This article is written in collaboration with Dr. Linda Warren of Bainbridge Pediatrics.

Two years ago, my mentor and colleague, Michelle Naden, invited me to join a team of therapists named Collaborative Family Therapy. It had been a dream of mine to work in a collaborative way with other therapists, health care professionals, and community resources to better serve families, so I felt honored to accept the invitation. Working openly with a team has created layers of meaningful support for me and the people I serve. One of these layers has been Bainbridge Pediatrics, a group of three pediatricians and their support staff. Our teams share the value of seeking and providing a network of resources that can “wrap around” the families that seek our assistance. This is for the purpose of minimizing isolation and maximizing communication between providers and patients, and between providers.

We decided to write a piece on family eating because it is a topic that crops up often in our work. Food can be a tricky issue for many young people and their parents. On the medical side, Michelle Bombardier, SLE, and Catherine Whiting, OT, approached Dr. Linda Warren at Bainbridge Pediatrics to discuss working together to address feeding problems developing in young children and their families on Bainbridge Island. These medical providers were seeing more families struggling with the challenges of feeding their kids, and on the mental health side, we at CFT were seeing more families struggling with eating disorders. Dr. Warren introduced us to several excellent books on the topic. She and her medical colleagues also began a monthly group for “Picky Eaters.” She initiated this piece that focuses on how to create a family environment that promotes healthy eating for all ages. Our teams work to help families decrease stress around eating and to increase communication and connection within the family. Some of the most useful resources that guide us in this area are the books written by Ellyn Satter, a licensed nutritionist and therapist, who has written extensively about children and food.

Satter, licensed nutritionist and therapist, says that it is the parents’ responsibility to provide good nutrition for their children. The what, how, and when to eat can become confusing and overwhelming questions for families. Some of the questions we hear are:  How much responsibility should a parent take when it comes to decisions about eating, and how much should be shared with the children? How does responsibility shift as children grow? Different messages bombard us through the media, and we have become a society that is conflicted about food and body image. Concerns about “healthy” body shape and size, food allergies, and the relationship between food and behavior are just a few of the topics that parents and children raise when they consult us.

We will begin to answer some of these questions with Ellyn Satter’s definition of the “division of responsibility” (1990) between parent and child. She refers to this division in the following way:

1. The parent’s job is to decide what, when and where to provide food, regular snacks, and meals. They are also responsible to offer a variety of foods.

2. The child’s job is to decide whether and how much to eat or not to eat. Control in this area is with the child.

In exploring the first part of the division of parents’ responsibility, Satter provides some helpful things for parents not to do. She says: Don’t become a short order cook, and don’t pressure your kids to eat (1987). This means no bribing, arguing, rewarding with dessert, or tricking kids into eating it.  She coaches parents to offer a child the food, and let them sit and decide if they want to eat. If they don’t eat, Satter says to wait until the next snack or mealtime to offer food, milk, or juice. The goal is to raise a competent and “intuitive eater,” (Tribole & Resch, 2003) one who knows what he or she wants to eat, knows when he or she is full, and who enjoys eating.

The second part of Satter’s division states that how much a child eats is his or her responsibility. Often parents become concerned about their child not eating enough, or too much. It is helpful to develop trust that a child will eat what he or she needs, and to know that this will fluctuate over time. It can be helpful to look at a larger time frame and to focus on what a child eats over the course of a month, rather than a day or week.  Satter (2005) believes that parents need to stay within their division of responsibility, which is to provide the structure and the food choices. When parents gravitate towards the children’s responsibility of how much to eat, a power struggle often ensues. The struggle can be fueled when parents continue to worry over their children’s eating habits. Satter says it is helpful for parents to keep these worries in check so children can learn how much is enough, a skill that is important to develop on the way to becoming “intuitive eaters” (Tribole and Resch, 2003).

