Family-Based Treatment for Anorexia Nervosa

Status: Strong Research Support


Family-Based Treatment (FBT) for anorexia nervosa is an outpatient intervention for adolescents designed to restore weight without hospitalization; however, if a patient is medically unstable, a brief stay in an inpatient unit to resolve the medical concerns may be warranted, followed by a course of FBT. While there are many types of family therapy, FBT specifically refers to a treatment modality developed at the Maudsley Hospital in London, England or its adaptations. FBT is typically conducted in 20 sessions over 12 months, although a shorter course is sufficient for many cases while additional sessions may be necessary for others. FBT consists of three phases. In the first phase, parents are placed in charge of the process of nutritional rehabilitation and weight restoration with the help of the therapist. The adolescentís autonomy in other domains (friendships, school) is kept intact, at a level consistent with the patientís stage of development. In the second phase of treatment, once the acute starvation is reversed, control over eating is returned to the adolescent. The third phase of treatment addresses termination and issues of family structure and normal adolescent development. FBT views the parents of adolescents with anorexia nervosa as a resource for resolving the problem, and corrects misperceptions of blame directed to the parents and to the ill adolescent. Siblings play a supportive role in treatment, and are protected from the job assigned to the parents. The focus of FBT is not on what caused the anorexia nervosa, but on what can be done to treat it with as little reliance on hospitalization as possible.

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