Family members’ reflections upon a family-based inpatient treatment program for adolescent anorexia nervosa: a thematic analysis

Abstract Background Family-based outpatient treatment is usually recommended as the treatment of choice when a child develops anorexia nervosa. However, some young persons will inevitably require higher levels of care. Qualitative research on family perspectives may help inform strategies to adapt family-based practices into intensified treatment settings. Our overarching aim was to investigate family members’ perspectives following a family-based inpatient treatment program for adolescent anorexia nervosa and to discuss clinical implications for treatment providers. Methods A subsample of eight families taking part in a naturalistic outcome study at a specialized eating disorder unit participated in the study (8 patients, 14 parents, and 10 siblings). The thematic analyses were inductive, predominantly descriptive, and guided by a multi-perspective framework. Results Five main themes were identified: 1: Expectations and evaluation of needs. Entering treatment from different vantage points, 2: Interactions with peers during the admission as highly beneficial or problematic, 3: Perspectives on staff expertise and the eating disorder unit’s structure, 4: Influencing within family relationships in different ways, and 5: Being admitted is at best only half the job: reflections on leaving the eating disorder unit. Conclusions Our study offers insight into how former inpatients and their family members experienced an inpatient treatment program designed to align treatment with the central elements of an outpatient family-based treatment approach for adolescent anorexia nervosa. Overall, the findings support emerging research underlining the necessity of strengthening the family-based treatment approach within intensified treatment settings. Moreover, the results emphasized the need for more knowledge on how to optimize inpatient treatment as well as the importance of providing smooth transitions between care settings.

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Feasibility, acceptability, and effectiveness of family-based treatment for adolescent anorexia nervosa: an observational study conducted in Brazil

Brazilian Journal of Psychiatry ◽

10.1590/s1516-44462010005000001 ◽

2010 ◽

Vol 32 (2) ◽

pp. 169-172 ◽

Cited By ~ 18

Author(s):

Gizela Turkiewicz ◽

Vanessa Pinzon ◽

James Lock ◽

Bacy Fleitlich-Bilyk

Keyword(s):

Body Mass Index ◽

Anorexia Nervosa ◽

Eating Disorder ◽

Observational Study ◽

End Of Treatment ◽

English Speaking ◽

Adolescent Anorexia Nervosa ◽

Family Based Treatment ◽

Family Based

OBJECTIVE: There is strong evidence that family-based treatment is effective in cases of adolescent anorexia nervosa. Although family-based treatment has been studied in English-speaking countries, there is a need to examine the generalizability of this approach to non-English speaking cultures. This pilot-study aimed to examine the feasibility, acceptability, and effectiveness of family-based treatment in Brazil. METHOD: Observational study of adolescents with anorexia nervosa (excluding menstrual criteria), as determined with the Diagnostic and Well-Being Assessment, referred for treatment at a specialized center in São Paulo, Brazil. The following data were collected at baseline, at the end of treatment, and after six months of follow-up: weight; height; body mass index; menstrual status; Eating Disorder Examination Questionnaire score; and Children Global Assessment of Functioning Scale score. RESULTS: Of 11 eligible patients/families, 9 (82%) enrolled in the study, and 7 (78%) completed the treatment. The mean patient age was 14.64 ± 1.63 years (range, 12.33-17.00 years). The Wilcoxon signed rank test showed statistically significant improvement in weight and body mass index at the end of treatment, as well as after six months of follow-up, at which point none of the patients met the diagnostic criteria for any eating disorder. CONCLUSION: The results suggest that family-based treatment is acceptable and feasible for Brazilian families. Outcomes suggest that the approach is effective in this cultural context, leading to improvements similar to those reported in previous studies conducted in other cultures.

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