Perceived change mechanisms in multi-family therapy for anorexia nervosa: A qualitative follow-up study of adolescent and parent experiences.
Maudsley family therapy
adolescents
anorexia nervosa
family based treatment
family therapy
group therapy
multi-family therapy
qualitative
Journal
European eating disorders review : the journal of the Eating Disorders Association
ISSN: 1099-0968
Titre abrégé: Eur Eat Disord Rev
Pays: England
ID NLM: 9436977
Informations de publication
Date de publication:
11 2023
11 2023
Historique:
revised:
20
01
2023
received:
10
09
2022
accepted:
24
06
2023
medline:
5
10
2023
pubmed:
7
7
2023
entrez:
7
7
2023
Statut:
ppublish
Résumé
Multi-family therapy (MFT-AN) is a promising group-based treatment for adolescent anorexia nervosa. This study aimed to explore how young people and parents perceived change to occur during MFT treatment. Young people (10-18 years) diagnosed with anorexia nervosa or atypical anorexia nervosa and their parents who completed MFT-AN alongside family therapy for anorexia nervosa within the preceding 2 years were eligible for this study. Semi-structured qualitative interviews were conducted. Recordings were transcribed verbatim and analysed using reflexive thematic analysis. Twenty-three participants (8 young people, 10 mothers and 5 fathers) completed interviews. Five main themes were identified; (1) Powerful connection, (2) Intensity, (3) New learning and perspective shifts, (4) Comparisons, and (5) Discharge is not recovery. There was a strong sense that being with others in a similar position in an intense environment were key factors in promoting change. Comparisons were inevitable and could promote insight and foster motivation, but could also be unhelpful at times. Participants spoke about how recovery continues beyond service use and requires ongoing attention and support. Through the mechanisms of connection, intensity, new learning and comparisons change is perceived to occur in MFT-AN. Some of these are considered unique to this treatment format.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
822-836Informations de copyright
© 2023 Eating Disorders Association and John Wiley & Sons Ltd.
Références
Aebi, M., Kuhn, C., Metzke, C. W., Stringaris, A., Goodman, R., & Steinhausen, H.-C. (2012). The use of the development and well-being assessment (DAWBA) in clinical practice: A randomized trial. European Child & Adolescent Psychiatry, 21(10), 559-567. https://doi.org/10.1007/s00787-012-0293-6
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5 (5th ed.). American Psychiatric Association.
Bandura, A. (1997). Self-efficacy: The exercise of control. ix, 604. W H Freeman/Times Books/ Henry Holt & Co.
Bardone-Cone, A. M., Hunt, R. A., & Watson, H. J. (2018). An overview of conceptualizations of eating disorder recovery, recent findings, and future directions. Current Psychiatry Reports, 20(9), 79. https://doi.org/10.1007/s11920-018-0932-9
Baudinet, J., Eisler, I., Dawson, L., Simic, M., & Schmidt, U. (2021). Multi-family therapy for eating disorders: A systematic scoping review of the quantitative and qualitative findings. International Journal of Eating Disorders, 54(12), 2095-2120. https://doi.org/10.1002/EAT.23616
Baudinet, J., Eisler, I., Simic, M., & Schmidt, U. (2021). Brief early adolescent multi-family therapy (BEAM) trial for anorexia nervosa: A feasibility randomized controlled trial protocol. Journal of Eating Disorders, 9(1), 71. https://doi.org/10.1186/s40337-021-00426-4
