A Pilot Study of a Family-Based Treatment for Adolescent Anorexia Nervosa: 18- and 36-Month Follow-ups

Paulson-Karlsson, Gunilla; Engström, Ingemar; Nevonen, Lauri

doi:10.1080/10640260802570130

Cited by 37 publications

(33 citation statements)

References 40 publications

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“…It has been shown to be effective in an open trial involving 20 participants at another U.S. academic centre and the authors suggest that this is a first step in providing evidence of successful dissemination (Loeb et al, 2007). Another recent pilot study examining a combination of conjoint and separated Family-Based Treatment also has shown positive results in Sweden (Paulson-Karlsson, Engstrom, & Nevonen, 2009). However, these studies did not examine aspects of dissemination such as treatment fidelity and acceptability.…”

mentioning

confidence: 99%

Family-Based Treatment for Adolescents With Anorexia Nervosa: A Dissemination Study

2010

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Objective This open trial of Family-Based Treatment for Anorexia Nervosa was completed in order to assess the dissemination of this treatment, including effectiveness, fidelity, and acceptability. Method Fourteen adolescents with Anorexia Nervosa were recruited with mean age 14.0±1.5 years (range 12–17 years). Therapists were trained using a workshop, manual and weekly supervision. Sessions were videotaped and rated for treatment fidelity. Pre- and post-treatment assessments were compared. Results Weight was significantly increased by an average of 7.8 kg. Dietary restraint showed significant improvement, as did interoceptive deficits and maturity fears. Of the 9 participants who had secondary amenorrhea at baseline, 8 had regained menstrual function. Treatment fidelity was rated as at least considerable 72% of the time in phase I of the treatment. Adolescents and parents found the treatment to be acceptable. Discussion This preliminary investigation of the dissemination of Family-Based Treatment for adolescents with Anorexia Nervosa indicates that this treatment is effective not only for weight restoration, but also in improving some psychological symptoms including dietary restraint, interoceptive deficits, and maturity fears. In addition, this treatment was adopted with considerable fidelity and was acceptable to adolescents and parents.

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confidence: 99%

Family-Based Treatment for Adolescents With Anorexia Nervosa: A Dissemination Study

2010

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“…Investigations into the change processes that occur over the course of structural family therapy are notably absent [7], [40]. In families of AN patients, restructuring typically involves several overlapping processes:…”

Section: Methodsmentioning

confidence: 99%

“…Yet, the key features of these therapeutic changes still require identification and characterisation. Specifically, the critical variables involved in the mechanisms leading to the improvement of nutritional and psychological states of AN patients still need to be defined [5], [7]. As conflictual communication and nonverbal behaviour in families of patients with psychiatric disorders have been considered as fundamental components of interaction processes [8]–[10], they constitute important variables for revealing key features of therapeutic changes in family therapy.…”

Section: Introductionmentioning

confidence: 99%

Affiliative Behaviour and Conflictual Communication during Brief Family Therapy of Patients with Anorexia Nervosa

et al. 2013

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ObjectiveAlthough patients with anorexia nervosa (AN) present positive responses to family therapy, the key features of therapeutic changes still require identification. This study explores the role of conflictual communication and affiliative nonverbal behaviour in therapeutic change in brief strategic family therapy (BSFT) for AN patients.MethodsTen female AN patients and their parents were included in the sample and took part in a 6-month follow-up of BSFT. The durations of conflictual communication and of affiliative nonverbal behaviour estimated by eye contact were compared between the first and the last sessions of family-based treatment using nonparametric statistical tests.ResultsAn increase of the Body Mass Index associated with an increase in the conflictual communication expressed during BSFT sessions were observed. Moreover, affiliative nonverbal behaviour expressed by the father and the patient decrease, after a BSFT follow-up, in conflictual situations only. By contrast, no significant difference was observed in affiliative nonverbal behaviour expressed by the mother.ConclusionThe present study demonstrates that the impact of the BSFT differs between members of a family: the AN patient and the father have established a new form of emotional functioning with a decrease in emotional involvement. The study of the combination between verbal and nonverbal communication can represent an important step in the understanding of the mechanisms of therapeutic change.

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“…Several methodological limitations were identified in the studies assessed: lack of description regarding the inclusion and exclusion criteria 29,30 , loss of a significant number of participants (> 25%) during treatment and follow-up 9,24 , lack of clarity regarding the remission criteria or remission assessed exclusively on the basis of biological markers 12,25,[29][30][31] , difficulty in randomizing baseline participants 26,31 , presence of confounding variables, such as the need for hospitalization, the use of antidepressants for the treatment of comorbidities, which were not necessarily controlled in the analyses 18,22,26,27,30,31 and non-probabilistic samples 20,25,29,30 . In only one study no methodological limitations were found 28 .…”

Section: Methodological Limitationsmentioning

confidence: 99%

“…The use of proven effective treatments by the respective health care professionals, is therefore fundamental. However, due to the complex interaction of clinical and psychiatric problems, with emphasis on the ambivalent attitudes of patients and their families towards treatment 8,10 , there are significant obstacles that moderate the effectiveness of psychotherapeutic interventions and contribute to a limited number of studies in the area 11,12 .…”

Section: Introductionmentioning

confidence: 99%

Evidence-based psychotherapy for treatment of anorexia nervosa in children and adolescents: systematic review

Alckmin-Carvalho

Vega

Cobelo

et al. 2018

Arch. Clin. Psychiatry (São Paulo)

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Background: Efficacy studies on the treatment of anorexia nervosa (AN) in childhood and adolescence are scarce and systematic reviews are almost non-existent. Objective: Systematic review of the literature regarding the modalities of psychological intervention based on evidence used in the treatment of AN in childhood and adolescence. Methods: The research was carried out in the databases: PubMed, PsycINFO and Cochrane, using the combined keywords: anorexia nervosa and evidence-based therapy. Articles published between 1990 and 2015 were assessed. Results: Of the 139 eligible articles, 14 were selected, of which 10 (71.4%) were conducted in the United States and England. The sample ranged from 9 to 167 participants. Randomized Clinical Trial represented the most frequent design (n = 9; 63.4%), with more than half of the interventions structured in 20 or more sessions (n = 9, 64.3%). Nine types of treatments were tested, with the most tested being Family-Based Treatment (FBT) (n = 7; 50%). Interventions involving the family seem to be more effective, however, the rates for complete remission are modest. Discussion: Although evidence of efficacy was verified in the treatments analyzed, the limited number of studies, the various methodological limitations and the methodological heterogeneity between studies make the findings inconclusive.

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A Pilot Study of a Family-Based Treatment for Adolescent Anorexia Nervosa: 18- and 36-Month Follow-ups

Cited by 37 publications

References 40 publications

Family-Based Treatment for Adolescents With Anorexia Nervosa: A Dissemination Study

Family-Based Treatment for Adolescents With Anorexia Nervosa: A Dissemination Study

Affiliative Behaviour and Conflictual Communication during Brief Family Therapy of Patients with Anorexia Nervosa

Evidence-based psychotherapy for treatment of anorexia nervosa in children and adolescents: systematic review

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