Child protective services, law enforcement, and doctors are all involved with treatment for Munchausen syndrome by proxy (MSBP). Treatment is very complex and involves the child, the caregiver, and possibly other family members. When a caregiver is known to have MSBP, his or her doctor will need to tell other family members how the illness affects everyone involved. Family members may be asked to support the caregiver and child as much as they can.

The child will be placed in a safe situation, away from the offending caregiver. And doctors will monitor the child for symptoms and will provide counseling. Young children who are victims of MSBP may respond well to play therapy.

A diagnosis of MSBP may be confirmed if the child's symptoms improve or disappear after the child has been separated from the caregiver. A hospital stay may be needed or continued if the child's current symptoms are serious. The child may later be placed in foster care.

Treatment for the caregiver includes a complete physical and psychological exam followed by counseling. The counselor tries to help the caregiver understand how she has harmed her child. Also, strategies are offered to help the caregiver manage anxiety, stress, self-esteem problems, and problems with feeling in control of her life. Whether the child returns to the caregiver's custody depends on the severity of the case and on the caregiver's response to treatment.

Treatment for the caregiver usually is coordinated through the legal system. Long-term psychotherapy is used to help the caregiver acknowledge and express her need for support, respect, and connection. Dealing with these emotional needs more directly may help prevent her from projecting them onto her child. Therapy also focuses on helping her to develop empathy, so she understands the effect her behavior has had on her child. Medicines are used as treatment only if another condition, such as anxiety disorder, exists along with MSBP.

Caregivers with MSBP very often resist treatment. Typically, they experience extreme denial about the problem and diagnosis. Also, these caregivers often try to manipulate health professionals involved in their treatment.