ABSTRACT
Here we outline the most common dilemmas that stump families and clinicians throughout Phase II, as families focus on transitioning greater independence around eating back to the child. For example, as adolescents are deemed ready to take on greater responsibility for managing eating, they are likely able to engage in a more healthy way in treatment. This can pose challenges for both the clinician and parents in knowing when to align with the patient, and when to intervene on eating disorder behaviors. Therefore, we review use of externalization in Phase II, as we have found it helpful to orient everyone to the ways in which the adolescent has progressed, yet continues to remain on some level under the influence of his or her illness. We outline the practical steps that can help patients gradually return to increased physical activity, which can be especially challenging when excessive or compensatory exercise has been a part of the illness. We review what to do when weight progress is stalled and individuals have difficulty reaching their target healthy weight range, as well as how to make adjustments to nutrition to support weight maintenance once weight restoration is achieved.
