Family versus individual therapy for anorexia: Impact on family conflict

Abstract

This study evaluated the impact on family relations of behavioral family systems therapy (BFST) versus ego‐oriented individual therapy (EOIT) as treatments for adolescents with anorexia nervosa. Twenty‐two adolescents meeting DSM‐III‐R anorexia nervosa criteria were randomly assigned to receive approximately 16 months of either BFST or EOIT along with a common medical and dietary regimen. BFST emphasized parental control over eating, cognitive restructuring, and problem‐solving communication training. EOIT emphasized building ego strength, adolescent autonomy, and insight. Measures included body mass index, self‐reported general and eating‐related conflict, and observed general and eating‐related communication. Both treatments produced significant reductions in negative communication and parent‐adolescent conflict, with some differences between conditions and between eating and non‐eating related conflict measures; the improvements in eating‐related conflict were maintained at a 1‐year follow‐up. The study demonstrated that structured therapies for adolescent anorexia do impact family relations, even when the family is never seen as a unit during the therapy. © 1995 by John Wiley & Sons, Inc.

A Randomized Controlled Trial of Adjunctive Family Therapy and Treatment as Usual Following Inpatient Treatment for Anorexia Nervosa Adolescents

“…These studies compared the contribution of FT to that of individual therapy [16], [17], [21], [22], [54], or compared two types of FT intervention [18], [19], [54], [55], or compared two FT durations [23], [24]. Overall, these studies suggest that: FT participants have a better outcome; conjoint and separated FT have similar effects; FT of six or 12 months' duration have similar effect.…”

The State of the Evidence Base for Psychodynamic Psychotherapy for Children and Adolescents

“…As is often found, the non-psychodynamic approach produced changes faster, but in this instance carried the cost of a somewhat higher rate of hospitalization. Both therapies produced equally large improvements in attitudes to eating and depressed affect and family functioning 62 . Robin and colleagues concluded that parental involvement was essential to the success of their interventions for younger adolescents with anorexia nervosa, but that family dynamics could still be influenced without requiring the adolescent and her parents to be in the room together for all therapy sessions.…”

Catherine Freer Wilderness Therapy Expeditions: An Exploratory Case Study of Adolescent Wilderness Therapy, Family Functioning, and the Maintenance of Change

“…Less understood although, is how, when, and to what extent family involvement is most effective in adolescent mental health treatment (e.g., Eisler et al 2000;Robin et al 1995). Since families are recognized as a key component in the treatment of child and adolescent emotional and behavioral issues (Diamond et al 1996), effort needs to be taken by mental and behavioral health service providers to include families in a manner that is guided by empirical understanding and with skills and knowledge to respectfully maintain the dignity of the family system (Dishion and Kavanagh 2003;Hill and Garfat 2003).…”