Family Therapy

Family Therapy for Eating Disorder Recovery in Pittsford, NY

When a child, adolescent, or young adult is struggling with an eating disorder, the whole family is affected. Parents lie awake running through meals in their heads. Siblings feel invisible or walk on eggshells. Mealtimes become battlegrounds. The love is enormous — and so is the exhaustion, the fear, and the helplessness.

Family therapy creates a space where all of that can be held. Together.

Family Based Treatment (FBT): An Evidence-Based Approach

For families supporting a young person in eating disorder recovery, I draw primarily on Family Based Treatment (FBT)— also known as the Maudsley Approach — which is one of the most well-researched and effective treatments available for adolescent anorexia nervosa and other restrictive eating disorders.

FBT is built on a core, empowering premise: parents are not the cause of the eating disorder, and they are the most powerful resource in their child's recovery. Rather than removing the young person from the family system to treat them in isolation, FBT works to mobilize the family — particularly parents — as the primary agents of nutritional rehabilitation and recovery support.

Treatment typically unfolds in three phases:

Phase 1 — Weight Restoration and Parental Control of Eating
Parents take an active, directive role in supervising all meals and snacks. This phase is often the most intensive and the most anxiety-provoking. The work of therapy here is to help parents act as a united, compassionate front — to externalize the eating disorder and separate it from their child — while reducing guilt, conflict, and blame within the family.

Phase 2 — Returning Control to the Adolescent
As weight is restored and the young person demonstrates increasing stability, control over eating is gradually and thoughtfully returned to them. Family sessions shift toward exploring how the family can support growing autonomy while maintaining connection.

Phase 3 — Establishing a Healthy Adolescent Identity
Recovery is not just about weight restoration — it is about the young person reclaiming their identity, relationships, and future. This phase attends to developmental tasks that may have been interrupted by the eating disorder and to the longer-term health of the whole family system.

Grounded in Relational-Cultural Theory

FBT provides the structure. Relational-Cultural Theory (RCT) provides the heart.

Throughout every phase of treatment, I hold the relational reality of the family in view. Eating disorders thrive in disconnection — in silence, in shame, in the feeling of being alone in one's struggle. Recovery happens in the context of authentic, mutual relationships where people feel genuinely seen and less alone.

This means that family therapy in my practice is not just about what parents do at mealtimes. It is about how family members relate to one another — how they repair ruptures, how they hold space for one another's fear and grief, how they find their way back to connection after an illness that can make everyone feel isolated. I pay close attention to the relational dynamics within the family, including the ways in which larger forces — cultural messages about bodies, weight, and food; family history; and systemic stressors — have shaped each person's experience.

Who Family Therapy Is For

I offer family therapy for a range of family configurations and needs, including:

• Parents of children or adolescents in active eating disorder recovery who want to implement FBT with professional guidance

• Parents of young adults who are navigating how to support recovery while honoring their child's emerging independence

• Siblings who have been affected by a family member's eating disorder and need space of their own within the family work

• Grandparents or other caregivers who play a significant role in the young person's daily life and nutrition support

• Families earlier in the process who are not yet sure what they're dealing with but know something is wrong and want help figuring it out

You do not need to have a formal diagnosis in hand before reaching out. If food, eating, or your child's relationship with their body is causing significant distress in your family, that is enough.

What to Expect

Family therapy sessions are typically 60–90 minutes and may include the full family, a parent or caregiver subsystem, or a combination depending on the phase of treatment and what is most clinically useful at a given moment. I work collaboratively with any other treatment providers involved in your child's care — including pediatricians, dietitians, and psychiatrists — to ensure a coordinated, consistent approach.

Sessions are available in person in Pittsford, NY and via telehealth for families across New York State.

A Note to Parents

If you are reading this because your child is struggling, I want you to know: you are not to blame. Eating disorders are serious, biologically influenced illnesses — not the result of parenting failures. The fact that you are here, doing research, looking for help, is already an act of love and advocacy for your child.

This work is hard. And you do not have to do it alone.

Schedule an Intake Appointment →

Questions first? Reach out at connect@daytonwalsh.com or 585-210-2028.

Dayton R. Walsh, PhD is a licensed clinical psychologist in Pittsford, NY specializing in family therapy for eating disorder recovery using Family Based Treatment (FBT) and Relational-Cultural Theory. She serves families in the greater Rochester area and offers telehealth throughout New York State.