Family-Based Treatment in Higher Levels of Care: A Systematic Review and Meta-Analysis

Family-Based Treatment (FBT) is the gold standard outpatient eating disorder treatment for children and adolescents with eating disorders. Especially within the past decade, higher levels of care (HLOC) programs including inpatient medical settings and partial hospitalisation programs have incorporated elements of FBT to improve the effectiveness of their treatments. The present study aimed to systematically review the state of the research on FBT adaptations in HLOC and describe the outcomes of those treatment programs.

Articles were identified via a systematic search of three databases (PsycINFO, PubMed, Cochrane Database of Randomized Controlled Trials) according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses.

Forty articles were identified including 35 studies and 5 programme descriptions, representing 17 inpatient and 23 partial hospitalisation and/or intensive outpatient programs. Thirty quantitative studies and five qualitative studies were included. Findings supported suitability and effectiveness of treatments in improving weight, eating disorder and mental health symptoms and family functioning.

Burgeoning research supports the effectiveness of FBT adapted to HLOC, with the most evidence for improving weight and eating disorder symptoms. The present review identifies further areas of research needed to expand on the current evidence, such as with controlled trials with sufficient follow-up data.