The family-based treatment model is recommended in the National Institute of Clinical Excellence (NICE) guidance, for psychological treatment of anorexia nervosa in young people.  The eating disorder service recommends that it is combined with multi-family therapy. This treatment model offers sessions separately from family members, as well as sessions together with family members.   

There are typically 20 sessions over a period of a year. Reviews are planned for the first month and then every three months.  The main theme/values in the model are; the importance of the family helping the person recover, and an ethos of no blame or shame to be directed at any family member.  

Psycho-education is provided about the effects of malnutrition, the risks and advice about nutrition. Parents take on the temporary role of supporting the person to manage their eating with our teams support.  

This is a three phase approach. The first phase is to ensure we achieve a good therapeutic relationship with all family members. In the second phase we aim to work together to ensure parents move towards offering independence appropriate to the persons stage of development. In the final phase we explore any concerns the person and their family may have and plan for relapse prevention.  

This model aims to support all family members and sessions will be planned around this.  

Multi-family therapy

The eating disorder service has been offering multi family therapy (MFT) for nine years. MFT itself, has existed for over thirty years and has proved to be effective in a number of fields; one of which is eating disorders. The National Institute of Clinical Excellence, cites MFT as a valuable therapy in treating adolescent anorexia nervosa.

The MFT programme is conducted over four days. The programme requires this length of time as it provides in-depth psycho-education and interventions, as well as ways to enable the family to plan for a future without an eating disorder. The team consists of a family therapist, dietician, nurses, specialist practitioners and occupational therapists. Each team member is highly qualified and skilled in their respective areas. Families who have recovered, also attend to relate their experiences and answer any questions. There are three/four further days, to provide different interventions at each stage of the recovery journey. These follow up sessions are spread over a number of months.

The participants consist of several families working with staff from the eating disorder team. They will share research and knowledge, and participate in interventions on a structured programme. The programme is designed to address individual family’s specific problems.

This model is combined with single family therapy. As an eating disorder impacts on the whole family. It is therefore essential that all family members understand the illness in order to help their loved one move forward. This will assist them to overcome this life-threatening illness as quickly as possible.

Example family statement:

Initially I did not want to talk about the illness; I was worried about privacy, time off work…however, I am so glad I attended; I no longer blame myself. I know I am no longer alone. I was able to get all my concerns listened to and questions answered.

Example patient statement:

Initially I did not want to take time away from studying… I was concerned about my weight and shape compared to others… However, it has increased my family’s understanding, and they no longer blame me or themselves. I no longer feel alone.