Multi-family therapy for bulimia nervosa in adolescence: a pilot study in a community eating disorder service

Stewart, Catherine; Baudinet, Julian; Fiskå, Malin; Pretorius, Natalie; Voulgari, Stamatoula; Hunt, Katrina; Eisler, Ivan; Simic, Mima

doi:10.1080/10640266.2019.1656461

Cited by 16 publications

(26 citation statements)

References 39 publications

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“…According to this finding, in this study, participants (mainly the parents) focused discourse mostly on their own therapeutic process. This is in contrast with studies on other MFT models, in which participants’ discourse on improvement was focused on the symptoms related to the children/adolescents’ diagnoses (identified patient) and only secondarily were other aspects, such as caregiver's burden, evaluated (Dennhag et al, 2019; Engman‐Bredvik et al, 2016; Stewart et al, 2019). In that regard, in IFT, the facilitators do not make a distinction between “identified patients” and “family members”; all participants are submitted as active subjects in therapy, and they participate in therapeutic mechanisms the same way (Sempere & Fuenzalida, 2017).…”

Section: Discussionmentioning

confidence: 84%

Interfamily Therapy, a multifamily therapy model settled in infant‐juvenile mental health services of Havana (Cuba): A qualitative study from participants’ perspectives

Ruiz-Íñiguez

Montero

Martínez-González³

et al. 2021

J Marital Family Therapy

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Interfamily therapy (IFT) is a specific model for multifamily therapy (MFT) of recent expansion in Latin American and European countries. In IFT a multifamily group becomes a community of learning where professionals and family members establish collaborative relationships and participate in dialogues. This study used a qualitative phenomenological approach to explore the participants’ perspective of 14 members and ex‐members of two IFT groups conducted in Infant‐Juvenile Mental Health Centers in Havana (Cuba). In this study IFT was well accepted and effective, and it was perceived as beneficial due to its positive influence for participants, with benefits on a personal, family and social level. In addition, participants articulated a series of therapeutic elements of IFT that were essential to promote these benefits. In conclusion, IFT seems to be a useful therapeutic model in the treatment of children, adolescents and their families in a Cuban psychiatric setting.

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Section: Discussionmentioning

confidence: 84%

Interfamily Therapy, a multifamily therapy model settled in infant‐juvenile mental health services of Havana (Cuba): A qualitative study from participants’ perspectives

Ruiz-Íñiguez

Montero

Martínez-González³

et al. 2021

J Marital Family Therapy

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“…MFT-BN integrates ideas from different therapeutic models, including systemic family therapy, cognitive behavioural therapy and dialectical behaviour therapy. The MFT-BN model has been described in detail elsewhere, including a session-by-session plan [ 30 ] and preliminary findings published [ 27 ]. Each group varies slightly in content and structure to meet the needs of each specific MFT-BN cohort.…”

Section: Methodsmentioning

confidence: 99%

“…To date, there has been very little research into MFT interventions for BN; indeed, only one peer review article has been published [ 19 ]. In an uncontrolled case series, Stewart et al [ 27 ] found that MFT-BN for adolescents was associated with improvements in bingeing and purging behaviours, co-morbid mood, anxiety and emotional regulation difficulties, and parent/caregiver perceived burden. The authors concluded that the intervention could play an important role as a “first step” towards recovery.…”

Section: Introductionmentioning

confidence: 99%

Multi-family therapy for bulimia nervosa: a qualitative pilot study of adolescent and family members’ experiences

