Evaluation: The Maudsley Method of
Treating Anorexia
Phase One: Weight Restoration
A therapist works with the patient's
family in dealing with the dangers of
malnutrition associated with anorexia.
They help the parents in re-feeding their
child, and also gets any siblings involved
to support the patient through the
re-feeding process.
The therapist also works with the
parents to ensure there is no criticism or
blame being placed on the individual.
Instead, the therapist helps to
externalise the disorder by making the
point that the symptoms are out of the
patient's control - the therapy is
judgement-free.
Family based therapies like the Maudsley Method is only useful if
the individual has a family that is willing to participate. This is
especially important as it can be a time consuming and stressful
process for both the patient and the families (a lot of strain is put
on the relationship between the patient and their families,
particularly because in this stage, the individual may feel forced
into eating etc which can be upsetting). Therefore, the method may
not be suitable for all families.
Phase Two: Returning Control to the Adolescent
When the patient is seen to
be steadily putting on
weight, and seems open to
an increased food intake,
phase 2 begins.
Phase 2 serves to encourage the parents of the
patient to help the patient take control over eating
again. For example, the parents may allow their child
to eat lunch at school on their own once again,
rather than the parents having to be there to ensure
feeding is happening. This gives the individual who is
recovering a sense of more control and
independence. If a parent is unsure whether their
child will feed themselves, compromises can be
made. For example, the individual can go out with
friends, but may have to eat with the family
beforehand to ensure that they will eat.
As the Maudsley Method focuses largely on
adolescents, it may not be a suitable method for
everyone, such as adults who are suffering from
anorexia - in these cases, the parents of these
individuals have less control as they are adults now.
Dare et al found that the Maudsley method was
good in terms of effectiveness for adolescent,
however was ineffective with adults. This supports
the idea that the Maudsley Method is not a
method which cannot be used to treat everybody.
Phase Three: Establishing a Healthy Adolescent Identity
Phase 3 begins when the
individual is able to maintain
a weight that is above 95% of
their ideal body weight, and
any self-starvation issues
have been abandoned.
The focus of phase 3 shifts from the impact symptoms
have had on the individual to the future and external
problems that they might face. This is to ensure they
build a healthy adolescent identity. This can be dealing
with issues that were put on hold as a consequence of
anorexia (e.g. puberty and dealing with periods for girls),
building healthy relationships with others around them,
and coming up with suitable parental boundaries so that
the individual can maintain their own sense of
independence and individuality. Basically, this is the
stage where they are readied for complete integration
back into society.
Lock et al compared family based therapies like the Maudsley method
with adolescent-focused therapy and found no differences at the end
of the study. However, after 6 and 12 months, family-based therapy
was shown as being more successful in terms of remission. This
suggests that family based therapies are better in the long term.
The Maudsley Method is a
family-based therapy which aims to
rehabilitate those suffering from
anorexia. It often occurs within
15-20 sessions over a 12 month
time frame. It uses three different
phases.
LeGrange and Eisler found that up to 90% of individuals
that took part in family-based therapy fully recovered.
This was a much larger percentage than the amount
who fully recovered attending specialist referral centres
(only 50% fully recovered). This suggests that family
based therapies are extremely successful for individuals
suffering from anorexia.
This is supported by Nauert who found that more than 50% of
individuals who used the Maudsley method were in full remission
after 1 year, compared to only 23% of using adolescent-focused
therapy. Only 10% of those that took part in the Maudsley method
were found to have relapsed. As this supports the findings of
Legrange and Eisler, this suggests that there is reliability in saying
that the maudsley method is an effective way of treating
anorexia.