A Pilot Study of Maudsley Family Therapy With Group Dialectical Behavior Therapy Skills Training in an Intensive Outpatient Program for Adolescent Eating Disorders

Abstract

This pilot, multimodal program warrants further investigation and may be an effective intermediate level of care treatment option for adolescent eating disorders.

Augmentative Approaches in Family‐Based Treatment for Adolescents with Restrictive Eating Disorders: A Systematic Review

“…All participants in comparative studies were aged 10–20 years at baseline. Five non‐comparative studies (Gelin, Hendrick, & Simon, ; Girz, Robinson, Foroughe, Jasper, & Boachie, ; Hurst & Zimmer‐Gembeck, ; Paulson‐Karlsson, Engstrom, & Nevonen, ; Robinson, Strahan, Girz, Wilson, & Boachie, ) had adolescent‐only samples, with the remaining samples comprising a mixture of children (<11 years), adolescents and young adults (>18 years) (Doyle, ; Henderson et al, ; Hoste, ; Johnston, O'Gara, Koman, Baker, & Anderson, ; Jones, Volker, Lock, Taylor, & Jacobi, ; Ornstein et al, ; Rienecke, Richmond, & Lebow, ; Rockwell, Boutelle, Trunko, Jacobs, & Kaye, ). Three non‐comparative studies reported mean ages of 14–15 years without stating overall age ranges (Hollesen, Clausen, & Rokkedal, ; Robinson et al, ; Salaminiou, Campbell, Simic, Kuipers, & Eisler, ), while Doyle et al (2013) reported outcomes in an intensive outpatient program separately for children (10–13 years) and adolescents (14–18 years), between whom there were no significant differences on any assessments.…”

“…FBT‐based interventions featuring adjunctive components included the use of additional individual or group CBT (Hurst & Zimmer‐Gembeck, ; Doyle, ; Rockwell et al, ) or DBT (Doyle, ; Johnston et al, ; Marzola et al, ; Rockwell et al, ) sessions, and Lock et al () introduced three additional parent skills‐focused sessions to the standard FBT for families identified as responding poorly with regard to early weight gain upon reassessment mid‐Phase I (this group of families was labelled FBT/IPC+, whereas early responders were in the FBT/IPC− group). Rhodes, Baillee, Brown, and Madden () introduced a ‘parent‐to‐parent consultation’ into FBT Session 10, wherein parents currently attending FBT met with parents who had recently completed treatment, with the aim to increase parental self‐efficacy and thereby patients' weight‐gain.…”

“…Paulson‐Karlsson (2009) classified patients as having achieved full remission following 18‐months of separated and conjoint FBT sessions if they no longer met DSM‐IV (APA, ) criteria for AN, an outcome achieved for 72% and 78% of patients at EOT‐ and 36‐month follow‐up, respectively. Johnston et al () reported 64% of patients completing a multimodal intensive outpatient program met Morgan‐Russell ‘good outcome’ criteria (>85%IBW, regular menses) at 1‐year follow up. They also reported that 42% of treatment completers met these criteria and had EDE Global Scores within 1SD of community norms, the additional criterion applied in more stringent definitions of full remission from AN (e.g., Agras et al, ; Couturier & Lock, ; Eisler et al, ; Madden et al, ).…”

“…That is, for studies identifying specific psychological factors as reasons for the use of the innovative approach, such as anxiety, cognitive rigidity, OC symptoms or emotion dysregulation and/or personality disorder features, it was similarly not reported to what extent these patients' presentations differed from those who would be expected to achieve good outcomes in standard treatment. For example, in the studies reporting on DBT‐integrated FBT to target emotion regulation and distress tolerance skills proposed to impact responses to FBT (Doyle, ; Johnston et al, ), the absence of assessments of these variables resulted in a lack of clarity as to whether these interventions were provided to individuals with such features or skills deficits, and if changes in these did occur and were related to overall outcome throughout treatment.…”

Intensive treatment program (ITP): A case series service evaluation of the effectiveness of day patient treatment for adolescents with a restrictive eating disorder

“…This increases opportunities for young people to practice new skills in their home environment and everyday life, as opposed to the more restricted environment of an inpatient or residential model of care. The vast majority of published literature on day treatments concerns adult populations (Abbate‐Daga et al, ; Zipfel et al, ) or mixed adult and adolescent populations (Dancyger et al, ; Green et al, ; Hepburn & Clark‐Stone, ) however, in recent years literature concerning adolescents is increasing (Bryson, Scipioni, Essayli, Mahoney, & Orstein, ; Goldstein et al, ; Herpertz‐Dahlmann et al, ; Hoste, ; Johnston, O'Gara, Koman, Baker, & Anderson, ; Ornstein, Essayli, Nicely, & Masciulli, ; Ornstein, Lane‐Loney, & Hollenbeak, ). For a review see Friedman et al ().…”