Accumulating evidence supports family-based therapy (FBT) for treating eating disorders during adolescence. However, just as for other manualized therapies, successful FBT depends on the availability of trained FBT therapists. Unfortunately, trained FBT therapists are not widely distributed, even though adolescents with eating disorders are found everywhere.
One approach to this problem is to have families travel to specialized centers for short-term, intensive treatment. To test the concept, researchers at the University of California-San Diego (UCSD) developed a 5-day intensive treatment program for teens, designed around the principles of FBT (Eur Eat Disord Rev. 2015 Mar 16. Doi:10.1002/erv.2353[Epub ahead of print].
Testing the concept in two types of family settings
Erica Marzola, MD, and her colleagues retrospectively examined the long-term efficacy of intensive family therapy in both single-family and multi-family settings. Their subjects were 74 adolescents with eating disorders who participated in a 5-day intensive treatment program at UCSD between 2006 and 2013. A stringent definition of full remission was used: >=95% of weight expected for gender, age, and height; a global score on the EDE-Q within 1 standard deviation of norms; and absence of binge-purge behaviors. Partial remission was defined as weight ≥ 85% of expected weight or ≥ 95% but with an elevated EDE-Q global score and presence of binge-purge symptoms less than once per week.
The researchers followed the adolescents for 30 months. During that time, 60.8% of the teens reached full remission, and 27% got to partial remission. Poor outcome occurred in 12.2%. The program used single-family and multifamily formats, and these appeared comparable. These preliminary results suggest that intensive FBT may be a useful strategy, particularly when access to specialized treatment is limited by geography.