For Shawn Burkland and her daughter Megan taking a walk together was a welcome change. Megan is recovering from an eating disorder she developed as a sophomore in high school.
"I thought it was normal, that I didn't need any help," Megan Burkland said.
But what was normal to Megan, was shocking to her mom.
"She was 81 pounds. She had lost 29 pounds," said Shawn Burkland.
As Megan ate less and less, and exercised obsessively, her family struggled to find help.
"It wasn't easy to find care. By pushing and pushing we were able to get in," Burkland explained.
The program the family found at Seattle Children's uses a treatment called the Maudsley approach. Unlike individual therapy, the focus is on getting families involved in a child's recovery. Blame isn't part of the game.
"Whose fault, and finger pointing is just absolutely a waste of time at the very beginning stages," said Seattle Children's Pediatrician Dr. Cora Breuner. She headed the team that helped Megan recover.
What's most important when a child with an eating disorder comes into the program?
"To provide nourishment for the child and make sure the child takes the nourishment in," said Dr. Breuner.
She said in the team approach children see a nutritionist, and a therapist when they are in her care. But families play a crucial role too.
"The families need to be involved with their eating breakfast, snack, lunch, snack, dinner snack."
"We were together nearly 24 hours a day, for particularly the first 6 or 7 months," recalled Shawn Burkland.
Mealtimes were grueling. Megan fiercely resisted eating.
"I don't need help. Why am I doing this. I don't want to be here," Megan remembers feeling during that time. Her mother had a very different recollection.
"Just maintaining a firm, non-emotional attitude, when you really just want to sit there and cry or scream right back at her," Burkland explained.
Shawn Burkland said she reached out to others who were critical in Megan's recovery too.
"The people at school were amazing. The nurse took over two meals a day, sat with her every single day and had snacks or lunch. Her friends would come and have lunch with us in the car," Burkland said.
"It is not for the faint of heart," acknowledged Dr. Breuner, "But it works."
It worked for Megan, who gradually recovered her health.
"I'm really lucky that I have such a supportive mom. I think it was really one of the most important things to me," Megan said.
"A University of Chicago study published in the "Archives of General Psychiatry" looked at teens who went through the family based treatment. Even a year later almost half of them had conquered their eating disorders, more than double the success of individual therapy.