Family therapy approaches for anorexia nervosa

Abstract

Analysis 4.1. Comparison 4 Family therapy approaches short-term vs family therapy approaches long-term, Outcome 1 Remission long-term follow-up

Evidence-Based and Novel Psychological Therapies for People with Anorexia Nervosa

“…Family therapy for the treatment of eating disorders was introduced in the 1970s following changes to the accepted general beliefs and assumptions of the role family processes play in the development and maintenance of anorexia [25,33]. For example, Minuchin et al's [34] psychosomatic family model argues that family processes involving rigidity, over-involvement and conflict avoidance, along with existing psychological vulnerability in the individual, underpin the development of anorexia, and therapy should therefore involve the family to work towards changing the family dynamic.…”

“…Until this time, families were generally considered to hinder treatment and so patients were treated in isolation from their parents [35]. Other associations between eating disorders and family dynamics have since been examined suggesting specific areas where families have an impact, such as attachment, parenting style, communication orientation or family conflict [18,36,37], though more recent models hold in mind that no blame should be attributed to the family, rather treatment works with the family [33].…”

“…Reviews of FBT have summarised studies comparing different formats of FBT, and different types of family therapy to FBT [33,61], finding no significant differences between the various formats and types. For example, comparing conjoint therapy (for family and patient together) to separate therapy (patient and family seen separately), studies have found no significant differences in outcomes [63,64].…”

“…An expanding pool of evidence exists that supports the use of FBT as the primary intervention for treating children and young people with anorexia [9,68] however there is still limited evidence to suggest FBT is consistently superior to other psychological treatments or treatment as usual [33]. Despite much of the research on anorexia treatment for adolescents focusing on FT-AN, a lack of high-quality studies comparing FT-AN to individual treatments means it cannot reliably be deemed superior [69].…”

Developments in the psychological treatment of anorexia nervosa and their implications for daily practice

“…For children and adolescents with anorexia nervosa, all the major guidelines recommend family-based treatment (FBT) and this has been addressed in this journal by Hilbert et al in 2017 [ 14 ] and by Lock in 2018 [ 15 ▪ ]. The Cochrane Database of Systematic Reviews (CDSR) suggests that FBT may be more effective than treatment as usual (TAU) in the short term [ 16 ].…”