Category: Eating Disorders
Objective: Implementation of family-based treatment (FBT) for adolescent eating disorders in community settings has been lacking to date. One obstacle to the implementation of FBT in community settings is the lack of clarity regarding family perspectives of this treatment - for example, little is known about how families rate FBT techniques, feasibility, and efficacy. This study seeks to examine family perspectives of FBT, conducted in an outpatient hospital setting. We hope that by better understanding family perspectives of FBT in this setting, we may obtain preliminary information about perceived treatment strengths and weaknesses, to encourage its implementation in a community setting. In this study, family members’ reports of FBT helpfulness were evaluated in relation to eating disorder outcome and changes in family environment, from baseline to end-of-treatment (EOT).
Method: Participants were 41 adolescents (ages 9 - 20 years, mean age = 14.57; 92.5% female), and 48 parents, all presenting at an outpatient eating disorders research-clinical program at The University of Chicago. Family members’ perspectives of the helpfulness of FBT were assessed using an Eating Disorders Treatment Follow-up Questionnaire, administered at EOT. Eating disorder symptomatology and outcome were assessed using the Eating Disorder Examination (EDE) and percent expected body weight (EBW), taken at baseline and EOT. Family environment was assessed using the Family Environment Scale (FES), completed by the adolescent and parents at baseline and EOT.
Results: Decrease in EDE global score was predictive of adolescent perception of FBT helpfulness (b = -.554, t(29) = -3.585, p < .001). Increase in percent EBW, from baseline to EOT, was predictive of mother perception of FBT helpfulness (b = .481, t(21) = 2.513, p < .020). Change in FES was not found to be significant predictor of FBT helpfulness across any family members’ reports. Further, there were no significant findings for fathers’ views of FBT.
Discussion: The contrast in family members’ reports of FBT suggests that different family members evaluate treatment helpfulness using different markers of outcome. Namely, patients prioritize improvements in cognition, while mothers prioritize improvements in EBW. Such feedback is invaluable, because it provides clinicians with understanding regarding families’ opinions, and may thus guide improvements in care. Optimizing FBT in a clinical setting enhances its reputation as a helpful and viable treatment, and therefore favors its implementation into the community.