1. Families around the table Helping families feed their anorexic child Ivan Eisler Rotterdam 2010

2. Phases of treatment Phase 1:Engagement and development of the therapeutic contract Phase 2:Helping the family to challenge the symptom Phase 3:Exploring issues of individual and family development Phase 4:Ending and discussion of future plans

3. Phase 1: Engagement and development of the therapeutic contract i.Meeting the family ii.Family perceptions of the problem and its development iii.Exploration of the effect of anorexia on the family iv.Giving information v.Exploring the strengths and resources in the family vi.Addressing feelings of guilt and blame

4. Phase 2: Helping the family to challenge the symptom (1) i.Challenging beliefs about the impossibility of parental action ii.Exploring parental roles iii.Externalizing the problem iv.Discussing the effects of starvation v.‘Extreme’ possibilities

5. Phase 2: Helping the family to challenge the symptom (2) i.The role of the symptom in everyday family interaction ii.Control of eating versus control over life iii.The advantages and disadvantages of change iv.Broadening the time frame

6. Frameworks for change Problem framework and a systemic formulation ----------------------------------------------------------------- Maintenance framework or constraints to change Meaning creating framework Influencing framework

7. Developing a systemic formulation The nature of the problems that the young person and the family are struggling with Problem narratives, beliefs and cognitions Emotions and feelings that may be connected to the problem Mapping significant patterns Strengths, resources and resilience factors ------------------------------------------------------------------- Self of therapist, therapeutic alliance, motivation

8. Maintenance framework Maintenance vs. aetiology Evolution of maintenance patterns Maintenance patterns in the here-and now

9. Meaning creating framework Exploring individual beliefs and cognitions Exploring alternative meanings Exploring shared beliefs Exploring weak or unspoken stories

10. Influencing framework Collaborative relationships, professional expertise and power Choosing and sequencing interventions Self-reflexivity

11. Tuesday 9.30 – 10.00MFG staff meeting 10.00-11.00Multi family introduction [interactional – e.g get families to introduce one of the families who they met at the Introductory evening, exploring expectations from the MFG. 11.00 – 11.30Morning Snack +weighing of the AN young people 11.30 – 12.45Parents: lunch that day planning Young people (YP): ‘Portraying anorexia’ (draw, model or write something that symbolizes anorexia for you/your family) 12.45 - 2.00Multi Family Lunch/observing YP’s eating patterns, how parents mange YP’s eating, intervening to promote change in patterns 2.00 – 3.00Extensive feed back on first lunch experience of all families to each other (separate groups observing) 3.00 – 3.30 Afternoon Snack 3.30 – 4.30Reflections on the ‘portrayals of anorexia’ and pros and cons of staying anorexic