Patients and Parents’ Experience of Multi-Family Therapy for Anorexia Nervosa: A Pilot Study

Abstract

Background: Family therapy is considered as the gold standard in treatment of adolescents with anorexia nervosa (AN). Among the different types of family therapy, multi-family therapy (MFT) is increasingly used for treating AN, and shows promising results. In this article, our focus relied on the patients’ and their parents’ perceptions of the effectiveness and the underlying mechanisms of the MFT. Methods: The present pilot exploratory qualitative study included two focus groups conducted using a semi-structured approach: one with the adolescents (n = 3), and another with one or two of their parents (n = 4 mothers; n = 2 fathers). The subjects discussed were the changes observed in both AN symptoms and family interactions following therapy, and the mechanisms underlying these changes. We crossed the perspectives of the adolescents and of the parents on these two points. Results: Qualitative analysis revealed that while both adolescents and parents had difficulties relating the changes they observed in the last year to MFT, they were able to say that the group cohesion had several positive effects and that their family dynamics had improved. In the light of analysis the adolescents perceived more improvements related eating disorders symptoms than their parents did, while parents were concerned about a negative effect of MFT on their children. Discussion: While both patients and parents perceived improvements in both AN symptoms and family interactions in the past year, it was not clear if they considered MFT to have led to these improvements. FG also explored the MFT mechanisms underlying changes. Both adolescents and their parents stressed the beneficial effects of identification to others members of the group and shared experience to overcome social isolation. Parents also mentioned the sympathy they felt for each other. The idea that they give a central place to families in the therapy was also described by the families.

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

“…As a point of difference, participants in this study did not mention any unhelpful aspects of the inevitable comparisons that occur between participants in the group. This has been reported by some participants, particularly parents, who receive MFT-AN in other studies [ 24 ]. Similarly, participants in MFT-AN studies have not identified wanting to be challenged more in group, as was the case in this study.…”

“…The current findings are broadly consistent with previous research on MFT for adolescent eating disorders [ 19 ]. This literature highlights the group as place of support and learning associated with symptom change [ 21 – 24 ]. As a point of difference, participants in this study did not mention any unhelpful aspects of the inevitable comparisons that occur between participants in the group.…”

“…Nevertheless, MFT can also be described as challenging. Some families have reported concerns about young people mixing in the group and sharing unhelpful eating disorder behaviours, especially if they are at different stages of the illness or recovery [ 24 ].…”

Multi‐family therapy for eating disorders: A systematic scoping review of the quantitative and qualitative findings

“…Across all studies, there was a common finding that MFT is experienced as both helpful and challenging with similar experiences described for adults and young people for both MFT‐AN and MFT‐BN. From data generated through observation, interviews and focus groups collected during and after treatment, there was a sense by most participants that MFT helped the family to view the eating disorder symptoms in new ways (Baumas et al, 2021 ; Duarte, 2012 ; Salaminiou, 2005 ; Voriadaki, Simic, Espie, & Eisler, 2015 ), take on new perspectives (Duarte, 2012 ; Engman‐Bredvik et al, 2016 ; Tantillo et al, 2015 ;Whitney, Currin, et al, 2012 ; Wiseman et al, 2019b ), gain new skills (Duarte, 2012 ; Tantillo et al, 2015 ) and feel more empowerment (Engman‐Bredvik et al, 2016 ; Salaminiou, 2005 ). Together, this helped people, particularly parents/caregivers, feel less guilty, scared, and anxious (Whitney, Currin, et al, 2012 ) and feel more confident (Whitney, Currin, et al, 2012 ; Wiseman et al, 2019b ).…”

“…A common theme across several studies was that MFT led to a shift in the quality of family connection and dynamics (Baumas et al, 2021 ; Berit Støre Brinchmann & Krvavac, 2021 ; Duarte, 2012 ; Tantillo et al, 2015 ; Wiseman et al, 2019b ). Commonly, parents/caregivers felt MFT provided a new support network that helped people in all family roles feel less alone and isolated (Duarte, 2012 ; Engman‐Bredvik et al, 2016 ; Salaminiou, 2005 ; Tantillo et al, 2015 ; Wiseman et al, 2019b ), which was also echoed by some patients, albeit fewer (Duarte, 2012 ; Salaminiou, 2005 ).…”