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Hilary Thomson

Emotion Focused Family Therapy (EFFT), and how it can really help you and your struggling teen

Today is International Youth Day and NIED would like to acknowledge all the teens and young adults in Canada who are struggling with mental illness. You are not alone.


Eating Disorders are mental illnesses that often (but not always) show up in adolescence. Although Eating Disorders can affect people of all ages, genders, races, and socioeconomic backgrounds, many often report pre-occupations with weight and shape starting around puberty. This is usually while they are still in school and living at home with their parents, who may not know what to do if their child is showing signs of an Eating Disorder.


Dr. Shari Mayman has been working in the field of Eating Disorders for 15 years. She started her career as psychologist in the Children Hospital of Eastern Ontario (CHEO) Eating Disorder program where she worked with many children and teenagers struggling with Eating Disorders and their families. At CHEO parents were heavily involved in their children’s care, as the program used a family-based approach. Dr. Mayman says that family-based therapy is an approach that is proven to work well, but it didn’t have a strong enough focus on the multitude of emotions that come up during the recovery process, both for the patient and their caregivers.


About ten years ago two psychologists, Dr. Adele Lafrance and Dr. Joanne Dolhanty, filled that gap with the creation of Emotion Focused Family Therapy (EFFT), a modality on which Dr. Mayman’s current practice, at Anchor Psychological Services in Ottawa, is focused. It was created to support parents of children of any age support their loved ones in recovery (both emotionally and practically), and to address “emotional blocks” that may be getting in the way of a them providing this support. Dr. Mayman says these “emotional blocks” are normal and expected, and often show up in the form of guilt, with parents wondering what they did to cause their child’s Eating Disorder. “Shame and self blame often come up,” Dr. Mayman says. “If you think you are the problem, then it is hard to be part of the solution.”

EFFT is focused on breaking down that self blame, as well as other emotions such as fear, anger, resentment, and grief, and giving caregivers the tools they need to support their own and their child’s emotional needs. Through a process called emotion coaching, parents and caregivers are taught how to coach their children through difficult feelings, which are often at the crux of the Eating Disorder. “Emotional avoidance is central to all mental health issues,” Dr. Mayman says. “Restricting, bingeing, purging and over-exercising are all emotion-numbing strategies.” EFFT also focuses on teaching caregivers strategies to facilitate symptom reduction, and to deal with the intense emotions that arise when symptoms are reduced or eliminated.


Another impactful component to EFFT is the repairing of any relational injuries, both past and present. This is not to place blame, but to create the trust that is needed in order for parents to effectively support their child through the recovery process. “Caregivers have this tremendous healing power when they have compassion and empowerment holding them up,” Dr. Mayman says. “Then they are also more ready to repair things that need to be repaired.”


By instilling parents with the confidence and tools they need to support their children, they are more likely to help them make change in a way that is sustainable and effective for everyone. Dr. Mayman says their goal is to have parents and caregivers acting like a Saint Bernard, with sensitivity for their child’s struggles; but also a steady and assured response to emotional stress. “It’s focused on empowering caregivers and giving them the ability to act as healing agent.”


Dr. Mayman wants to stress that the tools that are the foundation of EFFT are learned, and no parent should feel badly about not having the knowledge to heal their child’s Eating Disorder in their back pocket. This is why Dr. Mayman and her partner at Anchor Psychological Services, Dr. Katherine Henderson, offer workshops for parents three to four times a year, to help teach the EFFT skills in an immersive setting. Even though their practice is based in Ottawa, Dr. Mayman says there are EFFT practitioners all over Canada.

While EFFT is fairly new on the scene in the treatment of Eating Disorders it has spread like wildfire in treatment spaces across the country because of its effectiveness. For more information about EFFT or to find a practitioner in your area visit. www.efftinternational.org.

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