2022

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Background Multi-family therapy (MFT-BN) is a new treatment for adolescent bulimia nervosa with emerging empirical support. It extends the bulimia nervosa focussed family therapy model, by offering treatment in a group setting. Up to nine families work together with a team of clinicians over the course of 20 weeks. No qualitative study to date has investigated the experience of MFT-BN. This study aimed to explore this from the adolescent and parent/caregiver perspective. Methods Participants from two consecutive MFT-BN groups facilitated at the Maudsley Hospital in London, UK, were invited to participate in either a focus group or individual qualitative interview about the experience of MFT-BN. Of the 19 eligible participants (from 9 families), 15 (8 parents, 1 older sibling, 6 adolescents) consented and participated. Audio-recordings of interviews and focus groups were transcribed verbatim and analysed using reflexive thematic analysis. Results Three main themes were identified; (1) seeing and being seen, (2) holistic shift, (3) the unspoken. Participants reported overall shifts in cognitions, emotions, behaviours, and relationships both individually and within the family as a result of attending MFT-BN. Meeting other families with similar struggles and sharing experiences, skills and learning helped reduce isolation and promote change. There was also a sense from participants that some things did not, or could not, be spoken about in the group context and that more direct and challenging conversations might have been helpful at times. Discussion The current study identifies some of the perceived benefits and challenges of MFT-BN. The three themes demonstrate the holistic nature of change that can occur across the treatment, as well as the power and limits of the group therapy setting and process. Further research is needed to explore the experience of MFT-BN and its outcomes across a more diverse range of participants and treatment settings.

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“…There have been significant advances in the field of adolescent eating disorder treatment over the past 50 years. Family therapy has emerged as the current first-line recommended treatment ( 1 ), with individual and multi-family therapy also demonstrating promise ( 2 – 7 ). Despite these advances and the increase in treatment options, full remission rates at the end of treatment remain modest for both anorexia nervosa (20–50%) and bulimia nervosa (~40%) ( 8 ).…”

Section: Introductionmentioning

confidence: 99%

Adolescent Eating Disorder Day Programme Treatment Models and Outcomes: A Systematic Scoping Review

Baudinet

Simic

2021

Front. Psychiatry

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Background: Adolescent eating disorder day programmes (DP), or partial hospitalization programs, are becoming increasingly widespread worldwide. They typically function as an alternative to inpatient care and/or a step up or down in treatment intensity. There has been an increase in the number of publications within the last 5 years investigating DP outcomes. While there are now numerous programmes operating internationally, there is large variability in the content, structure and theoretical underpinnings of each programme. This makes it difficult to compare programme outcomes, and the impact the therapeutic model may have.Aims: To review existing literature on adolescent eating disorder DP treatment models and outcomes.Methods: A systematic scoping review was conducted. Four databases (PsychInfo, EMBASE, Medline, CENTRAL) were searched for relevant peer-reviewed journal articles and book chapters investigating adolescent eating disorder DPs that function as alternatives to inpatient treatment. No restrictions on study methodology were imposed. Studies were first mapped by location, study characteristics and day programme treatment characteristics, then narratively synthesized.Results: Forty nine studies were included in this review. All used a quantitative methodology. One study also included qualitative methods. The majority of studies included describe DPs in the USA (69%). Seventy-six percent of the studies described DPs that operate 5-days per week and most (57%) either only admit or only report on outcomes for restrictive eating disorders. Two-thirds (69%) reported on DPs that had a family focused treatment model, the remainder had a more integrated treatment model informed mostly by individual psychotherapeutic models. Generally, DP treatment is associated with weight gain and improvements in eating disorder and comorbid psychopathology. The studies that include follow-up data (27%) reveal improvements are usually maintained from 3 months to 2 years post-treatment. Early weight gain, early psychological change and early therapeutic alliance are associated with improved end of treatment outcomes. Findings regarding other potential predictors of outcome are mixed.Conclusions: Current evidence suggests day programmes are an effective alternative to inpatient treatment that lead to sustained improvements. DPs tend to either be young-person-only with a family-focused treatment model or all age with a more integrative model. Controlled, empirical investigations into the impact of the therapeutic model on outcomes are needed, as are investigations into treatment mechanisms and the individual and parent experience of day programme treatment.

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Multi-family therapy for bulimia nervosa in adolescence: a pilot study in a community eating disorder service

Cited by 16 publications

References 39 publications

Interfamily Therapy, a multifamily therapy model settled in infant‐juvenile mental health services of Havana (Cuba): A qualitative study from participants’ perspectives

Interfamily Therapy, a multifamily therapy model settled in infant‐juvenile mental health services of Havana (Cuba): A qualitative study from participants’ perspectives

Multi-family therapy for bulimia nervosa: a qualitative pilot study of adolescent and family members’ experiences

Adolescent Eating Disorder Day Programme Treatment Models and Outcomes: A Systematic Scoping Review

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