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Published in: Current Psychiatry Reports 5/2014

01-05-2014 | Eating Disorders (AS Kaplan, Section Editor)

Family Therapy for Adolescent Eating Disorders: An Update

Authors: Stuart B. Murray, Daniel Le Grange

Published in: Current Psychiatry Reports | Issue 5/2014

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Abstract

Family therapy has featured in the treatment of adolescent eating disorders for over 40 years, and the evolution of family therapy approaches, through a variety of theoretical lenses, has been significant. For instance, the recent dissemination of family-based treatment has resulted in a growing number of controlled empirical trials which continue to inform and augment treatment outcomes. In addition, a burgeoning number of alternate approaches to family therapy for eating disorders leave clinicians with more clinical considerations in practicing family therapy for eating disorders. In this paper, we aim to review the recent developments in family therapy for adolescent eating disorders, underscoring the impact on clinical practice and the likely implications for future research.
Literature
5.
go back to reference Swanson SA, Crow SJ, Le Grange D, Swendsen J, Merikangas KR. Prevalence and correlates of eating disorders in adolescents: results from the national comorbidity survey replication adolescent supplement. Gen Arch Psychiatry. 2011;68:714–23. doi:10.1001/archgenpsychiatry.2011.22.CrossRef Swanson SA, Crow SJ, Le Grange D, Swendsen J, Merikangas KR. Prevalence and correlates of eating disorders in adolescents: results from the national comorbidity survey replication adolescent supplement. Gen Arch Psychiatry. 2011;68:714–23. doi:10.​1001/​archgenpsychiatr​y.​2011.​22.CrossRef
7.
go back to reference Minuchin S, Rosman BL, Baker L. Psychosomatic families: anorexia nervosa in context. Cambridge: Harvard University Press; 1978. Minuchin S, Rosman BL, Baker L. Psychosomatic families: anorexia nervosa in context. Cambridge: Harvard University Press; 1978.
8.
go back to reference Selvini-Palazzoli M. Self-starvation: from the intrapsychic to transpersonal approach. London: Chaucer; 1974. Selvini-Palazzoli M. Self-starvation: from the intrapsychic to transpersonal approach. London: Chaucer; 1974.
9.
go back to reference Madanes C. Strategic family therapy. San Francisco: Jossey-Bass Publishers; 1981. Madanes C. Strategic family therapy. San Francisco: Jossey-Bass Publishers; 1981.
11.
go back to reference O’Halloran MS. Family involvement in the treatment of anorexia nervosa: a solution-focused approach. Fam J: Couns Ther Couples Fam. 1999;7:384–8.CrossRef O’Halloran MS. Family involvement in the treatment of anorexia nervosa: a solution-focused approach. Fam J: Couns Ther Couples Fam. 1999;7:384–8.CrossRef
13.••
go back to reference Lock J, Le Grange D. Treatment manual for anorexia nervosa: a family-based approach. 2nd ed. New York: Guilford Press; 2013. This treatment manual outlines the theory and clinical application of family-based treatment for adolescent anorexia nervosa. Lock J, Le Grange D. Treatment manual for anorexia nervosa: a family-based approach. 2nd ed. New York: Guilford Press; 2013. This treatment manual outlines the theory and clinical application of family-based treatment for adolescent anorexia nervosa.
14.
go back to reference Le Grange D. Family therapy for adolescent anorexia nervosa. J Clin Psychol. 1999;5:727–40.CrossRef Le Grange D. Family therapy for adolescent anorexia nervosa. J Clin Psychol. 1999;5:727–40.CrossRef
15.
go back to reference Whitney J, Eisler I. Theoretical and empirical models around caring for someone with an eating disorder: the reorganization of family life and inter-personal maintenance factors. J Ment Health. 2005;14:575–85. doi:10.1080/09638230500347889.CrossRef Whitney J, Eisler I. Theoretical and empirical models around caring for someone with an eating disorder: the reorganization of family life and inter-personal maintenance factors. J Ment Health. 2005;14:575–85. doi:10.​1080/​0963823050034788​9.CrossRef
16.
go back to reference Le Grange D, Lock J. Treating bulimia in adolescents: a family-based approach. New York: Guilford Press; 2007. Le Grange D, Lock J. Treating bulimia in adolescents: a family-based approach. New York: Guilford Press; 2007.
17.
