Understanding the uptake of family-based treatment for adolescents with anorexia nervosa: Therapist perspectives

Authors

  • Jennifer Couturier MD, MSc, FRCPC,

    Corresponding author
    1. Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
    2. Department of Pediatrics, McMaster University, Hamilton, Canada
    3. Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada
    • Pediatric Eating Disorders Program, McMaster Children's Hospital, Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1200 Main St. West, Hamilton, Ontario, Canada L8N3Z5
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  • Melissa Kimber MSW,

    1. Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
    2. Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada
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  • Susan Jack PhD,

    1. Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada
    2. School of Nursing, McMaster University, Hamilton, Canada
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  • Alison Niccols PhD,

    1. Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
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  • Sherry Van Blyderveen PhD,

    1. Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
    2. Department of Pediatrics, McMaster University, Hamilton, Canada
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  • Gail McVey PhD

    1. Department of Community Health Systems Resource Group, The Hospital for Sick Children, Toronto, Canada
    2. Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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  • supported by hamilton academic health sciences organization alternate funding plan innovation fund.

Abstract

Objective:

To explore and describe therapists' perceptions of the factors affecting their uptake of family-based treatment (FBT) for adolescents with anorexia nervosa (AN).

Method:

Fundamental qualitative description guided the sampling and data collection in this study. A purposeful sample of 40 therapists providing treatment to youth with AN, completed an in-depth interview. Conventional content analysis guided the development of initial codes and categories, whereas constant comparison analytic techniques were used to compare and contrast therapist perceptions across contexts. Summative content analysis was used to provide counts of keywords, phrases, and themes.

Results:

Therapists face several barriers to the implementation of FBT, divided broadly into interventional, organizational, interpersonal, patient/family, systemic, and illness factors. Therapists support the implementation of evidence-based practices, including FBT for AN, but fidelity to this model is not practiced. Specific concerns about the intervention included weighing the patient, providing nutritional advice, and the family meal. Ninety-five percent of therapists requested further training in the FBT model.

Discussion:

Further investigation into the barriers and facilitating factors to the use of FBT is warranted. Understanding effective dissemination and training strategies is critical to ensuring patients receive the best possible care. © 2012 by Wiley Periodicals, Inc. (Int J Eat Disord 2013)

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