Baudinet, J., & Simic, M. (2021). Adolescent eating disorder day programme treatment models and outcomes: A systematic scoping review. Frontiers in Psychiatry, 12, 539. https://doi.org/10.3389/fpsyt.2021.652604
Baudinet, J., Simic, M., & Eisler, I. (2021). Formulation in eating disorder focused family therapy: Why, when and how? Journal of Eating Disorders, 9(1), 97. https://doi.org/10.1186/s40337-021-00451-3
Baudinet, J., Simic, M., & Eisler, I. (2022). From treatment models to manuals: Maudsley single- and multi-family therapy for adolescent eating disorders. In M. Mariotti, G. Saba, & P. Stratton (Eds.), Systemic approaches to manuals (1st ed., pp. 349-372). Springer. https://doi.org/10.1007/978-3-030-73640-8
Baumas, V., Zebdi, R., Julien-Sweerts, S., Carrot, B., Godart, N., Minier, L., & Rigal, N. (2021). Patients and parents’ experience of multi-family therapy for anorexia nervosa: A pilot study. Frontiers in Psychology, 12(101550902), 584565. https://doi.org/10.3389/fpsyg.2021.584565
Birt, L., Scott, S., Cavers, D., Campbell, C., & Walter, F. (2016). Member checking: A tool to enhance trustworthiness or merely a nod to validation? Qualitative Health Research, 26(13), 1802-1811. https://doi.org/10.1177/1049732316654870
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101. https://doi.org/10.1191/1478088706qp063oa
Braun, V., & Clarke, V. (2020). One size fits all? What counts as quality practice in (reflexive) thematic analysis? Qualitative Research in Psychology, 18(3), 1-25. https://doi.org/10.1080/14780887.2020.1769238
Braun, V., & Clarke, V. (2021). To saturate or not to saturate? Questioning data saturation as a useful concept for thematic analysis and sample-size rationales. Qualitative Research in Sport, Exercise and Health, 13(2), 201-216. https://doi.org/10.1080/2159676X.2019.1704846
Byrne, C. E., Accurso, E. C., Arnow, K. D., Lock, J., & Le Grange, D. (2015). An exploratory examination of patient and parental self-efficacy as predictors of weight gain in adolescents with anorexia nervosa: Exploratory examination. International Journal of Eating Disorders, 48(7), 883-888. https://doi.org/10.1002/eat.22376
Carrot, B., Duclos, J., Barry, C., Radon, L., Maria, A.-S., Kaganski, I., Jeremic, Z., Barton-Clegg, V., Corcos, M., Lasfar, M., Gerardin, P., Harf, A., Moro, M.-R., Blanchet, C., & Godart, N. (2019). Multicenter randomized controlled trial on the comparison of multi-family therapy (MFT) and systemic single-family therapy (SFT) in young patients with anorexia nervosa: Study protocol of the THERAFAMBEST study. Trials, 20(1), 249. https://doi.org/10.1186/s13063-019-3347-y
Carter, J. C., Stewart, D. A., & Fairburn, C. G. (2001). Eating disorder examination questionnaire: Norms for young adolescent girls. Behaviour Research and Therapy, 39(5), 625-632. https://doi.org/10.1016/S0005-7967(00)00033-4
Coopey, E., & Johnson, G. (2022). Exploring the experience of young people receiving treatment for an eating disorder: Family therapy for anorexia nervosa and multi-family therapy in an inpatient setting. Journal of Eating Disorders, 10(1), 101. https://doi.org/10.1186/s40337-022-00609-7
