Multi-family therapy for bulimia nervosa in adolescence: a pilot study in a community eating disorder service

ABSTRACT

Multi-family therapy for Bulimia Nervosa (MFT-BN) was developed in response to the modest outcomes following both Family Therapy and Cognitive Behavior Therapy for adolescents with BN. BN impacts individuals and their family members with high levels of carer stress. MFT-BN targets barriers to treatment including low motivation to change, hostility and criticism, negative affect alongside emotion dysregulation and common comorbidities. MFT-BN enhances treatment, providing a community of support and acquisition of emotional regulation and interpersonal skills. The study describes the clinical characteristics of the group of participants to whom MFT-BN is offered and presents the outcomes of families who have participated in it. Prior to MFT-BN, adolescents who received it were more likely to have self-harmed and had elevated levels of eating disordered cognitions than those who did not receive MFT-BN. Following MFT-BN, parents report decreases in the negative experiences of caregiving and in their own symptoms of anxiety. Adolescents report reductions in anxiety and depression alongside improvement in emotion regulation. Improvements in symptoms of eating disorders include reductions in eating disorder cognitions and modest reductions in binge and purge symptoms after 14 weeks of treatment. Adolescents who participated in MFT-BN were less likely to drop out of outpatient treatment.

Notes

1. Studies 1 and 2 have different date ranges. MFT-BN was not offered in the service between September 2016 and September 2018 because of changes in the clinical team and study 1, therefore, end prior to this break in clinical provision.

2. Studies 1 and 2 include different measures of anxiety and mood. This reflects a change in routine outcome measures in the service during the audited period because of local and national requirements. The RCADS was included in the study rather than MFQ data because this change coincided with improvements in routine outcome collection for the MFT-BN group.