January 9, 2012

Social Dynamics in the Home Matter

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Reviewed by: 
Joseph V. Madia, MD By:

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Anorexia nervosa patients see greater results with supplemental family therapy

(dailyRx News) Although it may seem unnatural to discuss family issues to fix individual disorders, this practice recently helped patients recovering from anorexia nervosa.  

Scrutiny into the research of anorexia nervosa treatment favors the use of tailored family therapy sessions to help patients post-hospitalization.  

A study available through the journal PLoS One discusses supplemental cognitive treatments focused on family dynamics.  

"Ask a therapist about anorexia nervosa therapy."

Nathalie Godart, M.D., Ph.D., of the Department of Adolescents and Young Adults Psychiatry in France, acted as lead author on the study. Dr. Godart and her team of fifteen compared two outpatient treatment programs designed for children with severe anorexia nervosa.

The study involved 18-months of therapy in girls ages 13 to 19 with the eating disorder. Treatment involved independent psychiatric sessions as well as sessions with the family included.  Sixty girls participated, divided into two groups of thirty.  

One group of girls received treatment as usual, including individual therapy and family therapy focused on the girl's struggles with anorexia.  The second group received the same treatment in addition to sessions focusing primarily on social dynamics within the family. 

Clinicians used the Morgan and Russell measurement scale to assess the value of family history and current clinical status as predictors of long-term implications of anorexia nervosa, assessing for good or intermediate results versus a poor outcome.

The study further evaluated patients based on their symptoms, social tendencies/adjustment, additional hospitalizations, as well as body mass index.

“We found two main results,” states Dr. Godart. “First, in anorexia nervosa (AN) adolescents, adding family therapy (including parents and siblings), with a specific focus on intra-familial dynamics (and not on eating behaviors), to an established integrative multi-disciplinary outpatient treatment, significantly improved the outcome at 18 months of follow-up.”

The doctor explains that this suggests a special effect is related to this type of therapy in relation to treatment success.

Godart continues, “Second, we showed that weight and menstruation normalization occurred significantly more often in the family therapy group, despite the fact that these symptoms were not specifically targeted during the therapy sessions.”

"While it's important to address the overt eating behaviors, there are often underlying issues that need to be addressed in the family that impact the teen," explains dailyRx contributing expert Shannon Kolakowski, Psy.D., a licensed psychologist whose worked in a broad range of clinical settings. "There can be family dynamics that are unhealthy, such as putting the teen in the middle of parent arguments, or expecting the daughter to meet really high, unrealistic expectations, so it's helpful to look at the role each person plays, and how their role may be contributing to unhealthy dynamics."

Although such actions may be ignored as typical family behavior, they impact adolescent behavior. Dr. Kolakowski notes, "Families learn to take responsibility for their role in family conflict, set boundaries, using positive parenting methods, use conflict resolution, and most importantly, work together as a team."

This study supports a focus on maintaining holistically healthy habits in order to keep healthy weight on and unhealthy weight off. Talk to your healthcare provider about eating programs focused on nutrition and adequate caloric intake for your height, age, and sex.  

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Reviewed by: 
Joseph V. Madia, MD
Review Date: 
January 6, 2012

Last Updated:
July 17, 2012