Family based treatment of Anorexia Nervosa Flashcards
Regarding the treatment of AN, what does the evidence support as the most effective treatment?
Family-based treatment
What is the key component of FBT?
The parents are given the responsibility to return their child to physical health and ensure full weight restoration.
What does FBT work?
The patient is treated as an outpatient by an interdisciplinary team assisting the family in tackling the eating disorder and helping the child to make changes in his or her eating behaviour.
What are the advantages of FBT?
- Young person remains in their environment, allowing ongoing connection with family, friends and activities
- The family becomes empowered
- Resource allocation
What is the first thing you should advise the family?
That the eating disorder is not their fault
But it is their responsibility that the child gets well.
If the parents are dwelling on the cause/etiology, what can you offer them as an explanation?
AN is a combination of many different things, including genetic and environmental factors
Why do we advise the parents that it is their responsibility to take charge of their kids disorder?
Because the child has become unable to care for him or herself, because he or she is overwhelmed by the powerful illness.
Should parents be firm or lenient?
Parents are given permission to take a firm stand against the eating disorder and to insist on adequate nutrition, which should start slowly but immediately.
How should parents approach mealtime and excess activity?
Parents should interrupt all abnormal food and exercise related behaviour. Provide guidance that referring can be difficult, because their child will become angry and defiant. They should impose changes and consequences, so it is not the child’s decision
If the kid is super closed and insistent that everything is ok, how can you form a relationship?
First understand that this is a psychiatric illness.
Try to explore the aspects of the child’s illness that they d not like, such as thinning of their hair or preoccupation with their weight.
What type of behavioural strategies can you advise parents to help with changing their behaviour?
Rewarding desirable behaviour
Providing consequences for undesirable behaviours
What are the primary goals of medical visits?
To assist the family
To check the weight
To show an interest in the kid as a whole, not just their weight
Eventually, education re the benefiting effects of weight restoration
What is the goal of weight gain?
0.2 - 0.5 kg per week
Nutritional restoration is non-negotiable
How many meals and snacks are essential?
Three supervised meals a day and two snacks
This must be non-negotiable
Do you need to restrict exercise while refeeding?
Yes. For most patients stopping physical activity as the refeeding process gets started is necessary, but other activities can continue provided they do not interfere with adequate nutrition and weight gain. Once weight gain is steady, you can resume activity slowly while monitoring.
