Family Therapy for Child and Adolescent Eating Disorders: A Critical Review

Fam Process. 2016 Sep;55(3):577-94. doi: 10.1111/famp.12242. Epub 2016 Aug 19.

Abstract

Eating disorder-focused family therapy has emerged as the strongest evidence-based treatment for adolescent anorexia nervosa, supported by evidence from nine RCTs, and there is increasing evidence of its efficacy in treating adolescent bulimia nervosa (three RCTs). There is also emerging evidence for the efficacy of multifamily therapy formats of this treatment, with a recent RCT demonstrating the benefits of this approach in the treatment of adolescent anorexia nervosa. In this article, we critically review the evidence for eating disorder-focused family therapy through the lens of a moderate common factors paradigm. From this perspective, this treatment is likely to be effective as it provides a supportive and nonblaming context that: one, creates a safe, predictable environment that helps to contain anxiety generated by the eating disorder; two, promotes specific change early on in treatment in eating disorder-related behaviors; and three, provides a vehicle for the mobilization of common factors such as hope and expectancy reinforced by the eating disorder expertise of the multidisciplinary team. In order to improve outcomes for young people, there is a need to develop an improved understanding of the moderators and mediators involved in this treatment approach. Such an understanding could lead to the refining of the therapy, and inform adaptations for those families who do not currently benefit from treatment.

Keywords: Adolescence; Anorexia Nervosa; Bulimia Nervosa; Common Factors; Eating Disorders; Family Therapy; adolescencia; anorexia nerviosa; bulimia nerviosa; factores comunes; terapia familiar; trastornos alimenticios; 公因式; 家庭心理治疗; 精神性厌食症; 精神性贪食症; 青少年; 饮食失调.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Anorexia Nervosa / psychology
  • Anorexia Nervosa / therapy*
  • Child
  • Family Therapy / methods*
  • Feeding and Eating Disorders / psychology
  • Feeding and Eating Disorders / therapy*
  • Female
  • Humans
  • Male
  • Patient Care Team
  • Treatment Outcome