Stay the course: practitioner reflections on implementing family-based treatment with adolescents with atypical anorexia.

Atypical anorexia nervosa Eating disorders Family-based treatment Treatment outcomes Weight restoration

Journal

Journal of eating disorders
ISSN: 2050-2974
Titre abrégé: J Eat Disord
Pays: England
ID NLM: 101610672

Informations de publication

Date de publication:
2019
Historique:
received: 14 11 2018
accepted: 02 04 2019
entrez: 4 5 2019
pubmed: 3 5 2019
medline: 3 5 2019
Statut: epublish

Résumé

Atypical anorexia nervosa (AN) has received minimal empirical attention regarding effective diagnosis and treatment. Family-based treatment (FBT) might be a promising treatment for atypical AN, yet it is unclear as to what adaptations are needed to the current manualized FBT for AN model. The objective of the current study was to identify how FBT practitioners applied FBT for atypical AN for adolescents in their clinical practice, and if there were any implementation challenges and adaptations to the model for this population. The current study employed fundamental qualitative description, with the aim of capturing practitioners' reflections on working with adolescents with atypical AN in clinical practice. A purposeful sample of practitioners with training in FBT were recruited and each participant completed an individual, semi-structured interview. Data was analyzed using conventional content analysis. A total of 23 practitioners participated in this study. The results indicate that practitioners maintained some fidelity to manualized FBT in treating atypical AN, but they differed in their discussions around target weights, what constitutes weight restoration, and the dosage for FBT phases. Salient practice challenges included operationalizing the The results of this qualitative study demonstrate practitioner reflections on the delivery and adaptations of FBT for adolescents with atypical AN. These reflections highlight the need to establish the delivery of coherent and consistent treatment and messaging with patients and families. Further, practitioners' reflections highlight common strategies to increase the sense of urgency in parents to support their child with atypical AN.

Sections du résumé

BACKGROUND BACKGROUND
Atypical anorexia nervosa (AN) has received minimal empirical attention regarding effective diagnosis and treatment. Family-based treatment (FBT) might be a promising treatment for atypical AN, yet it is unclear as to what adaptations are needed to the current manualized FBT for AN model. The objective of the current study was to identify how FBT practitioners applied FBT for atypical AN for adolescents in their clinical practice, and if there were any implementation challenges and adaptations to the model for this population.
METHODS METHODS
The current study employed fundamental qualitative description, with the aim of capturing practitioners' reflections on working with adolescents with atypical AN in clinical practice. A purposeful sample of practitioners with training in FBT were recruited and each participant completed an individual, semi-structured interview. Data was analyzed using conventional content analysis.
RESULTS RESULTS
A total of 23 practitioners participated in this study. The results indicate that practitioners maintained some fidelity to manualized FBT in treating atypical AN, but they differed in their discussions around target weights, what constitutes weight restoration, and the dosage for FBT phases. Salient practice challenges included operationalizing the
CONCLUSIONS CONCLUSIONS
The results of this qualitative study demonstrate practitioner reflections on the delivery and adaptations of FBT for adolescents with atypical AN. These reflections highlight the need to establish the delivery of coherent and consistent treatment and messaging with patients and families. Further, practitioners' reflections highlight common strategies to increase the sense of urgency in parents to support their child with atypical AN.

Identifiants

DOI: 10.1186/s40337-019-0240-8 PMID: 31049201 PMC: PMC6482523
pubmed: 31049201
doi: 10.1186/s40337-019-0240-8
pii: 240
pmc: PMC6482523
doi:

Types de publication

Journal Article

Langues

eng

Pagination

10

Subventions

Organisme : NICHD NIH HHS
ID : R01 HD082166
Pays : United States

Déclaration de conflit d'intérêts

The current study was approved by the University of Calgary Institutional Ethics Board.Dr. Le Grange is the Co-Director of the Training Institute for Child and Adolescent Eating Disorders, LLC, and receives royalties from Routledge and Guilford Press. Dr. Loeb receives royalties from Routledge, and is a faculty member of and consultant for the Training Institute for Child and Adolescent Eating Disorders.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Références

