Abstract
BackgroundFamily-based treatment (FBT) has demonstrated efficacy for anorexia nervosa (AN) in youth in randomized, controlled trials. It is important to assess if it shows a similar effectiveness when implemented in standard care.AimTo evaluate outcomes of FBT for restrictive-type eating disorders, delivered as standard care in a public mental health service. Outcomes are remission, frequency of hospital admissions and day-patient treatment, and frequency of other adaptations within 12 months from commencement of treatment. Second, to compare the collaborative clinical decisions of successful treatment in standard care made by family therapist at the end of treatment, with more objective definitions of recovery.MethodsThe design is a prospective, uncontrolled study of a consecutive series of patients with restrictive-type eating disorders, treated with FBT in a specialty unit at the Child and Adolescent Mental Health Centre in the Capital Region of Denmark.ResultsFBT was successfully completed within 12 months by 57% of participants, and 47% completed with 20 sessions or fewer. Weight restoration was achieved by 75% within 12 months, and 46% achieved both normalisation of body weight and behavioural symptoms of AN within 12 months. A total of 20% needed intensified treatment. All aspects of remission were often not present simultaneously, and the collaborative clinical decisions of successful treatment only partly aligned with other parameters of remission.ConclusionFBT showed good results when implemented as standard care, and it can be adapted to the specifics of local service organisation without compromising effectiveness.
Highlights
Family-based treatment (FBT) focussing on anorexia nervosa (AN) has been established as an efficacious treatment for AN in children and adolescents [1, 2], quantity and quality of the evidence still leaves something to be desired [3]
The distribution implied that 69% of the participants had reached a normal weight when defined as ≥ 95% of their Individually expected body weight (IEBW), whereas the remaining 31% had a lower weight (Table 2)
Our findings add to the knowledge base that FBT can be implemented effectively in a public mental health service, and at other sites than those where the treatment was developed, manualised and tested; standard FBT yielded good outcome for 52% of patients within 12 months, as measured by the collaborative clinical decision of successful treatment made by family and therapist at end of treatment (EOT)
Summary
Family-based treatment (FBT) focussing on anorexia nervosa (AN) has been established as an efficacious treatment for AN in children and adolescents [1, 2], quantity and quality of the evidence still leaves something to be desired [3]. Phase two focuses on gradually returning age-appropriate control of eating to the youth. Phase three focuses on relapse prevention, returning to normal family life, and continuing development of age appropriate autonomy [11]. Family-based treatment (FBT) has demonstrated efficacy for anorexia nervosa (AN) in youth in randomized, controlled trials. Aim: To evaluate outcomes of FBT for restrictive-type eating disorders, delivered as standard care in a public mental health service. To compare the collaborative clinical decisions of successful treatment in standard care made by family therapist at the end of treatment, with more objective definitions of recovery. Conclusion: FBT showed good results when implemented as standard care, and it can be adapted to the specifics of local service organisation without compromising effectiveness
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