Couturier, J., Isserlin, L., Norris, M., Spettigue, W., Brouwers, M., Kimber, M., McVey, G., Webb, C., Findlay, S., Bhatnagar, N., Snelgrove, N., Ritsma, A., Preskow, W., Miller, C., Coelho, J., Boachie, A., Steinegger, C., Loewen, R., Loewen, T., … Pilon, D. (2020). Canadian practice guidelines for the treatment of children and adolescents with eating disorders. Journal of Eating Disorders, 8(101610672), 4. https://doi.org/10.1186/s40337-020-0277-8
Dawson, L., Baudinet, J., Tay, E., & Wallis, A. (2018). Creating community-The introduction of multi-family therapy for eating disorders in Australia. Australian and New Zealand Journal of Family Therapy, 39(3), 283-293. https://doi.org/10.1002/anzf.1324
Dickerson, V. C. (2011). Insider knowledge. Family Process, 50(4), 561-566. https://doi.org/10.1111/j.1545-5300.2011.01368.x
Eisler, I., Simic, M., Blessitt, E., & Dodge, L., & MCCAED Team. (2016). Maudsley service manual for child and adolescent eating disorders. https://mccaed.slam.nhs.uk/wp-content/uploads/2019/11/Maudsley-Service-Manual-for-Child-and-Adolescent-Eating-Disorders-July-2016.pdf
Eisler, I., Simic, M., Hodsoll, J., Asen, E., Berelowitz, M., Connan, F., Ellis, G., Hugo, P., Schmidt, U., Treasure, J., Yi, I., & Landau, S. (2016). A pragmatic randomised multi-centre trial of multifamily and single family therapy for adolescent anorexia nervosa. BMC Psychiatry, 16(1), 422. https://doi.org/10.1186/s12888-016-1129-6
Engman-Bredvik, S., Suarez, N. C., Levi, R., & Nilsson, K. (2016). Multi-family therapy in anorexia nervosa-A qualitative study of parental experiences. Eating Disorders: The Journal of Treatment & Prevention, 24(2), 186-197. https://doi.org/10.1080/10640266.2015.1034053
Escoffié, A., Pretorius, N., & Baudinet, J. (2022). Multi-family therapy for bulimia nervosa: A qualitative pilot study of adolescent and family members’ experiences. Journal of Eating Disorders, 10(1), 91. https://doi.org/10.1186/s40337-022-00606-w
Espíndola, C. R., & Blay, S. L. (2009). Anorexia nervosa’s meaning to patients: A qualitative synthesis. Psychopathology, 42(2), 69-80. https://doi.org/10.1159/000203339
Fairburn, C. G., & Beglin, S. J. (2008). Eating disorder examination questionnaire. In C. G. Fairburn (Ed.), Cognitive behavior therapy and eating disorders (pp. 309-313). Guilford Press.
Fink, K., Rhodes, P., Miskovic-Wheatley, J., Wallis, A., Touyz, S., Baudinet, J., & Madden, S. (2017). Exploring the effects of a family admissions program for adolescents with anorexia nervosa. Journal of Eating Disorders, 5(1), 51. https://doi.org/10.1186/s40337-017-0181-z
Fletcher, A. J. (2017). Applying critical realism in qualitative research: Methodology meets method. International Journal of Social Research Methodology, 20(2), 181-194. https://doi.org/10.1080/13645579.2016.1144401
Fonagy, P., & Allison, E. (2014). The role of mentalizing and epistemic trust in the therapeutic relationship. Psychotherapy, 51(3), 372-380. https://doi.org/10.1037/a0036505
Fonagy, P., Steele, M., Steele, H., Moran, G. S., & Higgitt, A. C. (1991). The capacity for understanding mental states: The reflective self in parent and child and its significance for security of attachment. Infant Mental Health Journal, 12(3), 201-218. https://doi.org/10.1002/1097-0355(199123)12:3<201::AID-IMHJ2280120307>3.0.CO;2-7
Gelin, Z., Cook-Darzens, S., Simon, Y., & Hendrick, S. (2016). Two models of multiple family therapy in the treatment of adolescent anorexia nervosa: A systematic review. Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity, 21(1), 19-30. https://doi.org/10.1007/s40519-015-0207-y