go back to reference Le Grange D, Lock J. Bulimia nervosa in adolescents: treatment, eating pathology, and comorbidity. South Afr Psychiatry Rev. 2002;5:19–22. doi:10.4314/ajpsy.v5i3. Le Grange D, Lock J. Bulimia nervosa in adolescents: treatment, eating pathology, and comorbidity. South Afr Psychiatry Rev. 2002;5:19–22. doi:10.​4314/​ajpsy.​v5i3.
20.••
go back to reference Couturier J, Kimber M, Szatmari P. Efficacy of family-based treatment for adolescents with eating disorders: a systematic review and meta-analysis. Int J Eat Disord. 2013;46:3–11. doi:10.1002/eat.22042. A meta-analytic review which found that FBT demonstrates similar outcomes to individual treatment for adolescent anorexia nervosa at the end of treatment, but demonstrated superiority at 6- and 12-month follow—up.PubMedCrossRef Couturier J, Kimber M, Szatmari P. Efficacy of family-based treatment for adolescents with eating disorders: a systematic review and meta-analysis. Int J Eat Disord. 2013;46:3–11. doi:10.​1002/​eat.​22042. A meta-analytic review which found that FBT demonstrates similar outcomes to individual treatment for adolescent anorexia nervosa at the end of treatment, but demonstrated superiority at 6- and 12-month follow—up.PubMedCrossRef
21.
go back to reference Ellison R, Rhodes P, Madden S, Miskovic J, Wallis A, Baillie, et al. Do the components of manualized family-based treatment for anorexia nervosa predict weight gain? Int J Eat Disord. 2012;45:609–14.PubMedCrossRef Ellison R, Rhodes P, Madden S, Miskovic J, Wallis A, Baillie, et al. Do the components of manualized family-based treatment for anorexia nervosa predict weight gain? Int J Eat Disord. 2012;45:609–14.PubMedCrossRef
22.
go back to reference Robinson AL, Strahan E, Girz L, Wilson A, Boachie A. ‘I know I can help you’: parental self-efficacy predicts adolescent outcomes in family-based therapy for eating disorders. Eur Eat Disord Rev. 2013;21:108–14. doi:10.1002/erv.2180.PubMedCrossRef Robinson AL, Strahan E, Girz L, Wilson A, Boachie A. ‘I know I can help you’: parental self-efficacy predicts adolescent outcomes in family-based therapy for eating disorders. Eur Eat Disord Rev. 2013;21:108–14. doi:10.​1002/​erv.​2180.PubMedCrossRef
24.
go back to reference Eisler I, Dare C, Hodes M, Russell G, Dodge E, Le Grange D. Family therapy for adolescent anorexia nervosa: the results of a controlled comparison of two family interventions. J Child Psychol Psychiatry. 2000;41:727–36. doi:10.1111/1469-7610.00660.PubMedCrossRef Eisler I, Dare C, Hodes M, Russell G, Dodge E, Le Grange D. Family therapy for adolescent anorexia nervosa: the results of a controlled comparison of two family interventions. J Child Psychol Psychiatry. 2000;41:727–36. doi:10.​1111/​1469-7610.​00660.PubMedCrossRef
28.
go back to reference Fisher CA, Hetrick SW, Rushford N. Family therapy for anorexia nervosa (review). The Cochrane Collaboration. The Cochrane Library, 2010, Issue 4. Fisher CA, Hetrick SW, Rushford N. Family therapy for anorexia nervosa (review). The Cochrane Collaboration. The Cochrane Library, 2010, Issue 4.
30.
go back to reference Schmidt U, Lee S, Beecham J, Perkins S, Treasure T, Yi I, et al. A randomized controlled trial of family therapy and cognitive behavior therapy guided self-care for adolescents with bulimia nervosa and related disorders. Am J Psychiatr. 2007;164:591–8. doi:10.1176/appi.ajp.164.4.591.PubMedCrossRef Schmidt U, Lee S, Beecham J, Perkins S, Treasure T, Yi I, et al. A randomized controlled trial of family therapy and cognitive behavior therapy guided self-care for adolescents with bulimia nervosa and related disorders. Am J Psychiatr. 2007;164:591–8. doi:10.​1176/​appi.​ajp.​164.​4.​591.PubMedCrossRef
32.••
go back to reference Le Grange D, Lock J, Agras WS, Moye A, Bryson SW, Booil J, et al. Moderators and mediators of remission in family-based treatment and adolescent focused therapy for anorexia nervosa. Behav Res Ther. 2012;50:85–92. doi:10.1016/j.brat.2011.11.003. This paper performed complex mediator and moderator analyses for FBT in adolescent anorexia nervosa, noting that patients with more severe eating-related psychopathology perform better in FBT as opposed to individual treatment.PubMedCentralPubMedCrossRef Le Grange D, Lock J, Agras WS, Moye A, Bryson SW, Booil J, et al. Moderators and mediators of remission in family-based treatment and adolescent focused therapy for anorexia nervosa. Behav Res Ther. 2012;50:85–92. doi:10.​1016/​j.​brat.​2011.​11.​003. This paper performed complex mediator and moderator analyses for FBT in adolescent anorexia nervosa, noting that patients with more severe eating-related psychopathology perform better in FBT as opposed to individual treatment.PubMedCentralPubMedCrossRef
