The importance of family interventions in the treatment of eating disorders
DOI:
https://doi.org/10.25118/2763-9037.2019.v9.53Keywords:
Eating disorders, family therapy, familybased treatment, systemic family therapyAbstract
Eating disorders are characterized by inappropriate eating behaviors, with great impairment to the individual’s physical health and psychosocial relationships and with strong impact on family relationships and on caregivers. As the age of onset of these symptoms usually lies withinadolescence and young adulthood, the family system may contribute to the improvement of the clinical condition and maintenance of the gains achieved. Therefore, several studies focusing on family interventions and family participation have been conducted. The initial focus of family therapies for eating disorders was anorexia nervosa (AN), due to its severity. However, over time, successful approaches have been adapted to other eating disorders, such as bulimia nervosa (BN) and avoidant restrictive food intake disorder (ARFID). Currently, family-based treatment (FBT) is considered the gold standard for family inclusion in the treatment of Eds, with a wide body of evidence suggesting positive results. In this article, in addition to FBT, we will also address systemic family therapy, with a focus on changes in family dynamics.
Downloads
Metrics
References
Gorrell S, Loeb KL, Le Grange D. Family-based treatment of eati ng disorders: a narrati ve review. Psychiatr Clin North Am. 2019;42:193-204.
Shimoguiri AFDT, Serralvo FS. A importância da abordagem familiar na atenção psicossocial: um relato de experiência. Nova Perspect Sist. 2017;26:69-84.
Souza LM, Santos MA. Anorexia e bulimia: conversando com as famílias. São Paulo: Vetor; 2007.
Grandesso MA. Sobre a reconstrução do significado: uma análise epistemológica e hermenêutica da prática clínica. São Paulo: Casa do Psicólogo; 2000.
Minuchin S, Rosman BL, Baker L. Psychosomati c families: anorexia nervosa in context. Cambridge: Harvard University; 1978:viii.
de Almeida Marti ns EM, Rabinovich EP, Silva CN. Família e o processo de diferenciação naperspecti va de Murray Bowen: um estudo de caso. Psicol USP. 2008;19:181-97.
Kerr ME, Bowen M. Family evaluati on: an approach based on Bowen theory. New York: W W Norton & Co; 1988.
Bueno RK, de Souza SA, Monteiro MA, Teixeira RHM. Processo de diferenciação dos casais de suas famílias de origem. Psico. 2013;44:2.
Russell GF, Szmukler GI, Dare C, Eisler I. Anevaluati on of family therapy in anorexia nervosa and bulimia nervosa. Arch Gen Psychiatry. 1987;44:1047-56.
Lock J, le Grange D. Family-based treatment of eati ng disorders. Int J Eat Disord. 2005;37 Suppl:S64-7; discussion S87-9.
Marks A. The evoluti on of our understanding and treatment of eati ng disorders over the past 50 years. J Clin Psychol. 2019;75:1380-91.
Lock J, Le Grange D. Treatment manual for anorexia nervosa: a family-based approach. New York: Guilford; 2013.
le Grange D, Eisler I. Family interventi ons in adolescent anorexia nervosa. Child Adolesc Psychiatr Clin N Am. 2009;18:159-73.
Associação Americana de Psiquiatria. Manual Diagnósti co e Estatí sti co de Transtornos Mentais, 5ª edição (DSM-5). Porto Alegre: Artmed; 2014.
Lock J, Sadeh-Sharvit S, L’Insalata A. Feasibility of conducti ng a randomized clinical trial using familybased treatment for avoidant/restricti ve food intake disorder. Int J Eat Disord. 2019;52:746-51.
Le Grange D, Lock J, Agras WS, Bryson SW, Jo B. Randomized clinical trial of family-based treatment and cogniti ve-behavioral therapy for adolescent bulimia nervosa. J Am Acad Child Adolesc Psychiatry. 2015;54:886-94.e2.
Esteves de Vasconcellos MJ. Pensamento sistêmico: uma epistemologia cientí fi ca para uma ciência novo-paradigmática. 4º Congresso Brasileiro de Sistemas; Franca, SP; 2005.
Stürmer TR, Marin AH, Oliveira DS de. Compreendendo a estrutura familiar e sua relação com a parentalidade: relato de caso de um casal em terapia de abordagem sistêmica. Rev Bras Psicoter. 2016;18:55-68.
Watzlawick P, Beaum JH, Jackson DD. A pragmáti cada comunicação humana. São Paulo: Culturix; 1967.
Murray SB, Anderson LK, Cohn L. Innovati ons in family therapy for eati ng disorders: novel treatment developments, pati ent insights, and the role of careers. New York: Routledge; 2016.
Ponciano ELT. Família nuclear e terapia de família: conexões entre duas histórias. Estud Pesqui Psicol. 2002;2:25-37.
Carneiro TF. Terapia familiar: das divergências às possibilidades de articulação dos diferentes enfoques. Psicol Cienc Prof. 1996;16:38-42.
Schmidt U, Treasure J. Anorexia nervosa: valued and visible. A cogniti ve-interpersonal maintenance model and its implicati ons for research and practi ce. Br J Clin Psychol. 2006;45:343-6.
Hibbs R, Rhind C, Salerno L, Lo Coco G, Goddard E, Schmidt U, et al. Development and validati on of a scale to measure caregiver skills in eati ng disorders. Int J Eat Disord. 2015;48:290-7.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Debates em Psiquiatria allows the author (s) to keep their copyrights unrestricted. Allows the author (s) to retain their publication rights without restriction. Authors should ensure that the article is an original work without fabrication, fraud or plagiarism; does not infringe any copyright or right of ownership of any third party. Authors should also ensure that each one complies with the authorship requirements as recommended by the ICMJE and understand that if the article or part of it is flawed or fraudulent, each author shares responsibility.
Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) - Debates em Psiquiatria is governed by the licencse CC-By-NC
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material
The licensor cannot revoke these freedoms as long as you follow the license terms. Under the following terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- NonCommercial — You may not use the material for commercial purposes.
No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
