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Adolescent Focused Psychotherapy for Adolescents with Anorexia Nervosa

Abstract

The paper describes a manualized specific form on individually based developmentally oriented therapy for Anorexia Nervosa (AN) in adolescents. Adolescent focused psychotherapy for AN is derived from a self-psychology model and is designed to address key deficits in development associated with AN. Adolescents with AN are viewed as using food and weight to avoid negative affective states associated with adolescent developmental issues that they perceive as intolerable. To develop a more constructive coping style and improve self-efficacy, adolescent patients need to first learn to identify and define their emotions, and later, to tolerate emotions, particularly negative ones. In withdrawing from the environment and situations which provoke distress through self-starvation and preoccupations with food and weight, emotional and psychological development is arrested. Learning to identify and cope adaptively with emotions and developmental challenges presented by the environment form the key therapeutic targets of treatment. Specific therapeutic procedures, a case illustration and discussion of therapeutic rationale are also provided.

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References

  1. Bydlowski, S., Corcos, M., Jeammet, P., Paterninit, S., et al. (2005). Emotion-processing deficits in eating disorders. The International Journal of Eating Disorders, 37(4), 321–329. doi:10.1002/eat.20132.

    Article  PubMed  Google Scholar 

  2. Crisp, A. H. (1980). Anorexia nervosa: Let me be. London: Academic Press.

    Google Scholar 

  3. Crisp, A. H. (1997). Anorexia nervosa as flight from growth: Assessment and treatment based on the model. In D. M. Garner & P. Garfinkel (Eds.), Handbook of treatment for eating disorders (pp. 248–277). New York: Guilford.

    Google Scholar 

  4. Gowers, S., Clark, A., Roberts, C., Griffiths, A., Edwards, V., Bryan, C., et al. (2007). Clinical effectiveness of treatments for anorexia nervosa in adolescents. The British Journal of Psychiatry, 191, 427–435. doi:10.1192/bjp.bp.107.036764.

    Article  PubMed  Google Scholar 

  5. Krautter, T., & Lock, J. (2004). Is manualized family-based treatment for adolescent anorexia nervosa acceptable to patients? Patient satisfaction at end of treatment. Journal of Family Therapy, 26, 65–81. doi:10.1111/j.1467-6427.2004.00267.x.

    Article  Google Scholar 

  6. Le Grange, D., & Lock, J. (2005). The dearth of psychological treatment studies for anorexia nervosa. The International Journal of Eating Disorders, 37, 79–81. doi:10.1002/eat.20085.

    Article  PubMed  Google Scholar 

  7. Levenkron, S. (2001). Anatomy of anorexia. New York: Guilford Press.

    Google Scholar 

  8. Lock, J. (2005). Adjusting cognitive behavioral therapy for adolescent bulimia nervosa: Results of a case series. American Journal of Psychotherapy, 59, 267–281.

    PubMed  Google Scholar 

  9. Mcintosh, V. W., Jordan, J., Carter, F. A., Luty, S. E., McKenzie, J. M., Bulik, C. M., et al. (2005). Three psychotherapies for anorexia nervosa: a randomized, controlled trial. The American Journal of Psychiatry, 162, 741–747. doi:10.1176/appi.ajp.162.4.741.

    Article  PubMed  Google Scholar 

  10. Pike, K., Walsh, B. T., Vitousek, K., Wilson, G. T., & Bauer, J. (2004). Cognitive-behavioral therapy in the posthospitalization treatment of anorexia nervosa. The American Journal of Psychiatry, 160, 2046–2049. doi:10.1176/appi.ajp.160.11.2046.

    Article  Google Scholar 

  11. Robin, A., Siegal, P., Koepke, T., Moye, A., & Tice, S. (1994). Family therapy versus individual therapy for adolescent females with anorexia nervosa. Journal of Developmental and Behavioral Pediatrics, 15(2), 111–116. doi:10.1097/00004703-199404000-00008.

    CAS  Article  PubMed  Google Scholar 

  12. Robin, A., Siegal, P., Moye, A., Gilroy, M., Dennis, A., & Sikand, A. (1999). A controlled comparison of family versus individual therapy for adolescents with anorexia nervosa. Journal of the American Academy of Child and Adolescent Psychiatry, 38(12), 1482–1489.

    CAS  Article  PubMed  Google Scholar 

  13. Thoma, H. (1967). Anorexia nervosa. New York: International Universities Press.

    Google Scholar 

  14. Treasure, J. L., Todd, G., Brolly, M., Tiller, J., Nehmed, A., & Denman, F. (1995). A pilot study of a randomized trial of cognitive-behavioral analytical therapy vs educational behavioral therapy for adult anorexia nervosa. Behaviour Research and Therapy, 33, 363–367. doi:10.1016/0005-7967(94)00070-Z.

    CAS  Article  PubMed  Google Scholar 

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Correspondence to James Lock.

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Fitzpatrick, K.K., Moye, A., Hoste, R. et al. Adolescent Focused Psychotherapy for Adolescents with Anorexia Nervosa. J Contemp Psychother 40, 31–39 (2010). https://doi.org/10.1007/s10879-009-9123-7

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Keywords

  • Anorexia nervosa
  • Psychotherapy
  • Developmental
  • Adolescence