A conceptual comparison of family-based treatment and enhanced cognitive behavior therapy in the treatment of adolescents with eating disorders

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Background

The aim of this paper is to give a conceptual comparison of family-based treatment (FBT), a specific form of family therapy, and enhanced cognitive behavior therapy (CBT-E) in the management of adolescents with eating disorders.

Main text

FBT and CBT-E differ in the conceptualization of eating disorders, the nature of involvement of parents and the child/adolescent, the number of treatment team members involved, and evidence of efficacy. FBT is the leading recommended empirically- supported intervention for adolescents with eating disorders. Data from randomized controlled trials indicate that FBT works well with less than half of the parents and adolescents who accept the treatment, but cannot be used with those who do not have available parents, or for those with parents who are not accepting of a FBT model, or are unable to participate in a course of this treatment. CBT-E has shown promising results in cohort studies of patients between ages 11 and 19 years, and has recently been recommended for youth with eating disorders when FBT is unacceptable, contraindicated, or ineffective.

Conclusion

There is a need to compare these two treatments in a randomized controlled trial to assess their acceptability, effectiveness, relative cost and cost-effectiveness, and to explore moderators of treatment response.

Related collections

Most cited references 26

Record: found
Abstract: found
Article: not found

Cognitive behaviour therapy for eating disorders: a "transdiagnostic" theory and treatment.

Christopher Fairburn, Zafra Cooper, Roz Shafran (2003)

This paper is concerned with the psychopathological processes that account for the persistence of severe eating disorders. Two separate but interrelated lines of argument are developed. One is that the leading evidence-based theory of the maintenance of eating disorders, the cognitive behavioural theory of bulimia nervosa, should be extended in its focus to embrace four additional maintaining mechanisms. Specifically, we propose that in certain patients one or more of four additional maintaining processes interact with the core eating disorder maintaining mechanisms and that when this occurs it is an obstacle to change. The additional maintaining processes concern the influence of clinical perfectionism, core low self-esteem, mood intolerance and interpersonal difficulties. The second line of argument is that in the case of eating disorders shared, but distinctive, clinical features tend to be maintained by similar psychopathological processes. Accordingly, we suggest that common mechanisms are involved in the persistence of bulimia nervosa, anorexia nervosa and the atypical eating disorders. Together, these two lines of argument lead us to propose a new transdiagnostic theory of the maintenance of the full range of eating disorders, a theory which embraces a broader range of maintaining mechanisms than the current theory concerning bulimia nervosa. In the final sections of the paper we describe a transdiagnostic treatment derived from the new theory, and we consider in principle the broader relevance of transdiagnostic theories of maintenance.

0 comments Cited 344 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Randomized clinical trial comparing family-based treatment with adolescent-focused individual therapy for adolescents with anorexia nervosa.

James Lock, Daniel Le Grange, W Stewart Agras … (2010)

Evidence-based treatment trials for adolescents with anorexia nervosa are few. To evaluate the relative efficacy of family-based treatment (FBT) and adolescent-focused individual therapy (AFT) for adolescents with anorexia nervosa in full remission. Randomized controlled trial. Stanford University and The University of Chicago (April 2005 until March 2009). One hundred twenty-one participants, aged 12 through 18 years, with DSM-IV diagnosis of anorexia nervosa excluding the amenorrhea requirement. Intervention Twenty-four outpatient hours of treatment over 12 months of FBT or AFT. Participants were assessed at baseline, end of treatment (EOT), and 6 months' and 12 months' follow-up posttreatment. Full remission from anorexia nervosa defined as normal weight (≥95% of expected for sex, age, and height) and mean global Eating Disorder Examination score within 1 SD of published means. Secondary outcome measures included partial remission rates (>85% of expected weight for height plus those who were in full remission) and changes in body mass index percentile and eating-related psychopathology. There were no differences in full remission between treatments at EOT. However, at both the 6- and 12-month follow-up, FBT was significantly superior to AFT on this measure. Family-based treatment was significantly superior for partial remission at EOT but not at follow-up. In addition, body mass index percentile at EOT was significantly superior for FBT, but this effect was not found at follow-up. Participants in FBT also had greater changes in Eating Disorder Examination score at EOT than those in AFT, but there were no differences at follow-up. Although both treatments led to considerable improvement and were similarly effective in producing full remission at EOT, FBT was more effective in facilitating full remission at both follow-up points. clinicaltrials.gov Identifier: NCT00149786.

