Parental caregiver burden and recovery of adolescent anorexia nervosa after multi-family therapy

Abstract

This study investigated whether parental caregiving burden changed during adjunct multi-family therapy of adolescent anorexia nervosa and eating disorders not otherwise specified (EDNOS) and whether caregiver burden at baseline and changes in caregiver burden during treatment were associated with treatment outcome. Twenty-four females, 13 to 16 years old, and their parents, participated in the study. Caregiver burden was measured with the Eating Disorders Symptom Impact Scale, by mothers (n = 23) and fathers (n = 22). Treatment outcome was measured by adolescent body mass index, level of global functioning and self-rated eating disorder symptoms by the Eating Disorders Examination Questionnaire 4.0. All patient outcomes improved and overall caregiver burden decreased significantly during treatment. When broken down in aspects of caregiver burden the decrease in parental perceived isolation, was found to be associated with improvement of BMI and Children's Global Assessment Scale. When analyzing fathers and mothers separately, we found that maternal feelings of guilt and paternal perceived burden of dysregulated behaviors at base-line were correlated to treatment outcome. Future studies are needed to clarify the role of caregiver burden as a potential mediator of treatment results. Clinical Implications • Multi-Family Therapy shows preliminary effectiveness as an adjunct treatment for adolescent anorexia nervosa. • Parents' parental burden decreased pre-to post Multi-family Therapy. • Fathers' perceived dysregulated behaviors in the patient pretreatment were associated with decrease of Body Mass Index during treatment. • Fathers are a resource in treatment and should be more specifically supported in the participation of Multi-Family Therapy.

Multi‐family therapy for eating disorders: A systematic scoping review of the quantitative and qualitative findings

“…Outpatient MFT‐AN for young people was associated with a range of caregiver/parent improvements. By the end of treatment, caregiver burden and most negative impacts of the illness significantly reduced in one study (Dennhag et al, 2019 ). Perceived caregiver isolation was the only aspect that did not change during MFT (Dennhag et al, 2019 ).…”

“…By the end of treatment, caregiver burden and most negative impacts of the illness significantly reduced in one study (Dennhag et al, 2019 ). Perceived caregiver isolation was the only aspect that did not change during MFT (Dennhag et al, 2019 ). In another study, parental mood improved (Salaminiou et al, 2017 ).…”

Psychosocial and financial impacts for carers of those with eating disorders in New Zealand

“…In response to this, care-giver issues have been more explicitly included in the new Maudsley model [ 33 ]. Subsequent research has explored the impact of providing direct interventions to reduce this carer burden [ 34 – 36 ].…”

Interfamily Therapy, a multifamily therapy model settled in infant‐juvenile mental health services of Havana (Cuba): A qualitative study from participants’ perspectives

“…According to this finding, in this study, participants (mainly the parents) focused discourse mostly on their own therapeutic process. This is in contrast with studies on other MFT models, in which participants’ discourse on improvement was focused on the symptoms related to the children/adolescents’ diagnoses (identified patient) and only secondarily were other aspects, such as caregiver's burden, evaluated (Dennhag et al, 2019; Engman‐Bredvik et al, 2016; Stewart et al, 2019). In that regard, in IFT, the facilitators do not make a distinction between “identified patients” and “family members”; all participants are submitted as active subjects in therapy, and they participate in therapeutic mechanisms the same way (Sempere & Fuenzalida, 2017).…”