Stay the course: practitioner reflections on implementing family-based treatment with adolescents with atypical anorexia
Abstract 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...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2019-04-01
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| Series: | Journal of Eating Disorders |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s40337-019-0240-8 |
| _version_ | 1797725881126354944 |
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| author | Gina Dimitropoulos Melissa Kimber Manya Singh Emily P. Williams Katharine L. Loeb Elizabeth K. Hughes Andrea Garber April Elliott Ellie Vyver Daniel Le Grange |
| author_facet | Gina Dimitropoulos Melissa Kimber Manya Singh Emily P. Williams Katharine L. Loeb Elizabeth K. Hughes Andrea Garber April Elliott Ellie Vyver Daniel Le Grange |
| author_sort | Gina Dimitropoulos |
| collection | DOAJ |
| description | Abstract 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 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 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 Diagnostic and Statistical Manual of Mental Disorders – 5th Edition (DSM-5) definition of atypical AN, identifying a ‘goal weight’ for adolescents and activating parents to take charge of the re-nourishment process. 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. |
| first_indexed | 2024-03-12T10:37:41Z |
| format | Article |
| id | doaj.art-64329f019f294649adc4f4618bfcdeb1 |
| institution | Directory Open Access Journal |
| issn | 2050-2974 |
| language | English |
| last_indexed | 2024-03-12T10:37:41Z |
| publishDate | 2019-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Eating Disorders |
| spelling | doaj.art-64329f019f294649adc4f4618bfcdeb12023-09-02T08:31:24ZengBMCJournal of Eating Disorders2050-29742019-04-017111110.1186/s40337-019-0240-8Stay the course: practitioner reflections on implementing family-based treatment with adolescents with atypical anorexiaGina Dimitropoulos0Melissa Kimber1Manya Singh2Emily P. Williams3Katharine L. Loeb4Elizabeth K. Hughes5Andrea Garber6April Elliott7Ellie Vyver8Daniel Le Grange9Faculty of Social Work, University of CalgaryDepartment of Psychiatry and Behavioural Neurosciences, McMaster UniversityFaculty of Social Work, University of CalgaryWerklund School of Education, University of CalgarySchool of Psychology, Farleigh Dickinson UniversityDepartment of Paediatrics, University of MelbourneDepartment of Pediatrics, University of CaliforniaDepartment of Pediatrics, University of CalgaryDepartment of Pediatrics, University of CalgaryDepartments of Psychiatry and Pediatrics, University of CaliforniaAbstract 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 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 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 Diagnostic and Statistical Manual of Mental Disorders – 5th Edition (DSM-5) definition of atypical AN, identifying a ‘goal weight’ for adolescents and activating parents to take charge of the re-nourishment process. 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.http://link.springer.com/article/10.1186/s40337-019-0240-8Eating disordersAtypical anorexia nervosaFamily-based treatmentWeight restorationTreatment outcomes |
| spellingShingle | Gina Dimitropoulos Melissa Kimber Manya Singh Emily P. Williams Katharine L. Loeb Elizabeth K. Hughes Andrea Garber April Elliott Ellie Vyver Daniel Le Grange Stay the course: practitioner reflections on implementing family-based treatment with adolescents with atypical anorexia Journal of Eating Disorders Eating disorders Atypical anorexia nervosa Family-based treatment Weight restoration Treatment outcomes |
| title | Stay the course: practitioner reflections on implementing family-based treatment with adolescents with atypical anorexia |
| title_full | Stay the course: practitioner reflections on implementing family-based treatment with adolescents with atypical anorexia |
| title_fullStr | Stay the course: practitioner reflections on implementing family-based treatment with adolescents with atypical anorexia |
| title_full_unstemmed | Stay the course: practitioner reflections on implementing family-based treatment with adolescents with atypical anorexia |
| title_short | Stay the course: practitioner reflections on implementing family-based treatment with adolescents with atypical anorexia |
| title_sort | stay the course practitioner reflections on implementing family based treatment with adolescents with atypical anorexia |
| topic | Eating disorders Atypical anorexia nervosa Family-based treatment Weight restoration Treatment outcomes |
| url | http://link.springer.com/article/10.1186/s40337-019-0240-8 |
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