A comparison of short- and long-term family therapy for adolescent anorexia nervosa.
ABSTRACT Research suggests that family treatment for adolescents with anorexia nervosa may be effective. This study was designed to determine the optimal length of such family therapy.
Eighty-six adolescents (12-18 years of age) diagnosed with anorexia nervosa were allocated at random to either a short-term (10 sessions over 6 months) or long-term treatment (20 sessions over 12 months) and evaluated at the end of 1 year using the Eating Disorder Examination (EDE) between 1999 and 2002.
Although adequately powered to detect differences between treatment groups, an intent-to-treat analysis found no significant differences between the short-term and long-term treatment groups. Although a nonsignificant finding does not prove the null hypothesis, in no instance does the confidence interval on the effect size on the difference between the groups approach a moderate .5 level. However, post hoc analyses suggest that subjects with severe eating-related obsessive-compulsive features or who come from nonintact families respond better to long-term treatment.
A short-term course of family therapy appears to be as effective as a long-term course for adolescents with short-duration anorexia nervosa. However, there is a suggestion that those with more severe eating-related obsessive-compulsive thinking and nonintact families benefit from longer treatment.
SourceAvailable from: Mima Simic[Show abstract] [Hide abstract]
ABSTRACT: The experiences of six families involved in a 4-day multi-family therapy (MFT) group for adolescent anorexia nervosa were examined day by day. Participants completed daily records (journals and rating scales) of their experiences. Parents completed the parents versus anorexia scale pretreatment and post-treatment. The researcher kept an observation journal of the MFT process. A week post-treatment, adolescents and parents took part in separate focus groups. The participants’ insights into the illness increased rapidly from Day 1 to 3, while participants’ emotions fluctuated throughout the 4 days. Motivation for recovery was enhanced for four of the five adolescents and self-efficacy improved for seven of 10 parents. In addition, some improvement in intra-family communication was reported in five of six families. Change was facilitated by the sharing of experiences with other families in a similar situation, role play activities, the increased ability to express emotions and the perceived mutual learning and support.Practitioner pointsSharing of experiences in intensive MFT for AN can help improve insight into the disorder and instill hopeParents becoming ‘firm’ as well as supportive with eating may be the most useful practical strategyRole plays can help increase empathy, motivation and mobilize families for actionOpen expression of feelings works positively, promotes cohesiveness in the group even when this includes difficult emotionsMFT treatment context can be experienced as challenging but nevertheless supportiveJournal of Family Therapy 02/2015; 37(1). DOI:10.1111/1467-6427.12067 · 1.02 Impact Factor
10/2014; 2(3):264-284. DOI:10.1080/21662630.2014.898390
[Show abstract] [Hide abstract]
ABSTRACT: Anorexia nervosa is a serious condition associated with high mortality. Incidence is highest for female adolescents, and prevalence data highlight a pressing unmet need for treatment. While there is evidence that adolescent-onset anorexia has relatively high rates of eventual recovery, the illness is often protracted, and even after recovery from the eating disorder there is an ongoing vulnerability to psychosocial problems in later life. Family therapy for anorexia in adolescence has evolved from a generic systemic treatment into an eating disorder-specific format (family therapy for anorexia nervosa), and this approach has been evidenced as an effective treatment. Individual treatments, including cognitive behavioral therapy, also have some evidence of effectiveness. Most adolescents can be effectively and safely managed as outpatients. Day-patient treatment holds promise as an alternative to inpatient treatment or as an intensive program following a brief medical admission. Evidence is emerging of advantages in detecting and treating adolescent anorexia nervosa in specialist community-based child and adolescent eating-disorder services accessible directly from primary care. Limitations and future directions for modern treatment are considered.Adolescent Health, Medicine and Therapeutics 01/2015; 6:9-16. DOI:10.2147/AHMT.S70300