Dec 1, 2013

Should my child's therapist tell me she has an eating disorder?

Category: Childhood Disorders
Posted By: Carrie
Question: My 13 year old daughter was recently diagnosed with severe depression after we took her to counseling for cutting herself.  She started Prozac and therapy. This morning I heard her throw up after breakfast for the first time and after she went to her room I went in and asked her about it.  After lying she finally admitted she's been doing it for weeks and that her therapist told her she has an ED (anorexia, specifically).

I was shocked.  I know the depression makes her appetite less but I did not expect she had an ED. Is it normal for her therapist not to tell me when she diagnoses my child with such a dangerous disorder? I feel like this is something I should have known about so I can watch for things like her throwing up after meals. Please help!


Answer: Dear Carrie, I’m really sorry to hear that your daughter is struggling.  And it must have been a real shock to find out that she also has anorexia.  Your question is a difficult one for me to answer.  The line of confidentiality is a very difficult one for therapists to hold and I really don’t know enough about the case to be able to advise.

It is true that therapist have an obligation to pass on information is the child is at risk and anorexia is certainly a risk.  However, it is probably not a risk in the short term, especially if she is not obviously or worrying underweight.  It might be something that the therapist was working with your daughter to be able to tell you so that she could maintain her trust in the therapy.

It is probable that without the therapist there was no one that your daughter had told about her eating issues.  If the therapist immediately breaks her trust and talks to you (when presumably your daughter had asked her not to) then there is a risk that your daughter will clam up and no longer talk to anyone, and she very clearly needs this outlet.

I completely understand that you would want to know about something so worrying.  And I understand your shock at finding out that the therapist had not spoken to you as soon as she found out.  As a mother I would be very upset to have something so important kept from me.  It is a really difficult situation, because, presumably you also need for your daughter to be able to speak to someone.  I guess the question is whether you feel you can really trust the therapist to hold the case and the information involved.

I do think that the fact that your daughter was less vigilant and somehow ‘allowed’ you to hear her throwing up after breakfast, is a good sign.  I would say that this usually happens when, consciously or unconsciously, the young person has come to want the issue to be known about.  It is worth bearing in mind that this might be the result of the work that she has been doing with the therapist.

The only thing that I would say is that you mentioned that you had taken your daughter for counseling.   I think that all talk therapy tends to get called counseling so perhaps she is being seen by a child psychotherapist.  However, there is a difference in training between a child psychotherapist and a counselor.  I would strongly suggest that with the severity of your daughter’s difficulties at the moment, you would need to find a fully qualified child and adolescent psychotherapist with a fair degree of post-qualification experience.

I hope that helps, I understand it’s not the straightforward answer you may have been looking for.

I really wish you and your daughter the very best in coming to understand and resolve the difficulties she is having at the moment,



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