Rescripting—A grounded theory study of the contribution that fathers make to Family‐Based Treatment when a young person has anorexia nervosa

Abstract

Aim To present a grounded theory of the contribution that fathers make to family‐based treatment when a young person has anorexia nervosa. Background Research indicates a potential to improve outcomes by involving both parents in the treatment of anorexia nervosa. However, fathers are underrepresented both within treatment and research. Family‐based treatment requiring the involvement of both parents presents an opportunity to better understand the role of the father in treatment. Design Classic grounded theory. Methods Individual interviews conducted with fifteen fathers involved in family‐based treatment. The COREQ checklist was followed. Results Fathers valued being involved in family‐based treatment and felt they had an important contribution to make. The analysis captures the overall contribution that fathers make and the impact of their involvement. Four categories; Being on the Outside, Finding a Way In, Finding a Way to Be and Finding a Way to Let Go and one core category Repositioning were generated from the data. A substantive theory of Rescripting, generated from categories and the core category, describes the way that participating in family‐based treatment changes fathers and their role. Conclusions Fathers make an important and significant contribution to family‐based treatment when a young person has anorexia nervosa. The findings inform clinicians about the importance of including fathers in the treatment of young people with anorexia nervosa. They highlight the importance of incorporating support mechanisms into family‐based treatment to harness and maximise the paternal contribution. Relevance to clinical practice Paternal contribution to family‐based treatment can be maximised to improve outcomes for young people with anorexia nervosa.

Caregivers in anorexia nervosa: is grief underlying parental burden?

“…Such vicious cycles can be worked on and interrupted without blaming one or the other parent. The clinical and empirical literature offers ample evidence of the unique and very significant role fathers play in their adolescent daughter’s recovery, including how their attendance in therapy is associated with improved treatment outcomes [ 59 , 68 ]. This information can be relayed to fathers to strengthen their motivation to join the family in its fight against the illness and improve their understanding of their daughter’s difficulties [ 63 , 67 , 69 ].…”

Parents' illness representations of their child with anorexia nervosa: A systematic review of qualitative studies using the common‐sense model

“…This component refers to the perceived symptoms of the disorder (Banerjee et al, 2022; Bear et al, 2021; Shiyanbola et al, 2018). Several studies reported that parents observed a range of symptoms associated with anorexia nervosa (Coelho et al, 2021; Cottee‐Lane et al, 2004; McMahon et al, 2022; Rosello et al, 2022; Thomson et al, 2014; Whitney et al, 2005; Williams, Russell‐Mayhew, et al, 2020). The most common symptoms observed included sudden changes in their child's eating behavior (e.g., dieting, eating “healthy,” becoming vegetarian, counting calories), physical appearance (e.g., weight loss), and increasing isolation from friends, family, and social activities (Coelho et al, 2021; Cottee‐Lane et al, 2004; McMullen, 2018; Rosello et al, 2022; Thomson et al, 2014; Williams, Russell‐Mayhew, et al, 2020).…”

“…This category is associated with the understanding of the symptoms of their child's anorexia nervosa (Moss‐Morris et al, 2002; Severtson et al, 2008). Findings across studies indicated that parents had a poor understanding of anorexia nervosa (Coelho et al, 2021; Cottee‐Lane et al, 2004; Honey & Halse, 2005; Hoskins & Lam, 2001; Karlstad et al, 2021; Marinaci et al, 2021; McMahon et al, 2022; McMullen, 2018; Robinson et al, 2020; Sharkey‐Orgnero, 1999; Thomson et al, 2014; Tierney, 2005; Whitney et al, 2005; Williams, Russell‐Mayhew, et al, 2020). First, parents reported having difficulties recognizing the symptoms of anorexia nervosa (Honey & Halse, 2005; McMahon et al, 2022; Sharkey‐Orgnero, 1999; Thomson et al, 2014; Williams, Russell‐Mayhew, et al, 2020).…”

“…Findings across studies indicated that parents had a poor understanding of anorexia nervosa (Coelho et al, 2021; Cottee‐Lane et al, 2004; Honey & Halse, 2005; Hoskins & Lam, 2001; Karlstad et al, 2021; Marinaci et al, 2021; McMahon et al, 2022; McMullen, 2018; Robinson et al, 2020; Sharkey‐Orgnero, 1999; Thomson et al, 2014; Tierney, 2005; Whitney et al, 2005; Williams, Russell‐Mayhew, et al, 2020). First, parents reported having difficulties recognizing the symptoms of anorexia nervosa (Honey & Halse, 2005; McMahon et al, 2022; Sharkey‐Orgnero, 1999; Thomson et al, 2014; Williams, Russell‐Mayhew, et al, 2020). For instance, they initially confused these symptoms with the normal development in adolescence (Honey & Halse, 2005; McMahon et al, 2022;Sharkey‐Orgnero, 1999; Thomson et al, 2014).…”

“…This component refers to the perceived symptoms of the disorder (Banerjee et al, 2022;Bear et al, 2021;Shiyanbola et al, 2018). Several studies reported that parents observed a range of symptoms associated with anorexia nervosa (Coelho et al, 2021;Cottee-Lane et al, 2004;McMahon et al, 2022;Rosello et al, 2022;Thomson et al, 2014;Whitney et al, 2005;Williams, Russell-Mayhew, et al, 2020). The most common symptoms observed included sudden changes in their child's eating behavior (e.g., dieting, eating "healthy,"…”