Therapy With Family Best Approach for Anorexic Girls
Girls receiving family therapy also resumed menstruation faster than the individual-therapy group.
The therapies were shown to be equally effective when other types of behavior were examined, such as eating attitudes, ability to get along with parents, self-esteem, depression, ego functioning, and desire for thinness, Robin tells WebMD. "My initial hypothesis was that individualized therapy would produce greater changes on ego functioning, depression, and awareness of feelings and so on. That's what individual therapists focus on. I was surprised at the results ... but they could be the result of the measures we used to see changes in ego function."
Families receiving both treatments scored very high at the start of the study on a test that measured the amount of conflict in the family over the girls' eating habits. For both groups, these scores decreased substantially after treatment and were maintained at follow-up. "I thought family therapy would produce a greater change in conflict. Perhaps the family problem is secondary to the starvation rather than being a family dynamic problem. As long as you get the child out of starvation, and it may not matter how you do that, the family problems may resolve," Robin tells WebMD.
So, while family therapy plays a key role, individual therapy still has its place. "In the ideal situation, if you have a young teen-ager with anorexia, a clinician should start off with family therapy to restore weight. As you get to the later stages and approach target weight, individual sessions can help deal with interpersonal and body image issues," Robin says.
Daniel le Grange, PhD, director of the eating disorders program at the University of Chicago Medical Center, tells WebMD, "What is encouraging is that individual therapy seems to be as effective as family therapy for improving eating attitudes, depression, and eating-related family conflicts."
No matter what type of therapy is prescribed, anorexia nervosa is a disease that eludes simple solutions. "It's important to remember that while we were able to help two-thirds or three-fourths, there's another quarter of patients who were helped somewhat but still didn't get to target weight. Even in the early-onset population with all this therapy, there's more to be learned," Robin tells WebMD.