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Childhood Mental Disorders and Illnesses
Parenting
Child Development and Parenting: Infants
Child Development and Parenting: Early Childhood

by Abigail H. Natenshon
Jossey-Bass, 1999
Review by Marilyn Graves, Ph.D. on Aug 15th 2003

When Your Child Has an Eating Disorder

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 away.

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 child.

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.

 

© 2003 Marilyn Graves

 

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