How young people perceive change to occur in family therapy for anorexia nervosa: a qualitative study

Abstract

Background Family therapy for anorexia nervosa (FT-AN) is the first line recommended treatment for child and adolescent anorexia nervosa. Despite evidence of its efficacy, little is understood about the treatment mechanisms. This study aimed to understand how young people who have received FT-AN perceive change to occur across treatment. Method Fifteen adolescents (age 12–18 years) completed individual semi-structured interviews online. Recordings were transcribed verbatim and analysed using reflexive thematic analysis. Results Four inter-connected themes describing the process of change during treatment were generated; (1) relationships as the vehicle for change, (2) an awakening, (3) through, not around – no way out, (4) the life beyond. Conclusions Current data match relatively closely with theoretical models of FT-AN and emphasise the importance of building trust with all family members, including the young person. Additionally, supporting the family to create a trusting context in which there is a sense that the only way out of the illness is by going through it (rather than avoiding it) is critical. Empirical investigation of each of the described mechanisms is needed.

Multi-family Therapy for Eating Disorders Across the Lifespan

“…This fits closely theoretically with the aspects of family functioning (roles, communication, general family functioning) that mediated outcomes in the Terache et al [ 43 •] quantitative study. It also supports the idea that MFT (and possibly other intensive treatments) may (re)activate several change processes recently reported for single-family therapy [ 76 ].…”