Pilot Study Comparing Multi‐family Therapy to Single Family Therapy for Adults with Anorexia Nervosa in an Intensive Eating Disorder Program

Abstract

Multi-family therapy (MFT) has yet to be evaluated in families of adults with anorexia nervosa (AN). The study aims were: (i) assess the feasibility of MFT for AN; and, (ii) assess whether MFT is associated with improved outcomes for families compared with single-family therapy (SFT). Adult patients with AN consecutively referred to an eating disorder treatment program were assigned (non-randomly) to receive eight sessions of SFT or MFT. Assessment occurred pre-therapy, immediately post-therapy, and at 3-month follow-up. A total of 37 female patients (13 SFT, 24 MFT) and 45 family members (16 SFT, 29 MFT) completed treatment. There were significant time effects for patients' BMI, eating disorder-related psychopathology and multiple family outcome measures. There were no differences between MFT and SFT on family outcome measures at end of treatment and 3 months post treatment. MFT is a feasible intervention that can be used in adult intensive treatment for those with AN.

Two models of multiple family therapy in the treatment of adolescent anorexia nervosa: a systematic review

“…In a controlled but non-randomized study comparing MFT to single family therapy (SFT) in an intensive ED program for severe adult AN, Dimitropoulos and her team [38] found significant physical and psychological improvements in both groups, but no significant differences between MFT and SFT at the end of treatment and 3 months follow-up. A randomized controlled study involving patients with poor prognosis [69] compared MFT Eat Weight Disord (two-family day workshops) with individually-focused family work, and found similar improvements in patients' BMI and reductions of carers' distress in both treatment modalities.…”

“…These usually take the form of time-limited outpatient workshops (6-8 sessions) involving educational/cognitivebehavioral, motivational, and problem-solving components, along with relational elements. Family workshops inspired by the cognitive-interpersonal maintenance model (also known as the New Maudsley Method), and other MFT models have also been developed for adults in outpatient, inpatient, or daycare settings [36][37][38][39][40]: these are characterized by a greater focus on skills-based learning for carers and on the promotion of an autonomy-supportive family atmosphere. Finally, some models are strongly guided by the systemic paradigm and include treatment interventions aimed at changing family dynamics [41].…”

The evidence base for Multiple Family Therapy in psychiatric disorders: a review (part 1)

“…Finally, themes emerging from self‐report questionnaires (Colahan and Robinson, ) and focus groups (Tantillo et al ., ) with families of adult AN patients who participated in systemically‐oriented MFT programmes underlined once more the importance of group support and trust, sharing, as well as restoring intra‐ and inter‐family connections. Satisfaction surveys based on questionnaires and structured interviews confirmed fair to high user satisfaction with MFT for child AN (Brunaux and Cook‐Darzens, ), adolescent AN and BN (Cook‐Darzens and Doyen, ; Eisler et al ., ; Marzola et al, ; Salaminiou, ; Scholz et al ., ; Simic and Eisler, ) and adult AN (Colahan and Robinson, ; Dimitropoulos et al ., ), with a general trend for parents to be more satisfied than patients.…”

The modeled cost‐effectiveness of family‐based and adolescent‐focused treatment for anorexia nervosa

“…We updated the most recent meta-analysis of FBT for AN treatment (Couturier et al, 2013). Although a number of randomized controlled trials related to FBT were found from 2010 (the cutoff year of the previous review), these were all trials which compared different types of FBT (Dimitropoulos, Farquhar, Freeman, Colton, & Olmsted, 2015;Le Grange et al, 2016), compared FBT to systemic family therapy (Agras et al, 2014) or different duration of inpatient stays prior to FBT (Madden et al, 2015). Therefore, only three trials from the previous metaanalysis were used to calculate the effect-size of efficacy of FBT versus AFT.…”