Review of "When Your Child Has an Eating Disorder"
By Abigail H. Natenshon Jossey-Bass, 1999 Review by Marilyn Graves, Ph.D. on Aug 15th 2003
This is a workbook aimed at parents and
caregivers. Natenshon is a
psychotherapist and cofounder of an eating disorders clinic. She indicates that the book may be helpful
in providing information for people who are unsure if their child has a problem
and need a starting point. Though it has the word "child" in the
title she points out that the age ranges here are from pre-teen to college
age. She lets parents and caregivers
know how to begin the process of identifying appropriate providers and talks
about developing a treatment team of providers which may include a medical
doctor, nutritionist, psychiatrist, or psychotherapy professional. Natenshon indicates that most children with
eating disorders get better. While this
is true, a small proportion of them die.
She provides information about hospitalization for children who are
medically at risk. In case it is not
clear from reading her book, let me point out that reading a book is not a
substitute for getting treatment for a child with an eating disorder. If you suspect your child has an eating
disorder, it is a good idea to get medical and psychiatric consultations right
Natenshon talks about the emotional issues that may
accompany an eating disorder and looks at issues like need for control and
problems establishing identity. She
says that many people who work in this area feel that independence is a key
emotional issue for children who display problems with eating behaviors but
with her book she gives parents a way of helping and participating in the
treatment without compromising the child's need to establish age appropriate
independence. She employs surveys,
checklists and activities so that the reader can see that they are doing
something tangible to help mitigate the problem. She gives examples of how to open up a dialogue with a child. She explains what one might expect in terms
of feedback from an individual psychotherapist and lets people know about how
family therapy can work as an adjunct to help preserve the child's sense of
respect for confidentiality.
Natenshon talks about the child's resistance to
treatment and about how difficult it can be for some children to express
emotions. On the parents' side she
explores parental fears about what will happen if the issue is talked about
openly. She gives some examples and
workbook exercises about how to bring these things up without alienating the
In addition to information about day treatment or
hospitalization options there is a chapter on medications and how they
work. She goes into some detail about
how a nutritionist is needed on the treatment team. She provides information about what to expect from an insurance
company and how to talk to them on the phone.
There are workbook exercises on how to assess
progress in treatment and she gives guidelines to assess recovery. Throughout the book, she does not focus
solely on eating behaviors but on the complex of emotional and developmental
issues that accompany the symptom.
There is a section on how to help a college-aged
child and a resource list which
includes the names of organizations and facilities. Natenshon includes her web address as a resource. Natenshon maintains an optimistic a solution
oriented approach. She provides parents
and caregivers with advice on how to advocate for their children. She is not blaming or critical.
There appear to be some minor editing problems in
this book. For example, on page 126,
Natenshon says that the medication "Zypresa" is an alternative name
for Wellbutrin, but I think she means Zyban.
Zyprexa or olanzapine is an antipsychotic not an antidepressant. Also, "(MAOIs)" which is beside
the name Wellbutrin probably was intended to go with the two lines above it and
thus is a spacing error in the printing of the book. These appear to be editing errors and do not detract from the
integrity or helpfulness of the advice.
Marilyn Graves, Ph.D. is a clinical psychologist who
has extensive experience working with children and adolescents. She is the editor of the Psychology and
Fiction topic in the Reading and Literature area of suite101.com