Toward a greater understanding of the ways family-based treatment addresses the full range of psychopathology of adolescent anorexia nervosa
Author(s)
Lock, James
Nicholls, Dasha
Type
Journal Article
Abstract
Family-based treatment (FBT) for anorexia nervosa (AN) is an empirically supported treatment for this disorder. Derived from several different schools of family therapy, it is a highly focused approach that initially targets weight restoration under parental management at home. However, the view that manualized FBT is solely a behavioral therapy directing parents to refeed their children AN with the single purpose of weight gain is a common but misleading over simplification of the therapy. Indeed, weight restoration is the main goal only in phase 1 of this 3-phase treatment. When practiced with fidelity and skill, FBT's broadest aim is to promote adolescent development without AN thoughts and behaviors interfering and disrupting these normal processes. Although weight restoration is a key starting point in FBT, the entire course of treatment takes into consideration the ongoing impact of starvation, cognitions, emotions, and behaviors on adolescent development. These factors associated with maintaining low weight are viewed in FBT as interfering with the adolescent being able to take up the tasks of adolescence and thus must be overcome before fully turning to those broader adolescent tasks. In addition, FBT recognizes that adolescence takes place in the context of family and community and respects the importance of learning in a home environment both for weight gain as well as related developmental tasks to have a lasting effect. Specifically, in this article we describe how the current FBT manualized approach addresses temperament/personality traits, emotional processing, cognitive content and process, social communication and connections, psychiatric comorbidity, and family factors. This report makes no claim to superiority of FBT compared to other therapies in addressing these broader concerns nor does it add interventions to augment the current manual to improve FBT.
Date Issued
2020-01-24
Date Acceptance
2019-12-09
Citation
Frontiers in Psychiatry, 2020, 10, pp.1-8
ISSN
1664-0640
Publisher
Frontiers Media
Start Page
1
End Page
8
Journal / Book Title
Frontiers in Psychiatry
Volume
10
Copyright Statement
© 2020 Lock and Nicholls. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
License URL
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000512150900001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Subjects
Science & Technology
Life Sciences & Biomedicine
Psychiatry
family-based treatment
anxiety
cognitions
social
family
COGNITIVE REMEDIATION THERAPY
RANDOMIZED CLINICAL-TRIAL
EATING-DISORDERS
EMOTION REGULATION
ANXIETY DISORDERS
SELF-ESTEEM
PERFECTIONISM
DEPRESSION
REMISSION
SATISFACTION
Publication Status
Published
Article Number
ARTN 968
Date Publish Online
2020-01-24