Family therapy as a model for treating childhood obesity: Useful tools for clinicians

Abstract

More than fifteen percent of children in Europe are overweight; another five percent are obese. The high prevalence of obesity emphasizes the necessity of developing evidence based treatment programs that are useful in a clinical setting. Management of childhood obesity is commonly based on lifestyle interventions where nutrition, physical activity, and behavior modification are the main targets. To incorporate lifestyle interventions, many childhood obesity treatment models use different psychological models, such as behavior modification or cognitive behavior therapy. This paper presents the key lessons from a research program on an empirically supported family therapy-based treatment, Standardized Obesity Family Therapy (SOFT). SOFT is based on systemic and solution-focused theories and has shown positive effects on the child with respect to degree of obesity, physical fitness, self-esteem, and family functioning in several studies. The distinguishing features of SOFT are the focus on family interactions as an important source for implementing and maintaining lifestyle changes, the multidisciplinary team approach, and a limited number of sessions (three to four per year). The main aim of this paper is to provide tools for clinicians in the field of obesity who work with families, alone or in a multidisciplinary team.

Single versus multiple-family intervention in childhood overweight—Finnmark Activity School: a randomised trial

“…Principles from Solution-Focused Brief Therapy and Standardised Obesity Family Therapy were applied in addition to elements from motivational interviewing 11 14 15. Counselling based on the families’ own resources aiming at increasing physical activity, reducing sedentary activity and increasing consumption of healthy food according to national guidelines was the main approach in both intervention arms.…”

Shared Patterns of Daily Occupations among Parents of Children Aged 4–6 Years Old with Obesity

“…Parents exercise varying degrees of control over the food that is purchased, meal planning, preparation and the availability of food. Most parents have a general sense of the importance of access to food and children's need for play and physical activities (Nowicka & Flodmark, 2010). However, psychological factors such as personality type, values and beliefs, along with cognitive style influence not only the choice of occupation but also where and with whom parents choose to spend their time.…”

“…The importance of involving both the mother and the father in lifestyle interventions is underscored by evidence suggesting that parenting styles and skills in daily life predict children' s body mass index (BMI) (Berge, Wall, Neumark-Sztainer, Larson, & Story, 2010;Robertson et al, 2008). One challenge is to focus on family interactions as an important source for implementing and maintaining lifestyle changes (Nowicka & Flodmark, 2008, 2010. However, there is insufficient knowledge of how parents' daily occupations are shared in relation to time and space.…”

Changes in Parents’ Time Use and Its Relationship to Child Obesity

“…This means that they may have gained awareness through reflections, alterations that may later lead to involving the children in new varieties of daily occupations. According to the family system theories, parents are active role models for facilitating change in the home and family environment (Hill & Mattessich, 1979), even small changes are of importance (Nowicka & Flodmark, 2010). It is important to recognize the mothers" and fathers" individual competencies since childhood obesity occurs within a familial context (Davison & Birch, 2001).…”