33.
go back to reference Murray SB, Loeb KL, Le Grange D. Mediators and moderators of treatment outcome for adolescent eating disorders. In Maric M, Prins PJM, Ollendick TH (Eds.). Mediators and Moderators of Youth Treatment Outcomes. Murray SB, Loeb KL, Le Grange D. Mediators and moderators of treatment outcome for adolescent eating disorders. In Maric M, Prins PJM, Ollendick TH (Eds.). Mediators and Moderators of Youth Treatment Outcomes.
36.•
go back to reference Le Grange D, Accurso EC, Lock J, Agras WS, Bryson SW. Early weight gain predicts outcome in two treatments for adolescent anorexia nervosa. Int J Eat Disord. 2013;47:124–9. doi:10.1002/eat/22221. This paper investigated the prognostic value of early weight gain in FBT and individual treatment for adolescent anorexia nervosa, reporting in both treatments that adolescents who demonstrate early weight gain are more likely to remitted of symptoms by the end of treatment.PubMedCrossRef Le Grange D, Accurso EC, Lock J, Agras WS, Bryson SW. Early weight gain predicts outcome in two treatments for adolescent anorexia nervosa. Int J Eat Disord. 2013;47:124–9. doi:10.​1002/​eat/​22221. This paper investigated the prognostic value of early weight gain in FBT and individual treatment for adolescent anorexia nervosa, reporting in both treatments that adolescents who demonstrate early weight gain are more likely to remitted of symptoms by the end of treatment.PubMedCrossRef
39.
go back to reference Zaitsoff SL, Doyle AC, Hoste RR, Le Grange D. How do adolescents with bulimia nervosa rate the acceptability and therapeutic relationship in family-based treatment? Int J Eat Disord. 2008;41:390–8. doi:10.1002/eat.20515.PubMedCrossRef Zaitsoff SL, Doyle AC, Hoste RR, Le Grange D. How do adolescents with bulimia nervosa rate the acceptability and therapeutic relationship in family-based treatment? Int J Eat Disord. 2008;41:390–8. doi:10.​1002/​eat.​20515.PubMedCrossRef
41.
go back to reference Murray SB, Griffiths S, Le Grange D. The role of collegial alliance in family-based treatment of adolescent anorexia nervosa. Int J Eat Disord, in press. doi:10.1002/eat22230 Murray SB, Griffiths S, Le Grange D. The role of collegial alliance in family-based treatment of adolescent anorexia nervosa. Int J Eat Disord, in press. doi:10.​1002/​eat22230
42.
go back to reference Murray SB, Thornton C, Griffiths S, Le Grange D. Collegial alliance and family-based treatment for adolescent anorexia nervosa: A case series. Manuscript in Review. Murray SB, Thornton C, Griffiths S, Le Grange D. Collegial alliance and family-based treatment for adolescent anorexia nervosa: A case series. Manuscript in Review.
43.
go back to reference Murray SB, Griffiths S. The integration of wider family therapy practices into family-based treatment for adolescent anorexia nervosa. Manuscript in Review. Murray SB, Griffiths S. The integration of wider family therapy practices into family-based treatment for adolescent anorexia nervosa. Manuscript in Review.
44.•
go back to reference Hildebrandt T, Bacow T, Markella M, Loeb K. Anxiety in anorexia nervosa and its management using family-based treatment. Eur Eat Disord Rev. 2012;20:e1–e16. doi:10.1002/erv.1071. This theoretical paper was the first to postulate as to the cognitive processes of change throughout FBT for adolescent anorexia nervosa.PubMedCrossRef Hildebrandt T, Bacow T, Markella M, Loeb K. Anxiety in anorexia nervosa and its management using family-based treatment. Eur Eat Disord Rev. 2012;20:e1–e16. doi:10.​1002/​erv.​1071. This theoretical paper was the first to postulate as to the cognitive processes of change throughout FBT for adolescent anorexia nervosa.PubMedCrossRef
45.
go back to reference Couturier J, Kimber M, Jack S, Niccols A, Van Blyderveen S, McVey G. Understanding he uptake of family-based treatment for adolescents with anorexia nervosa: therapist perspectives. Int J Eat Disord. 2013;46:177–88. doi:10.1002/eat.22049.47.PubMedCrossRef Couturier J, Kimber M, Jack S, Niccols A, Van Blyderveen S, McVey G. Understanding he uptake of family-based treatment for adolescents with anorexia nervosa: therapist perspectives. Int J Eat Disord. 2013;46:177–88. doi:10.​1002/​eat.​22049.​47.PubMedCrossRef
46.
