Abstract
Purpose
In manualized family-based treatment (FBT) for eating disorders, phase 1 of the 3-phase treatment—during which parents are put in control of eating-related issues—is perhaps the most critical phase, and is comprehensively addressed in the manual. Phase 2, during which control over eating is gradually returned to the patient, is more variable and the manual dedicates less space to this phase. The purpose of the current exploratory study was to assess Phase 2 practices of clinicians providing FBT and to compare these practices to the guidance offered in the manual.
Methods
In the current study, a survey assessing Phase 2 practices was sent to clinicians. Twenty-seven providers responded. Two providers reported that they did not provide FBT in an outpatient setting. One reported not currently providing outpatient FBT but had in the past. The remaining providers were currently providing FBT in an outpatient setting.
Results
No items addressing the core interventions of Phase 2, including encouraging age-appropriate independent eating, were endorsed by 100% of respondents as being addressed 100% of the time in Phase 2.
Conclusion
Responses reflected some adherence to the manual, along with examples of therapist drift and incorporation of therapeutic interventions that are not described in the FBT manual. Adherence to manualized treatments may improve outcome for some patients, while allowing for flexibility to address clinical situations that are not addressed in the manual.
Level of evidence
V. Opinions of respected authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees.
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Data availability
Data are available upon reasonable request.
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Dr. Jacobs has no conflicts to disclose. Dr. Muhlheim receives royalties from New Harbinger and consulting fees from Equip Health. Dr. Rienecke receives consulting fees from the Training Institute for Child and Adolescent Eating Disorders, LLC, and receives royalties from Routledge.
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Jacobs, S., Muhlheim, L. & Rienecke, R.D. Phase 2 of family-based treatment: an exploratory assessment of clinician practices. Eat Weight Disord 27, 2137–2142 (2022). https://doi.org/10.1007/s40519-022-01360-3
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DOI: https://doi.org/10.1007/s40519-022-01360-3