Drs. Keifer & Bell are the only board-certified Child, Adolescent & Adult Psychiatrists on Oahu offering comprehensive state of the art treatment for eating disorders. With over 14 years of experience using family therapy for Anorexia Nervosa and Bulimia, and 14 years of experience using Family Based Treatment (also known as the Maudsley Manual), our clinic has helped many patients with eating disorders reach full recovery in a brief period of time with low relapse rates.
History of Treatment for AN/Eating Disorders:
Eating disorders are chronic conditions that can last decades and may result in serious medical and psychological consequences. When a teenager suffers from anorexia, the destructive nature of the disorder can provoke significant strains to relationships with family members, extended family members and others. For years, effective treatment for eating disorders remained elusive. Standard treatment by most mental health providers during this time included individual oriented therapy via inpatient, outpatient or hospital based programs. These traditional models of therapy and treatment, often disruptive to a teenager’s education, social and family life, and were noted to have high relapse rates, remained the only option until the late 1960’s.
During this period, Salvador Minuchin, MD and colleagues at the Philadelphia Child Guidance Clinic, using his structural therapy theory, developed a family model for eating disorder treatment that resulted in extraordinary outcomes with markedly improved relapse rates. Recently, the Maudsley group in London, adopted Dr. Minuchin’s methods and developed a manualized version of family based treatment (FBT). Published outcomes utilizing family treatment for anorexia nervosa by the University of Chicago and Stanford University, demonstrating the efficacy of family treatment — 65-80% of patients are recovered at the end of treatment (6-12 months) and 75-90% are recovered at five-year follow up.
Consistent with Dr. Minuchin’s groundbreaking work decades ago, research suggest marked improvement in outcomes and low relapse rates when families are centrally involved with the doctor in treatment combatting anorexia nervosa and bulimia. Research also indicates early intervention is associated with significantly improved outcomes and cost savings for the patient and family (reduced need for hospitalizations and other expensive, often lengthy treatments).
Why early, highly effective treatment is important:
Historically, clinics offering traditional, individually based/Adolescent focused treatment typically accept the notion that Anorexia Nervosa is, more often than not, a chronic condition, requiring on average 3-5 + years of treatment, with a high relapse rate.
Although not widely available throughout the country, where it is available, family treatment and FBT offer a different prognostic outlook — higher recovery rates and lower relapse rates. Research and clinical experience drive our belief that most patients and families can recover with lasting results while remaining connected to peers, school and their community.
Anorexia Nervosa is the most lethal psychiatric condition, with an estimated mortality rate of 10% per decade, making your choice of treatment vital. When choosing a doctor/clinic for treatment, it is important to know about the doctors training, treatment philosophy, experience and outcomes. Based on the best available research, family therapy and family based treatment should be considered the first line or ‘gold standard’ for a loved one affected by anorexia nervosa or bulimia as using this type of intervention leads to a greater likelihood of recovery and reduces the likelihood of you or your adolescent developing a chronic condition.
Our clinic also has over 10 years experience utilizing the gold standard treatments. Having been mentored by two Minuchin protégés, Dr. H. Charles Fishman MD (former Director of Training at the Philadelphia Child Guidance Clinic) and Dr. Michael Rimm MD (Philadelphia Child Guidance Clinic/UH JABSOM), and extensive experience successfully using FBT/Maudsley manual, our Doctors utilize these proven, highly effective treatment approaches with all of his patients.
While our clinic has not conducted formal research, our clinical results are consistent with the outcomes reported by Dr. Minuchin, Dr. Fishman, the Maudsley group and FBT groups.
What is family treatment? What is FBT?
These approaches can mostly be understood as forms of intensive outpatient treatment where parents, in partnership with the doctor, form the backbone of treatment and play an active, positive and influential role in recovery from anorexia nervosa. Treatment involves weight restoration, supporting healthy relationships, addressing conflict and ensuring healthy teenage autonomy.
The integrated nature of this type of treatment contrasts that of traditional individual/adolescent focused treatment. Simply including the family in counseling and education does not make it ‘family treatment’. Family treatment for eating disorders is a unique intervention requiring advanced skill and experience working with patients and families in a specific manner.
Advantage of finding a therapist/doctor that uses family treatment exclusively:
Family treatment is the gold standard treatment and proven to be the most effective treatment for eating disorders. It is superior to individual/adolescent-focused treatment with respect to weight restoration weight, recovery rate, relapse rate and hospitalization rate.
Additionally, a recent study of over 4,000 patients with eating disorders found that family treatment is the most clinically effective and cost effective approach compared to individual treatment/AFT and mixed treatment (combining individual and family treatment).
If your treatment is not progressing at an acceptable rate or your provider is considering hospitalization or residential treatment, please call The Kahala Clinic for a consultation at 808-888-5228.
Helpful resources: http://feast-ed.org