An exploratory study of challenges and successes in implementing adapted family-based treatment in a community setting

Abstract

Although family-based treatment (FBT) is accepted as the first-line treatment for adolescent anorexia nervosa, studies show that it is infrequently used by clinicians in community settings. To elucidate some of the barriers to implementing this evidence-based treatment, mixed (quantitative and qualitative) methods were used in this exploratory study to examine therapist experiences with FBT. Twelve clinicians (N = 12) at a community treatment center retrospectively reported on their experiences with FBT training and supervision in FBT. A subset of clinicians (n = 7) additionally completed a structured interview about their experiences in using FBT. Results demonstrate that therapists endorsed certain common misconceptions about FBT prior to training, but that negative beliefs about FBT decreased after its implementation in their setting. These findings suggest that increased education about evidence-based treatments may diminish negative stereotypes about such treatments, which may ultimately increase their uptake in community settings. Sustainability of FBT is discussed in the context of how this community setting incorporated FBT principles into their ongoing clinical practice.

Translating evidence-based treatment for digital health delivery: a protocol for family-based treatment for anorexia nervosa using telemedicine

“…The interviews will explore the technical, ethical, and practical issues of delivering therapy via telemedicine, both in general and also when working with more than one client (i.e., with families). Further, the interviews will be able to capture the complexity of the family’s experience receiving FBT [ 43 , 61 , 69 ]. Further, the health economic assessments will involve (1) identifying, measuring and valuing both the costs and the consequences of FBT telemedicine or standard care (face-to-face); (2) assessing how changes in health-related quality of life are associated with demographic, socioeconomic and illness-related measures; and (3) an assessment of changes in inequalities in access to healthcare over time for young people with AN.…”

Delivery of Family-Based Treatment for Adolescent Anorexia Nervosa in a Public Health Care Setting: Research Versus Non-Research Specialty Care

“…In particular, it is thought that manualized treatment formats may be too rigid and not a "good fit" for most patients seen in community settings (14,15). Therapists commonly endorse misconceptions and negative beliefs about FBT prior to training (16). Further, therapists who implement FBT often make significant modifications to treatment delivery (17), and in so doing, may unintentionally compromise the effectiveness of treatment.…”

Attitudes Toward Family-Based Treatment Impact Therapists’ Intent to Change Their Therapeutic Practice for Adolescent Anorexia Nervosa

“…Understanding therapist attitudes and beliefs about evidence-based treatments may help to inform dissemination and implementation efforts. Preliminary research shows that patients view FBT as effective and acceptable (8,15). Preliminary data also suggest that community-based clinicians may hold negative beliefs about FBT that decrease over the course of supervision and implementation.…”