The Maudsley Model of Family Therapy

The following is a comprehensive introduction to the Maudsley Model of Family Therapy.

Reference: The Oak House, Victoria.

The Maudsley Model is a highly successful, family-based treatment approach utilising and integrating theories from a number of family therapy approaches. Originating in the United Kingdom in the 1970's, it empowers the family to be closely involved in the recovery process. The family therapy team at CREDS is fully trained to provide this unique and specialist therapy model. For adolescent clients, where this family-based program (Maudsley Model) is not suitable, we provide an adapted version of the programme, where frequency of therapy sessions varies depending on the individual needs of the client and the family.

The Maudsley Model aims to assist parents in bringing about the young person’s recovery from the eating disorder, in the home setting. The approach involves all family members living at home, (including siblings) with the young person is unwell. It endorses their experience in knowing their family members better than anyone else and therefore, opposes the tradition of finding families to blame for the eating disorder. The Maudsley Model sessions are conducted by CREDS practitioners who are specifically trained in this method of treatment. The outcomes for this treatment approach have been found to be the most successful approach in bringing about recovery. Traditionally, research has shown 40-50% of people with anorexia nervosa recover over 4 - 7.5 years, once treatment is sought. Undergoing treatment with Maudsley Model, independent international research demonstrates a recovery rate of 75-80% after one year of treatment for young people with anorexia nervosa. The Maudsley Model is beneficial for treating all types of eating disorders.

The Core Principles of the Maudsley Model

1. No one is blamed for the eating disorder, and recovery is prioritised over finding cause

2. The family is encouraged to separate the young person from the eating disorder, and the target of intervention is the eating disorder

3. The family’s own resourcefulness and expertise is respected

4. Hospitalisation is seen as a temporary solution

5. Family members are assigned roles

6. Medical safety precedes developmental issues

Three Phases of Maudsley Model Treatment:

Phase 1

• Weekly sessions (averaging 20 sessions - more if the eating disorder has been long term) until 90-95% ideal body weight is achieved.
• Every session involves weighing the young person at the beginning of the session.
• Parents are given the task of re-feeding the young person and siblings are given role of supporting the young person’s distress during this process.
• The eating disorder is ‘externalised’ – to manage guilt, blame and anger.

Phase 2

• Fortnightly sessions (averaging 9 sessions in total) to maintain weight at 90-95% AND the young person eats without cajoling by parents
  Every session involves weighing the young person at the beginning of the session
• Very gradually, the parents allow the young person to reclaim control over their eating and exercise behaviours and choices
• The ongoing impact of the eating disorder on the young person’s life is explored as all components of the eating disorder need to be challenged
• The young person restarts, or further develops, contact with peers and the adolescent-adult world

Phase 3

• Monthly sessions (averaging 6 sessions in total) occur when the parents are convinced the eating disorder will not return
• Adolescent concerns are isolated and addressed and the family is supported through problem solving to deal with these concerns
• Weighing of the young person is no longer necessary