The division of responsibility ideally shifts as children grow. For adolescents, autonomy and identity become central themes of their development, and they often become more self-conscious or struggle with self-confidence. With an influx of hormones, their bodies typically grow rapidly and they must adjust to internal and external changes daily. Adolescents need to make more choices for themselves, and parents need to let them explore these choices with food. Parents can still influence their growing children by offering healthy choices in the home and by eating meals together. The goal is for parents to support their children and to trust them to care for themselves. This will develop a healthy balance of responsibility between parents and teens.

Satter (1987) states:

• During the teen years, you continue teach and guide your child, building on the foundation of instruction and interaction that has gone before. The way you treat your child is the most powerful part of the instruction, as it has been at all previous times.  Your attitude of respect and interest and your willingness to play a supportive, rather than a controlling role, will have an enormous impact on the way you and your child feel about each other. (pp. 245-246)

Family meal times provide a great opportunity to create and nurture connections within families. These occasions offer parents the structure within which to live out the division of responsibility described by Satter. In order to provide more detail on the benefits of family meal time, we offer some interesting research findings that highlight some significant benefits of family meals:

A 1999 study from University of Michigan found that meal time at home was the single strongest predictor of better achievement scores and fewer behavioral problems with kids. Meal time proved more powerful than time spent in school, at church activities, studying, or playing sports.

A Harvard study in 2000 showed that eating family dinners together most or all days of the week is associated with eating more healthfully. These families consumed higher amounts of nutrients such as calcium, fiber, iron, B6 and B12, C and E.

A study in 2004 from the University of Minnesota found adolescents who ate with their families did better in school, were less likely to use drugs and alcohol, and were less likely to have low self-esteem and depression.

The information from these studies listed above reinforces the significance of family meal time as a way to help kids make positive choices in their lives. For more information about this topic we suggest the books below. We also invite you to contact us at CFT and Bainbridge Pediatrics to talk about your questions or concerns.

Recommended Reading:

How to Get Your Kid to Eat… But Not too Much, 1990, by Ellyn Satter. Secrets of Feeding a Healthy Family: Orchestrating and Enjoying the Family Meal, 1999, by Ellyn Satter.
Child of Mine: Feeding with Love and Good Sense, 2000, by Ellyn Satter
Intuitive Eating, a Revolutionary Program that Works, 2003, by Evelyn Tribole and Elyse Resch.
Your Child’s Weight: Helping without Harming, 2005, by Ellyn Satter.

I would like to invite readers to meet a trusted and knowledgeable colleague, Joseph Shaub.  I am honored to have him share his wisdom and experience with you.  He is a collaborative family lawyer and mediator with offices in Seattle and Bellevue.  He is licensed as both an attorney and marriage and family therapist.  Joe has many more informative and helpful articles on a variety of topics in his website: www.josephshaub.com.  He has offered this informative article on the benefits of the collaborative law process.

CHOOSING COLLABORATIVE LAW

Divorce is such a hard road.  Sadly, lawyers can make that road so much harder.  They’re not bad people - most of them are truly lovely folks if you knew them socially.  However, their role is to protect their client.  “Protect them from what?” you might ask.  Well, protect them from being “ruined,” “screwed,” “wrecked” or “destroyed by their spouse,” if you asked them.  Lawyers, in their role as protectors are also dispensers of paranoia.  It’s part of the training.  It’s like a magical transformation, but rather than turning from an ugly duckling to a swan, or Clark Kent to Superman, the divorcing person enters the lawyers office wanting the “fair” outcome, not wanting to screw their spouse and emerges hyper-vigilant and hyper-protective of their “rights,” having heard for an hour or two what they are “entitled to.”

The good news is that there’s a large and growing group of lawyers in King County who want to help smooth the path of this otherwise rocky life transition.  They are “collaborative lawyers” and its important for anyone commencing this process to know about them.