0 comments Cited 229 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

An evaluation of family therapy in anorexia nervosa and bulimia nervosa.

Donna Dare, I Eisler, David Russell … (1987)

A controlled trial comparing family therapy with individual supportive therapy in anorexia nervosa and bulimia nervosa was undertaken. Eighty patients (57 with anorexia nervosa; 23 with bulimia nervosa) were first admitted to a specialized unit to restore their weight to normal. Before discharge, they were randomly allocated to family therapy or the control treatment (individual supportive therapy). After one year of psychological treatment, they were reassessed, using body weight, menstrual function, and ratings on the Morgan and Russell scales. Family therapy was found to be more effective than individual therapy in patients whose illness was not chronic and had begun before the age of 19 years. A more tentative finding was the greater value of individual supportive therapy in older patients. To our knowledge, this is the first controlled trial of family therapy in anorexia nervosa and clarifies the specific indications for this treatment.

0 comments Cited 126 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

Riccardo Dalle Grave:

ORCID: http://orcid.org/0000-0002-9796-3721

+39-045-8103915 , rdalleg@gmail.com

Sarah Eckhardt: 0000-0003-0824-4328

Simona Calugi: 0000-0002-4028-1877

Daniel Le Grange: 0000-0001-7293-9496

Journal

Journal ID (nlm-ta): J Eat Disord

Journal ID (iso-abbrev): J Eat Disord

Title: Journal of Eating Disorders

Publisher: BioMed Central (London )

ISSN (Electronic): 2050-2974

Publication date (Electronic): 31 December 2019

Publication date PMC-release: 31 December 2019

Publication date Collection: 2019

Volume: 7

Electronic Location Identifier: 42

Affiliations

[1 ]GRID grid.416990.3, Department of Eating and Weight Disorders, , Villa Garda Hospital, ; Via Montebaldo 89 1-37016 Garda (VR), Verona, Italy

[2 ]Center for the Treatment of Eating Disorders, Children’s Minnesota, Minneapolis, MN USA

[3 ]ISNI 0000 0001 2297 6811, GRID grid.266102.1, Department of Psychiatry, , University of California, ; San Francisco, CA USA

[4 ]ISNI 0000 0004 1936 7822, GRID grid.170205.1, Department of Psychiatry and Behavioral Neuroscience, , The University of Chicago, ; Chicago, IL USA

Author information

Riccardo Dalle Grave http://orcid.org/0000-0002-9796-3721

Article

Publisher ID: 275

DOI: 10.1186/s40337-019-0275-x

PMC ID: 6937631

PubMed ID: 31893120

SO-VID: 1449425b-d4a4-4942-9c7f-2aae51bd4da4

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 16 September 2019

Date accepted : 19 November 2019

Custom metadata

Keywords: eating disorders,anorexia nervosa,treatment,family-based treatment,enhanced cognitive behavior therapy

Data availability:

Keywords: eating disorders, anorexia nervosa, treatment, family-based treatment, enhanced cognitive behavior therapy

A conceptual comparison of family-based treatment and enhanced cognitive behavior therapy in the treatment of adolescents with eating disorders

Read this article at

Abstract

Background

Main text

Conclusion

Related collections

Future Science Group: Coronavirus

Most cited references 26

Cognitive behaviour therapy for eating disorders: a "transdiagnostic" theory and treatment.

Randomized clinical trial comparing family-based treatment with adolescent-focused individual therapy for adolescents with anorexia nervosa.

An evaluation of family therapy in anorexia nervosa and bulimia nervosa.

Author and article information

Contributors

Journal

Affiliations

Author information

Article

History

Categories

Custom metadata

Comments

Comment on this article

Similar content 272

Cited by 14

Most referenced authors 105