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Parents as Critical Allies on the Eating Disorders Treatment Team

By Nicole Cifra, MD, MPH

Everyone recognizes that medicine has become increasingly complex over the last several decades. With that complexity comes increased need for collaborative care within a multidisciplinary team. As the home of the biopsychosocial model, the University of Rochester was an ideal place for me to train as a pediatrician and then as an adolescent medicine physician.

Practicing medicine in an environment that uses a biopsychosocial approach gave me ample opportunity to learn from professionals from other disciplines. During my pediatrics residency, I became comfortable collaborating with co-workers with backgrounds in social work, psychology, nursing, nutrition, and other medical specialties, to name a few. I learned a great deal, and I have a deep respect for all that these professionals offer to our mutual patients. I also became comfortable and more skilled collaborating with parents. The phrase “while we’re the experts in the medicine, you’re the expert in your child” became one of my most commonly used phrases when admitting children to the hospital with a variety of illnesses. I learned to collaborate with parents to meet our common goal: to optimize the health of their child.

When I started my adolescent medicine fellowship, treating children and young adults with eating disorders became a large part of my practice. I love it. As a result, the role of parents as members of the treatment team has taken on a whole new meaning. Partnering with parents and other family members has been one of my favorite parts of treating individuals with eating disorders. I decided to focus my scholarly work during fellowship on parental experiences and self-efficacy during their child’s treatment for these reasons.

Every patient has a different experience and everyone’s disease process is unique. I’ve found parents to be critical allies in teasing out these nuances. We’re fortunate enough to have a parent-peer mentor through the Western New York Comprehensive Care Center for Eating Disorders who has lived experience as a parent of a child with an eating disorder. She can come alongside families in ways that no one else on the team can, and helps equip parents with valuable tools and information to care for their child. She does an incredible job educating our patients’ parents about their child’s illness, as well as problem solving with them and planning ahead.

But while parents are receiving education on caring for their child with an eating disorder, I’m also learning from them. I learn about their child’s strengths, as often my patients are slow to acknowledge their own assets. I learn about what motivates their child, as well as potential obstacles. Parents fill me in on friendships and connections that the eating disorder has taken away in an effort to keep their child isolated. Their expertise in their child is so important.

Most importantly, though, they give a glimpse of who their child was before the eating disorder ravaged their life. When we see their true self peak through the eating disorder, the parts of their personality that many treatment team members have only heard about from their family, it is the single most rewarding part of my job.

To all of the parents I’ve worked with, thank you for being such a formative part of my education and training. You are the most important member of your child’s treatment team, and I have learned so much from you. Most of all, thank you for letting me be a part of your and your child’s journey.



  1. Michelle Morales

    Thank you Dr Nicole! When the treatment team included me as a vital member of the treatment team it empowered me. My daughters illness often made me question my decisions and parenting. This lack of self esteem was restored when the team treated me as the expert of my child.

  2. Amy

    Thank you Dr. Nicole for choosing the profession you did and validating the important role of parents in the recovery process. As a parent and caregiver in the trenches it means a lot.

  3. Carl

    Thank you. A very informative and balanced article and it is obvious you are passionate about your profession. It really is a multi disciplinary approach. We have a similar approach within our care team. The ‘backstory ‘ is often so important in terms of context and engagement especially when the sufferer is in a poor mental state. Parents need to explain their child and the changes they are experiencing – that is quite healing in itself which is imperative for the carer. And post discharge we are delivering care from home with FBT, monitoring, coordinating appointments etc and need to be engaged with the wider team to address issues and to provide feedback as to what is working and what isn’t.

    I’d like to add that the role of teachers in a ‘non clinical’ facing role at hospital and when home and other mentors are also an important part of the team – in restoring social confidence, reducing isolation, maintaining education and having a positive diversion in what can be a long road to recovery. ED sufferers often feel very judged so having those ‘safe’ non clinical interactions can be very beneficial.

    Thank you once again for sharing a balanced, respectful and very inclusive approach to treating these complex and difficult illnesses and acknowledging our role as parents.

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