The Maudsley approach or Family Based Treatment (FBT) is considered to be the treatment of choice for young people with Anorexia Nervosa. However, since the development of the New Maudsley Method in 2010, there has been some confusion between the two treatment approaches.
Maudsley (FBT) is an evidence-based approach that originated at the Maudsley Hospital in London in the 1970’s and 80’s as a preferred alternative to hospitalisation for young people suffering with Anorexia Nervosa. Maudsley FBT is a highly structured treatment that typically involves the family working together for approximately 1 year to help their child recover from this life threatening illness. It is the treatment of choice for children and adolescents under the age of 19 and is most effective if implemented within the first 3 years of the illness. Maudsley FBT is comprised of three stages: weight restoration, returning control of eating back to the young person and establishing a healthy adolescent identity. In the Maudsley FBT approach, parents serve a vital role, in that they are charged with the responsibility of weight restoration and refeeding their child. Siblings also play a role in treatment by acting as a support for the young person. While, this approach can be empowering, parents can sometimes find the process quite challenging and time consuming. Despite this, Maudsley FBT has the strongest efficacy and a faster recovery rate compared to individual therapy.
The New Maudsley Method
Maudsley FBT should not be directly compared to the New Maudsley Method. Unlike Maudsley FBT, the New Maudsley Method is not a treatment approach in its own right but rather is an additional treatment protocol for parents, carers, and clinicians which should be used as an adjunct to treatment. The primary aim of the New Maudsley Method is to reduce stress and empower the family and carers of all sufferers, with a particular focus on older clients and those within the Bulimia spectrum.
Given that the typical age of onset of Anorexia is in the early teenage years, this means that most older clients with Anorexia usually have a prolonged course of illness. As such, it is likely that the family and/or carer have had to live with Anorexia for many years and therefore may have formed rigid patterns of behaving that can act to maintain the illness and prevent them from effectively helping. These behaviours are modifiable by equipping parents and/or carers with a skill set similar to that used by clinicians in an inpatient setting which enable them to communicate with their loved one and to engage their intrinsic motivation to change.
Importantly, the New Maudsley Method takes into consideration the developmental stage of the client by contemplating what level of parental or carer involvement is appropriate depending on the clients age, the progress of treatment, the level of risk and various other practical considerations (such as whether the person with the eating disorder lives with their family and/or partner). The New Maudsley Method is also beneficial for clients with Bulimia Nervosa who may be less willing to involve family members in their recovery process and whose parents therefore have less control over their eating behaviour. More specifically, in the New Maudsley Method the clients have the responsibility not the parents. However, parents and carers are still considered to play a vital role in the recovery process.