Young people's experience of family therapy for anorexia nervosa: a qualitative meta-synthesis

摘要

Family therapy is a key treatment approach for anorexia nervosa (AN), and family-based treatment (FBT) is now well supported for the treatment of adolescents. Qualitative research exploring treatment for AN from the patient's perspective has an important role in understanding engagement and stimulating potential augmentations. The aim of this review was to describe patients' experiences of family interventions for AN. Five databases were searched: PSYCINFO, MEDLINE, SCOPUS, CINAHL, and Web of Science, and a systematic review and meta-synthesis of 15 studies were conducted. Fourteen descriptive themes emerged, which were grouped into four conceptual themes: relinquishing control ambivalently (initial treatment resistance, authoritative care, and recovery not done alone), improved family relationships (increase openness and honesty, decreased conflict, improved intra-family understanding, rectifying structural issues, and externalisation of AN), neglect of underlying issues (cause of AN, issues other than AN, and need for individual work), and failure to address some family issues (focus on surface issues, lack of family engagement, and involvement of siblings). Findings indicated significant concordance with quantitative research regarding strengths of family-based approaches, including support of family understanding and use of the family as a resource for recovery. Addressing a variety of underlying family and individual issues was implicated as an area for improvement.