Eat Weight Disord. 2001 Sep;6(3):157-65
pubmed: 11589418
Behav Res Ther. 2005 Jun;43(6):691-701
pubmed: 15890163
Nurs Outlook. 2005 May-Jun;53(3):127-33
pubmed: 15988449
Qual Health Res. 2005 Nov;15(9):1277-88
pubmed: 16204405
Int J Eat Disord. 2007 Apr;40(3):212-7
pubmed: 17173324
Behav Res Ther. 2007 Aug;45(8):1705-15
pubmed: 17374360
J Clin Psychiatry. 2007 May;68(5):738-46
pubmed: 17503983
Physiol Behav. 2007 Sep 10;92(1-2):283-90
pubmed: 17585973
Eur Eat Disord Rev. 2007 Sep;15(5):340-9
pubmed: 17701944
J Clin Psychiatry. 2008 Mar;69(3):381-4
pubmed: 18348598
J Adv Nurs. 2008 Apr;62(1):107-15
pubmed: 18352969
Eur Eat Disord Rev. 2009 Jul;17(4):269-80
pubmed: 19378348
Int J Eat Disord. 2010 Sep;43(6):492-7
pubmed: 19718666
Paediatr Child Health. 2010 Jan;15(1):31-40
pubmed: 21197168
Psychosom Med. 2011 Apr;73(3):270-9
pubmed: 21257978
Int J Eat Disord. 2012 Jul;45(5):711-8
pubmed: 22407912
J Adolesc Health. 2013 Nov;53(5):579-84
pubmed: 24054812
Int J Eat Disord. 2014 Jul;47(5):524-33
pubmed: 24616045
Pediatrics. 2014 Sep;134(3):e758-64
pubmed: 25157005
J Adolesc Health. 2015 Jan;56(1):121-5
pubmed: 25530605
Pediatrics. 2016 Apr;137(4):
pubmed: 27025958
Int J Eat Disord. 2017 Apr;50(4):424-432
pubmed: 28093790
Int J Eat Disord. 2017 Aug;50(8):952-962
pubmed: 28436084
Curr Probl Pediatr Adolesc Health Care. 2017 Apr;47(4):70-84
pubmed: 28532965
Glob Qual Nurs Res. 2017 Nov 24;4:2333393617742282
pubmed: 29204457
Int J Eat Disord. 2018 Jan;51(1):39-45
pubmed: 29215777

Auteurs

Gina Dimitropoulos (G)

1Faculty of Social Work, University of Calgary, 2500 University Drive NW, Calgary, Alberta T2N 1N4 Canada.

Melissa Kimber (M)

2Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada.

Manya Singh (M)

1Faculty of Social Work, University of Calgary, 2500 University Drive NW, Calgary, Alberta T2N 1N4 Canada.

Emily P Williams (EP)

3Werklund School of Education, University of Calgary, Calgary, Canada.

Katharine L Loeb (KL)

School of Psychology, Farleigh Dickinson University, Teaneck, New Jersey USA.

Elizabeth K Hughes (EK)

5Department of Paediatrics, University of Melbourne, Melbourne, Australia.
6Murdoch Children's Research Institute, Melbourne, Australia.
7Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia.

Andrea Garber (A)

8Department of Pediatrics, University of California, San Francisco, California USA.

April Elliott (A)

9Department of Pediatrics, University of Calgary, Calgary, Canada.

Ellie Vyver (E)

9Department of Pediatrics, University of Calgary, Calgary, Canada.

Daniel Le Grange (D)

10Departments of Psychiatry and Pediatrics, University of California, San Francisco, California USA.
Department of Psychiatry and Behavioral Neuroscience (Emeritus), The University of Chicago, Chicago, Illinois USA.

Classifications MeSH