Parents Allowed: Family-Focused Therapy Works Better for Teens with Eating Disorders

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Markus Moellenberg/Corbis

Treatment for anorexia has traditionally focused on individual rehabilitation of the patient, often in a residential treatment center away from the family. Indeed, for decades, leading treatment centers have recommended “parent-ectomy” — removing the influence of a dysfunctional family, who were often blamed for exacerbating the patient’s eating disorder — as part of treatment. But a new study suggests that tactic is misguided.

The first randomized controlled trial to compare outcomes of family-based treatment to individual therapy for teenagers with anorexia has found that involving the family in treatment is more than twice as effective as individual care.

The study, which was published in the October 4 issue of the Archives of General Psychiatry, was led by researchers at Stanford and the University of Chicago. It followed 121 adolescents aged 12 to 18 with anorexia. Half of the participants were given individual therapy, the other half were treated with the “Maudsley Method,” also known as family-based treatment (FBT), an approach to family therapy for anorexia pioneered at the Maudsley Hospital in London. (More on Does Teen Drug Rehab Cure Addiction or Create It?)

In the FBT group, parents were taught to monitor their children’s eating and exercise behaviors, and to support and reinforce healthy eating. Individual therapy for anorexia focused more on the psychological problems believed to underly patients’ eating disorders; patients were taught to be mindful of their feelings instead of trying to escape them by starving themselves, and were asked to control their own eating behavior, rather than ceding responsibility to parents.

Patients in both groups were in treatment for one year. At follow-up, one year after treatment, 49.3% of the family therapy group were in full remission, defined as reaching at least 95% of normal body weight and scoring in the normal range on a psychiatric measure of disordered eating. By comparison, 23% of individual-therapy patients were in remission. (More on SPECIAL: Health and Happiness).

Relapse rates for family-based treatment were also lower than those typically seen after residential treatment, according to the study authors, at about 10% versus 40%.

Anorexia is more common in females and affects about 1% of women and girls. It is marked by starvation-level dieting and over-exercise, and is fatal in about 10% of severe cases. (More on Top 10 Unusual Medical Treatments).