Goodman, R., Ford, T., Richards, H., Gatward, R., & Meltzer, H. (2000). The development and well-being assessment: Description and initial validation of an integrated assessment of child and adolescent psychopathology. Journal of Child Psychology and Psychiatry, 41(5), 645-655. https://doi.org/10.1111/j.1469-7610.2000.tb02345.x
Hamadi, L., & Holliday, J. (2020). Moderators and mediators of outcome in treatments for anorexia nervosa and bulimia nervosa in adolescents: A systematic review of randomized controlled trials. International Journal of Eating Disorders, 53(1), 3-19. https://doi.org/10.1002/eat.23159
Hempel, R., Vanderbleek, E., & Lynch, T. R. (2018). Radically open DBT: Targeting emotional loneliness in anorexia nervosa. Eating Disorders, 26(1), 92-104. https://doi.org/10.1080/10640266.2018.1418268
Heruc, G., Hurst, K., Casey, A., Fleming, K., Freeman, J., Fursland, A., Hart, S., Jeffrey, S., Knight, R., Roberton, M., Roberts, M., Shelton, B., Stiles, G., Sutherland, F., Thornton, C., Wallis, A., & Wade, T. (2020). ANZAED eating disorder treatment principles and general clinical practice and training standards. Journal of Eating Disorders, 8(1), 63. https://doi.org/10.1186/s40337-020-00341-0
Hilbert, A., Hoek, H. W., & Schmidt, R. (2017). Evidence-based clinical guidelines for eating disorders: International comparison. Current Opinion in Psychiatry, 30(6), 423-437. https://doi.org/10.1097/YCO.0000000000000360
Jennings, K. M., & Phillips, K. E. (2017). Eating disorder examination-questionnaire (EDE-Q): Norms for clinical sample of female adolescents with anorexia nervosa. Archives of Psychiatric Nursing, 31(6), 578-581. https://doi.org/10.1016/j.apnu.2017.08.002
Jewell, T., Blessitt, E., Stewart, C., Simic, M., & Eisler, I. (2016). Family therapy for child and adolescent eating disorders: A critical review. Family Process, 55(3), 577-594. https://doi.org/10.1111/famp.12242
Jewell, T., Herle, M., Serpell, L., Eivors, A., Simic, M., Fonagy, P., & Eisler, I. (2021). Attachment and mentalization as predictors of outcome in family therapy for adolescent anorexia nervosa. European Child & Adolescent Psychiatry, 32(7), 1241-1251. https://doi.org/10.1007/s00787-021-01930-3
Khalsa, S. S., Portnoff, L. C., McCurdy-McKinnon, D., & Feusner, J. D. (2017). What happens after treatment? A systematic review of relapse, remission, and recovery in anorexia nervosa. Journal of Eating Disorders, 5(1), 20. https://doi.org/10.1186/s40337-017-0145-3
Knatz Peck, S., Towne, T., Wierenga, C. E., Hill, L., Eisler, I., Brown, T., Han, E., Miller, M., Perry, T., & Kaye, W. (2021). Temperament-based treatment for young adults with eating disorders: Acceptability and initial efficacy of an intensive, multi-family, parent-involved treatment. Journal of Eating Disorders, 9(1), 110. https://doi.org/10.1186/s40337-021-00465-x
Levine, M. P. (2012). Loneliness and eating disorders. The Journal of Psychology, 146(1-2), 243-257. https://doi.org/10.1080/00223980.2011.606435
Lock, A., Epston, D., & Maisel, R. (2004). Countering that which is called anorexia. In Narrative inquiry (Vol. 14, pp. 275-301). John Benjamins. https://doi.org/10.1075/ni.14.2.06loc2
Lock, J., & Le Grange, D. (2012). Treatment manual for anorexia nervosa: A family-based approach (2nd ed.). Guilford Press.
