It’s both exciting and stressful when a child returns from residential treatment for an eating disorder. Parents can optimize success by planning a recovery routine. Here’s a letter from a parent who’s going through this right now.
The letter
Dear Ginny,
My child is coming home from almost two months of residential treatment. Before that, there was hospitalization and some seriously traumatizing eating experiences.
Of course I am happy to have my child stabilized and coming home, but I’m also terrified. How in the world am I going to keep them on the road to recovery?
I feel like it will be all too easy for them to slip right back into the eating disorder behaviors and I really don’t know what I’m supposed to do. I can’t sleep, and I can’t believe that I’m this stressed out about something that really should be a good thing.
What should I do to make this work?
Signed, Hannah
My response
Oh, Hannah, I totally understand. And I want to start by saying that having these conflicted feelings about eating disorder recovery is completely normal.
Dealing with hospitalization and residential treatment is incredibly stressful for parents. I think we need to talk about this more regularly because you are not alone. Your feelings and fear make so much sense to me and to anyone who has been through what you’re going through.
Planning for success = routine
The very first thing we need to talk about after residential treatment is routine.
You said that you’re worried about your child slipping into eating disorder behaviors, and the best way to prevent this is to maintain routines, schedules, and expectations when your child gets home. In some ways you want to maintain the structure that worked in residential treatment at home.
⭐ Get ready for recovery and find out how you can prepare yourself for maximum success.
⭐ Find out the essential steps and family rules you need to have in place for recovery.
⭐ Make your home recovery-ready with six simple steps that anyone can do.
Of course it would be great if your child came home from treatment and you could relax and enjoy being together again. But unfortunately, it doesn’t work that way. It typically takes at least a few months after residential treatment for your child to gather momentum in their recovery. Residential treatment is about stabilizing them, but the real work of recovery takes place at home. And during that time you make a big difference.
I often recommend that parents establish a home schedule that is fairly close to what was happening in residential. At a minimum, you should structure your child’s meals, bedtime, and time for connection with you and other family members. I expect your child will also continue to see a treatment team.
Here are the three essentials of recovering at home:
1. Feeding
Feeding a child in recovery is the cornerstone of success. I suggest that you plan out a schedule and a menu. Feeding a child with an eating disorder is time-intensive and emotionally exhausting. So while planning is a lot of work, I promise it’s better than feeling as if you are underwater, trying to manage your kids’ eating disorder and plan meals at the same time.
During the intensive stages of recovery, it’s a lot easier if parents know exactly when and what food will be served every day. Your plan doesn’t have to be exciting and amazing during this time. Keep it simple and easy.
Your child may not want to eat the food or join you for meals, but this should be a non-negotiable cornerstone of recovery unless explicitly stated by your child’s treatment team.
2. Sleep and social media
Next, I strongly recommend that you establish and enforce a bedtime. This is not easy, but it makes a significant difference in recovery.
Usually, the thing that keeps our kids up at night is social media or other phone and computer use. This is why it may seem harsh, but you should consider having a timeout on your wireless Internet connection and bedtime blocks on your child’s phone.
Sleep is absolutely essential to your child’s recovery. Their brain and body need to heal. And their phone and other electronics are the most common reason for lack of sleep.
Kids absolutely hate this, but I think it’s an important boundary to enforce. I know that it’s tempting to let our kids be free, but recovery is not a time for freedom, but boundaries. Thoughtful and compassionate boundaries are essential. This isn’t about you being rigid or mean; it’s about you loving your child enough to hold them in the safety of the boundaries you set for their health and wellness.
3. Connection
Finally, I suggest that you intentionally plan to connect with your child emotionally at least once per day.
In our busy world it’s all too easy to put our emotional connections on auto-pilot, assuming our kids know how much we love them because we’re doing all the things like taking them to treatment, serving their food, paying the mortgage, taking out the trash, and all the other things that go into raising a family. But relationships don’t run very well on autopilot, and recovery begins with weight and nutrition, but it is sustained by deep emotional connections.
