a supportive family environment can reduce stress and anxiety, improve self-esteem, and foster healthier relationships with food and body image.
The family also has the unique opportunity to model and mirror the behaviours for wellness that the individual in recovery is learning about. It is astronomically helpful to have other people eat in a similar way.
Reduce Treatment Trauma:
Traditional treatment (ie: hospital programs or highly medicalized care) is not for everyone, in part due to different personality types. There is such a high need for care, and incredibly limited resources, which means some programs need to operate in a very black and white, punitive manner. This means a patient can be labelled as “non-compliant” or “treatment resistant”, or could be asked to leave if they slip up and engage in any eating disorder behaviours.
We have personally heard many stories of patients lying to their treatment team about their slips and struggles out of fear of being kicked out of program.
Radical honesty is incredibly important in recovery, and if a patient feels too scared to talk about their challenges, true treatment is not occurring.
Some of the individuals we have worked with over the years have also expressed how traumatized they felt coming out of program, often citing mandatory weigh-ins and seeing their weight, feeling like a number, feeling afraid to make a mistake or struggle, or a total disconnect/distrust of their treatment team.
Challenges With Home-Based Recovery
There are so many positive reasons to choose a home-based program, such as our Intensive Virtual Recovery Program.
It is important that any choice your family makes is well informed, and that includes understanding the potential challenges of doing home-based recovery.
Here are some of the challenges and scenarios when home-based recovery may not be the appropriate fit:
In some cases the individual is not medically stable and needs access to daily monitoring and medical supervision, or requires tube-feeding.
If there is another member of the family who is actively struggling with an eating disorder. It is exceptionally challenging for a person to have to do anything with food when another person at home is doing the opposite.
If home is not a safe place, meaning the individual has suffered trauma or abuse in the home environment.
The family does not have the time or willingness to commit fully to the process of home-based recovery. Many caregivers need to take time off work and/or take their child out of school for a period of time to fully focus on the recovery process. Financially, this is not always an option, although Canadian residents can apply for Caregiver Benefits to help alleviate this.
Home-based recovery may not be appropriate if there are co-morbid disorders that also require specialized treatment. Some common co-morbid conditions that can be present are depression, anxiety, PTSD, OCD, OCPD, ADD/ADHD, psychosis. While some individuals will see their symptoms decrease with physical stabilization, there are certain cases where a more specialized form of care is necessary to treat these conditions.
If the caregivers find themselves overwhelmed and emotionally struggling to provide the level of care and supervision necessary in the early days of recovery. It can be a very challenging experience, and it is OK to acknowledge your own well-being, capacity and limitations.
Choosing what treatment modality (read more about other treatment options here) would work best for your family can be confusing and overwhelming. Even if home-based care is not the right option for your loved one, we are still happy to help. Reach out, book a FREE discovery call, and we can answer your questions and guide you in the appropriate direction for care.