Modified Maudsley - what's up with that?
The term "Modified Maudsley" is way too common. Unfortunately, it doesn't seem to mean what you think it means.
- It can mean "I'm a therapist who believes in the principles of Maudsley but doesn't use it strictly out of the book."
- Or "I involve parents in the treatment, but I don't put them in charge of food."
- Or even "I put parents in charge of food but I don't coach them or involve them in therapy."
- Or it can be what parents say when they're doing home refeeding without working with a professional at all - because they incorrectly think "Maudsley" *is* just refeeding.
- It can also be "I find the manualized Maudsley approach too reductionist but I don't blame parents and I do believe in re-feeding so I use "Modified Maudsley" as a shorthand."
- Infuriating use: "I hear this term all the time but haven't actually studied it or used it but it sounds nice and I'm nice, so I'm going to add it to all the other things I do without actually understanding it or how it might conflict with my other beliefs"
- There's another use, though, and this is what makes it really confusing, which is "We offer all the principles and tools of Maudsley but we ALSO offer other things at the same time - like access to a nutritionist, partial day treatment, a meal plan, cognitive behavioral and DBT techniques, support groups, and other therapies."
- "Normalized nutrition" would refer to an expected first step in ALL eating disorder treatment. It would include optimal weight normalization and cessation of compensatory behaviors.
- "Family-Based Maudsley Treatment" would be a term only used for manualized FBT by Lock and le Grange. No modification. NOT "Maudsley" or "Family Based Treatment" which would both be banned as indistinct.
- "Family Therapy" would also be banned as indistinct, and people would have to choose between "Family-Based Maudsley Treatment" and "Systems Family Therapy" or come up with new terms that don't sound anything like the above.
- "Magic Plate" would be the concept that parents choose, prepare, serve, and monitor "normalized nutrition" with the help of professionals. This concept would not be limited to Family-Based Maudsley Therapy.
- "Inpatient" and "Residential" treatment would be a place for "normalized nutrition" as well as other treatment tools and therapies.
- "Skills-Based Learning" would be used for Treasure's model for carers.
- "Evidence-based treatment" would refer only to treatment elements that have RCT data to support them.
- "Opinion-based treatment" would be everything else, not because these may not be helpful but because they aren't studied and should be.
- Recovery would be re-named Remission and defined as free of behavioral, medical, cognitive, and emotional symptoms of eating disorders - NOT just weight normalization.