go back to reference Couturier J, Kimber M, Jack S, Niccols A, Van Blyderveen S, McVey G. Using a knowledge transfer framework to identify factors facilitating implementation of family-based treatment. Int J Eat Disord, In Press. doi:10.1002/eat.22225. Couturier J, Kimber M, Jack S, Niccols A, Van Blyderveen S, McVey G. Using a knowledge transfer framework to identify factors facilitating implementation of family-based treatment. Int J Eat Disord, In Press. doi:10.​1002/​eat.​22225.
47.
go back to reference Rhodes P, Baillie A, Brown J, Madden S. Can parent-to-parent consultation improve the effectiveness of the Maudsley model of family-based treatment for anorexia nervosa? A randomized control trial. J Fam Ther. 2008;30:96–108. doi:10.1111/j.1467.2008.00418.x.CrossRef Rhodes P, Baillie A, Brown J, Madden S. Can parent-to-parent consultation improve the effectiveness of the Maudsley model of family-based treatment for anorexia nervosa? A randomized control trial. J Fam Ther. 2008;30:96–108. doi:10.​1111/​j.​1467.​2008.​00418.​x.CrossRef
48.
go back to reference Binford Hopf RB, Le Grange D, Moessner M, Bauer S. Internet-based chat support groups for parents in family-based treatment for adolescent eating disorders: a pilot study. Eur Eat Disord Rev. 2013;21:215–23. doi:10.1002/erv.2196.PubMedCrossRef Binford Hopf RB, Le Grange D, Moessner M, Bauer S. Internet-based chat support groups for parents in family-based treatment for adolescent eating disorders: a pilot study. Eur Eat Disord Rev. 2013;21:215–23. doi:10.​1002/​erv.​2196.PubMedCrossRef
49.
go back to reference Eisler I. Evaluation of single and multiple family therapy for adolescent anorexia nervosa. Presented at the Eating Disorder Research Society 16th Annual Meeting, October 7–9, 2010; Cambridge, MA, USA. Eisler I. Evaluation of single and multiple family therapy for adolescent anorexia nervosa. Presented at the Eating Disorder Research Society 16th Annual Meeting, October 7–9, 2010; Cambridge, MA, USA.
51.
go back to reference Scholz M, Asen E. Multiple family therapy with eating disordered adolescents: concepts and preliminary results. Eur Eat Disord Rev. 2001;9:33–42. doi:10.1002/erv.364.CrossRef Scholz M, Asen E. Multiple family therapy with eating disordered adolescents: concepts and preliminary results. Eur Eat Disord Rev. 2001;9:33–42. doi:10.​1002/​erv.​364.CrossRef
52.
go back to reference Rockwell R, Boutelle K, Trunko ME, Jacobs MJ, Kaye WH. An innovative short-term, intensive, family-based treatment for adolescent anorexia nervosa: case series. Eur Eat Disord Rev. 2011;19:362–7. doi:10.1002/erv.1094.PubMedCrossRef Rockwell R, Boutelle K, Trunko ME, Jacobs MJ, Kaye WH. An innovative short-term, intensive, family-based treatment for adolescent anorexia nervosa: case series. Eur Eat Disord Rev. 2011;19:362–7. doi:10.​1002/​erv.​1094.PubMedCrossRef
53.
go back to reference Le Grange D, Lock J, Loeb K, Nicholls D. Academy for eating disorders position paper: the role of the family in eating disorders. Int J Eat Disord. 2010;43:1–5. doi:10.1002/eat.20751.PubMed Le Grange D, Lock J, Loeb K, Nicholls D. Academy for eating disorders position paper: the role of the family in eating disorders. Int J Eat Disord. 2010;43:1–5. doi:10.​1002/​eat.​20751.PubMed
54.
go back to reference Murray SB, Loeb KL, Le Grange D. Indexing psychopathology throughout family-based treatment for adolescent anorexia nervosa: Are we on track? Adv Eat Disord: Theor, Res Pract, In Press. doi:10.1080/21662630.2013.831522. Murray SB, Loeb KL, Le Grange D. Indexing psychopathology throughout family-based treatment for adolescent anorexia nervosa: Are we on track? Adv Eat Disord: Theor, Res Pract, In Press. doi:10.​1080/​21662630.​2013.​831522.
55.
go back to reference Loeb KL, Le Grange D. Family-based treatment for adolescent eating disorder: current status, new applications and future directions. Int J Child Adolesc Health. 2009;2:243–54.PubMedCentralPubMed Loeb KL, Le Grange D. Family-based treatment for adolescent eating disorder: current status, new applications and future directions. Int J Child Adolesc Health. 2009;2:243–54.PubMedCentralPubMed
Metadata
Title
Family Therapy for Adolescent Eating Disorders: An Update
Authors
Stuart B. Murray
Daniel Le Grange
Publication date
01-05-2014
Publisher
Springer US
Published in
Current Psychiatry Reports / Issue 5/2014
Print ISSN: 1523-3812
Electronic ISSN: 1535-1645
DOI
https://doi.org/10.1007/s11920-014-0447-y

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