⭐ Get ready for recovery and find out how you can prepare yourself for maximum success.
⭐ Find out the essential steps and family rules you need to have in place for recovery.
⭐ Make your home recovery-ready with six simple steps that anyone can do.
Depending on how disconnected you and your child are right now, this might be hard or fairly easy. I suggest that you set aside at least 20-30 minutes of time each day when you sit together in the same room and either talk or do something together. This is separate from eating. Some people connect well over puzzles, coloring, light yoga, and other activities. Other people connect over a cup of tea and conversation. Maybe it’s a slow walk around the block with your dog or a long drive.
Put this time on your calendar for the duration of early recovery. This shows your child that their recovery is more than eating, and you are dedicated to the care of their whole self.
This time does not need to be deep and meaningful every time to be effective. If you walk the dog together and spend the time talking about how silly your dog is, that’s connection! If you’re working on a puzzle and you spend the time talking about how hard the puzzle is, that’s connection! It’s also OK if there’s nothing to say; just being physically together is healing for your child’s nervous system as long as you are in a positive frame of mind.
A few ground rules:
Avoid asking a lot of probing questions. This is time for connection, it’s not an interview. The best approach is to be comfortable with silence so you make space for your child to open up to you.
Don’t use this time to criticize, correct, or discuss anything that is contentious between you. While I’m not afraid of hard conversations, it’s best to hold this particular time sacred. Don’t use it to make your plan for the next day or tackle any other business you have in mind. Focus on the pleasure of being with your child.
That said, it might not always feel pleasurable, and that’s OK, too. If your child is sharing hard feelings like being sad, angry, jealous, or anything else, listen to their feelings with compassion and empathy, and avoid the tendency to try and fix or otherwise make the feelings go away. Your child’s recovery is dependent upon them feeling difficult feelings without hiding them, so don’t be afraid when they come up!
Managing your emotions
I’ve given you some ideas about structuring your child’s return from residential, and I hope they are helpful! Now let’s take a few minutes to talk about how you’re feeling.
A lot of times when a child is in a medical emergency parents go into a state of high functioning. We are capable of amazing feats of caregiving and sacrifice during an emergency. But emergency mode is simply not sustainable long term. It sounds to me as if you are suffering from symptoms of burnout. To help your child recover, we need to support your emotional management.
To help you recover from burnout, I suggest you gather your resources and ask for help wherever you can. Healing is difficult, and you deserve help. At the same time, you can take good care of yourself by establishing some boundaries in your own mind.
Here’s how to create boundaries in your own mind:
First, notice that you are having racing thoughts or worries. This can take practice, so I suggest you spend a week or so just trying to notice when you’re doing it.
Next, when you notice yourself doing it, I want you to be kind. Don’t say “Oh no! Not again!” Instead, gently and kindly say “Oh! I’m worrying. OK.” Just start noticing and acknowledging your feelings.
Once you start noticing your worries, you can move on to the next step, which is setting boundaries with your thoughts.
You can say to yourself “I have a lot of worries about my kid right now, and that makes sense. But when I worry like this I sap my energy, so I’m not going to do that right now.” Say this kindly and with compassion. You are treating yourself exactly as I suggest you treat your child when they don’t want to eat or have some other eating disorder worry.
Acknowledge the worry, say that it makes sense, and then say that worry is not going to run your life. This is how we let feelings pass rather than getting tangled up in them.
This approach to worry sounds deceptively simple, but it’s not easy. Practicing it is a lifelong process, but it works! The more you notice and respond to worry differently, the less it runs and interferes with your life.
Hannah, what I’m suggesting here is a two-fold approach. First, plan for your child’s return by putting a structure in place that will support recovery. Second, manage your thoughts and worries. Worries always make sense, but when they run our lives we end up struggling, unhappy, and not sleeping.
I hope these ideas help you move into this next chapter of your child’s recovery.
Parent support for return from residential treatment
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