Treatment concept

Our therapy concept has been evaluated for its effectiveness in longitudinal studies and has been proved to be effective in 90% of the reported cases. This method is the only one in Germany for the treatment of tube dependency that has proven its effectiveness. The therapy can be divided into four phases:

Online preparation

Parents are cared for at home, online and by telephone until intensive therapy begins. An online platform is provided for this purpose, on which parents can ask questions and receive all the support needed. Videos can also be uploaded and discussed here.

The aim here is to reduce food refusal and increase the interest in oral feeding. We don´t see a complete treatment of the tube dependency on the online consultation, but rather a supportive offer and preparation for the weaning from the tube.

Home visits (only in Germany)

Home visits are carried out for 14 days intervals. During home visits, a stable therapeutic relationship is established with both the child and parents. Based on this relationship, the child and its parents should be given stability in the feeding setting in order to explore feeding and being fed. The presence of aversion should be reduced and the pleasurable intake of food should be initiated. If the eating behavior stabilizes, an intensive phase follows immediately.

Intensive Treatment

As part of an intensive treatment of 10 to 14 days, the transition from tube feeding to complete oral nutrition should be ensured by daily supervision of all meals. Each meal is accompanied by our team until a stable nutritional intake is achieved. This means that between 6-8 hours of therapy are carried out daily. The following interventions are carried out during therapy:

  1. Stress reduction during feeding through adaptive affective mirroring.
  2. Making your child feeling comfortable in the feeding situation.
  3. Avoidance of stress triggers during the feeding situation and positive situation design.
  4. Developing of the feeding relationship between you and your child.
  5. Understanding and Explaining what your child wants to tell you when he/she refuses to eat.
  6. Build an adaptive feeding-eating relationship with a sustainable food intake.
  7. Giving you confidence and a sense of security to read your child signals and to feed it.

Follow-up

The child and parents supervision must be continued after the start of the food intake, as the child may briefly refuse to eat. Questions will arise regarding the amount, the development of the child and one's own role as a parent. For this purpose, one telephone appointment per week is held in the first four weeks after the end of the intensive therapy. In the following months, the parents can contact the therapist via phone or online chat.

Treatment Goal

As part of an intensive short-term treatment, the affect system should be increasingly activated and stabilized again. The aversive feelings that are now associated with the feeding situation should be reduced. At the same time, the interest in oral and soft food intake should be initiated. An intensive home-based short-term therapy can be regarded as promising if well prepared, since the oral motor skills are considered to be sufficient and the patient's health state is stable


Titelfoto by Luma Pimentel on Unsplash

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