Collaborative Law started in the early ‘90’s when a Minneapolis lawyer named Stu Webb decided he just wasn’t going to go to court any longer.  He asked all of his colleagues if any of them were willing to agree to forego the soul-rending process of divorce litigation and commit, with their clients, to working out all the details of a legal divorce by negotiated agreement.  He had a handful of takers… and the word got out.  Collaborative Law began to spread throughout the country.  To get an idea of its breadth and scope log onto the website of the International Academy of Collaborative Professionals at www.collaborativepractice.com.

This form of healing, supportive practice - in which lawyers make a paradigm shift from protecting the narrow interests of their clients no matter who else may be hurt in the process (the spouse or their children) to developing a broader view of what a client’s real interests are - is now being practiced by many professionals in Washington.  The lawyers in King County Collaborative Law understand that an adversarial divorce which locks people into years of animosity and children into a life of negotiation between enemy camps simply can’t be in anybody’s interests.

Collaborative Law, as practiced in Washington is a “team approach,” recognizing that there are many elements of a divorce - the legal, the financial, the parental and the emotional.  So, we have collaboratively trained lawyers to support, advise and advocate for their clients; collaboratively trained financial specialists to act as neutrals, assisting the couples in understanding their current and future financial needs - and resources - in a non-adversarial manner; collaboratively trained mental health professionals, who act as divorce coaches, assisting people in managing the most acute emotional reactions that come up during the divorce process and child specialists who support the children through this alien and utterly unwelcome change in their lives.

While the collaborative law team approach is certainly more costly than doing it yourself, or working with a mediator, only, it is no more expensive than a conventional adversarial divorce where lawyers run into court to win temporary orders on behalf of their clients, stressful and incredibly comprehensive information gathering is conducted through a “discovery” process and a costly (both financially and emotionally) settlement conference is conducted where both people are separated with their lawyers and a settlement official shuttles between the two rooms with offers and counter offers in an effort to pound out a settlement in a day.  This process leads to next-morning regret for at least one person as sure as the sun rise in the east.  This doesn’t even include trial, which virtually guarantees destruction of whatever is left of the relationship between two people who shared years of intimacy and often children that they both love.

Collaborative practice can expose people embarking on this awesomely challenging life journey to a group of professionals who are committed to helping both people identify and achieve high-end goals that will serve them for the ensuing days, months and years.  An image evoked by one collaborative professional often is that of the divorced husband and wife sitting side-by-side (with their new partners if that be the case) at their children’s graduations or weddings and experiencing the gratitude of these children in finding a way to end the marriage (if end it must) in a loving, respectful manner, mindful of the integrity of everyone involved.

It’s a challenge, to-be-sure.  Yet a challenge well worth taking.

For more information visit the Collaborative Law page of Joseph Shaub’s website: www.josephshaub.com and the website of King County Collaborative Law, www.kingcountycollab.org.

The developmental changes that occur in our children during adolescence and the teen years present unique elements to family communication and parenting. As a family therapist, mother, and stepmother, I am drawn to the complexity of this time and how we can be more intentional in our parenting to promote better connection and understanding.

The teen years present an interesting interplay between the need for young people to learn independence and their need to stay safe and connected to family. The question becomes how can we help our teenagers stay in touch with the values and commitments that are important to our families, while allowing them the space to learn responsibility and independence. This is a time for them to gain confidence in making decisions and taking care of their own needs in order to prepare them to manage themselves as young adults in their communities.

Here are a few thoughts on how to keep conversation and connection going during these years:

• Remain curious to your teen’s thoughts, ideas, hopes, and dreams – even if they differ from your own.

• Highlight the positive. Teens often suffer from a sense of low self-esteem and they need to be confirmed in their accomplishments to promote self-worth.

• Be consistent!

• Realize that your teens will make mistakes and grow them into learning opportunities.

• Be intentional in how you are speaking and responding to your teens. Learn what legacies you wish to pass to your children and what legacies you wish to leave behind.

• Let them know they are loved. As much as they may seem to push you away, they still desire connection. Renegotiate the level of closeness and be open to new ways of doing things.