Treating adolescents with eating disorders in the family context. Empirical and theoretical considerations

The author described the Maudsley approach for family treatment of adolescent AN and the empirical evidence supporting its use in this population. This treatment focuses on the family as a resource for recovery and puts the patients in charge of re-feeding their affected child. Its success seems to depend on the successful motivation of parents to take on this task and see it through while simultaneously supporting the processes of adolescent development as they reemerge. Although this treatment is promising, substantial data to support its being the best approach for adolescents with AN are lacking. The author also described a theoretical model for involving parents in CBT for adolescents with BN. Although CBT is accepted as the most efficacious treatment for adults with BN, it has not been tested systematically in adolescents. At the same time, it is clear that the adult models of CBT for BN are unlikely to be successful without modifications that take into account the realities of adolescence. Although CBT as a model is likely to be acceptable to adolescents, parents are needed to promote motivation, provide a supportive milieu for behavioral change, and provide guidance and support in stressful periods that lead to relapse. It is important that CBT that is appropriately modified to include parents be tested for its efficacy in adolescents with BN. Preliminary, uncontrolled results are promising.