Family Based Treatment for Adolescents with Anorexia Nervosa (Introduction…
Family Based Treatment for Adolescents with Anorexia Nervosa
Thesis Statement: Family based treatment for adolescents with anorexia nervosa has benefits over individual therapy, but therapists are having difficulty using it in their practice.
Point 1) The format of FBT for adolescents with AN
Point 2) Clinical outcomes for adolescent patients with AN using FBT
Point 3) Challenges of implementing FBT for adolescents with AN
Paragraph 1: the format of FBT for adolescents with AN
Treatment Manual for Anorexia Nervosa, Second Edition: A Family-Based Approach
By James Lock, Daniel Le Grange
Phase I: Initial evaluation and setting up treatment
Session I: First face to face meeting with adolescent and family; priority on engaging each family member.
Session II: Observed family meal; making note of the dynamic and how parents deal with AN behaviours/helping parents to convince the child to eat more than they are prepared to.
Phase II: Helping the adolescent eat on their own
Helping parents to negotiate the return of control of eating disorder symptoms to adolescent; continuing to engage parents until the adolescent is ready to start eating on their own.
Phase III: Adolescent issues
Preparing for the termination of treatment; how the adolescent can deal with potential issues that arise and strategies for parents to help should issues arise.
Paragraph 2: Clinical Outcomes of FBT for adolescents with FBT
Individuals who participated in FBT were more likely to achieve full remission at 6- and 12-month follow ups compared to individuals in adolescent-focused therapy (AFT)
(Lock et al., 2010)
Behavioural family systems therapy significantly reduced conflict over eating between parents and the adolescent.
(Robin et al., 1999)
Adolescents enrolled in FBT were less likely to relapse from full remission within the 12-month follow up period. (Lock et al., 2010)
Paragraph 3: Challenges Implementing Manualized FBT for Adolescent AN
Sub point 1
Therapists indicated that it is harmful to include parents who directly contribute to their child's eating disorder in the treatment plan; such as if the parent has an eating disorder themselves.
(Couturier et al., 2013)
In this case, patients may prefer to use individual treatment as it will help the child develop their own recovery strategies that they can use in spite of parents who are assholes.
Sub Point 2
Therapists may have difficulty following manualized FBT with full fidelity based on individual illness factors
FBT seems to work best with a straight diagnosis of anorexia nervosa, but most clinical cases are comorbid for other psychological disorders.
(Couturier et. al, 2013)
*Ask Jennifer for clarification on this.
Not all therapists feel comfortable including the family in the treatment of an adolescent with AN.
Based on undergraduate/graduate training, some therapists prefer to work with the adolescent only if they don't feel experienced enough to include the family .
(Couturier et al., 2013)