Session 2

Abstract

Session 2 of FBT is traditionally the family meal session, where parents are asked to choose and bring a meal to share during the therapy. Given the divergence of interventions in Session 2 from more traditional therapy meetings, we strive to alleviate clinician concerns about some of the uniquely challenging dilemmas herein. We outline a process for gathering a thorough understanding of mealtimes. Further, we discuss management of in-session eating disorder behaviors that commonly derail parents and clinicians alike. This includes a focus on management of aggressive behaviors and significant emotion dysregulation, addressing food refusal and using paradoxical interventions to evoke the eating disorder in the session. We include basic guidance for families and clinicians about the nutritional needs of young patients with EDs, with the aim of improving parent coaching to enhance their renourishment efforts. A fidelity coding framework for Session 2 is briefly outlined, and a full copy can be accessed in the appendix.