National Institute for Health and Care Excellence (NICE). (2017). Eating disorders (NICE guideline ng69). https://www.nice.org.uk/guidance/ng69
Richmond, T. K., Woolverton, G. A., Mammel, K., Ornstein, R. M., Spalding, A., Woods, E. R., & Forman, S. F. (2020). How do you define recovery? A qualitative study of patients with eating disorders, their parents, and clinicians. International Journal of Eating Disorders, 53(8), 1209-1218. https://doi.org/10.1002/eat.23294
Rockwell, R. E., Boutelle, K., Trunko, M. E., Jacobs, M. J., & Kaye, W. H. (2011). An innovative short-term, intensive, family-based treatment for adolescent anorexia nervosa: Case series: Anorexia nervosa family therapy. European Eating Disorders Review, 19(4), 362-367. https://doi.org/10.1002/erv.1094
Sadeh-Sharvit, S., Arnow, K. D., Osipov, L., Lock, J. D., Jo, B., Pajarito, S., Brandt, H., Dodge, E., Halmi, K. A., Johnson, C., Kaye, W., Wilfley, D., & Agras, W. S. (2018). Are parental self-efficacy and family flexibility mediators of treatment for anorexia nervosa? International Journal of Eating Disorders, 51(3), 275-280. https://doi.org/10.1002/eat.22826
Scholz, M., Rix, M., Scholz, K., Gantchev, K., & Thomke, V. (2005). Multiple family therapy for anorexia nervosa: Concepts, experiences and results. Journal of Family Therapy, 27(2), 132-141. https://doi.org/10.1111/j.1467-6427.2005.00304.x
Simic, M., Baudinet, J., Blessitt, E., Wallis, A., & Eisler, I. (2021). Multi-family therapy for anorexia nervosa: A treatment manual (1st ed.). Routledge. https://doi.org/10.4324/9781003038764
Simic, M., & Eisler, I. (2015). Multi-family therapy. In K. L. Loeb, D. Le Grange, & J. Lock (Eds.), Family therapy for adolescent eating and weight disorders (1st ed., pp. 110-138). Imprint Routledge.
Simic, M., Stewart, C. S., Konstantellou, A., Eisler, I., & Baudinet, J. (2022). From efficacy to effectiveness: Child and adolescent eating disorder treatments in the real world (part 1) - Treatment course and outcomes. Journal of Eating Disorders, 10(1), 27. https://doi.org/10.1186/s40337-022-00553-6
Stewart, C., Voulgari, S., Eisler, I., Hunt, K., & Simic, M. (2015). Multi-family therapy for bulimia nervosa in adolescence. Eating Disorders: The Journal of Treatment & Prevention, 23(4), 345-355. https://doi.org/10.1080/10640266.2015.1044348
Voriadaki, T., Simic, M., Espie, J., & Eisler, I. (2015). Intensive multi-family therapy for adolescent anorexia nervosa: Adolescents’ and parents’ day-to-day experiences. Journal of Family Therapy, 37(1), 5-23. https://doi.org/10.1111/1467-6427.12067
Wallis, A., Rhodes, P., Dawson, L., Miskovic-Wheatley, J., Madden, S., & Touyz, S. (2017). Relational containment: Exploring the effect of family-based treatment for anorexia on familial relationships. Journal of Eating Disorders, 5(1), 27. https://doi.org/10.1186/s40337-017-0156-0
Whitney, J., Murphy, T., Landau, S., Gavan, K., Todd, G., Whitaker, W., & Treasure, J. (2012). A practical comparison of two types of family intervention: An exploratory RCT of family day workshops and individual family work as a supplement to inpatient care for adults with anorexia nervosa. European Eating Disorders Review, 20(2), 142-150. https://doi.org/10.1002/erv.1076
Wierenga, C. E., Hill, L., Peck, S. K., McCray, J., Greathouse, L., Peterson, D., Scott, A., Eisler, I., & Kaye, W. H. (2018). The acceptability, feasibility, and possible benefits of a neurobiologically-informed 5-day multifamily treatment for adults with anorexia nervosa. International Journal of Eating Disorders, 51(8), 863-869. https://doi.org/10.1002/eat.22876
Wiseman, H., Ensoll, S., Russouw, L., & Butler, C. (2019a). Implementing multi-family therapy within a community eating disorder service for children and young people. Journal of Systemic Therapies, 38(3), 50-66. https://doi.org/10.1521/jsyt.2019.38.3.50
Wiseman, H., Ensoll, S., Russouw, L., & Butler, C. (2019b). Multi-family therapy for young people with anorexia nervosa: Clinicians’ and carers’ perspectives on systemic changes. Journal of Systemic Therapies, 38(3), 67-83. https://doi.org/10.1521/jsyt.2019.38.3.67
World Health Organization (Ed.) (2004). International statistical classification of diseases and related health problems (ICD-10). (10th revision, 2nd edition) World Health Organization.