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Anorexic Teens May Gain From Whole-Family Treatment
Date:10/5/2010

, and find solutions at home where the child is living," explained Lock, who is also psychiatric director of the Comprehensive Eating Disorders Program at Stanford's Lucile Packard Children's Hospital.

"It's behaviorally focused. It's process focused. It absolutely really makes the point that families, as far as we know, aren't the cause," Lock said.

The family therapy explored in this study focused on parents actively helping kids learn to eat and gain weight, then turning more autonomy over to the patients as their functioning improves.

Here, 121 adolescents, mostly girls, were randomly assigned to receive either family-based therapy or individual therapy. They ranged in age from 12 to 18 years.

Both groups received 24 hours of professional treatment over the course of a year. Follow-ups were scheduled six and 12 months after treatment ended.

At the end of treatment, both groups had the same full remission rates with full remission defined partly as achieving normal or close-to-normal weight and displaying an average number of symptoms.

But differences started to emerge at the six- and 12-month marks.

At six months, 40 percent of those in family-based treatment were in full remission versus 18 percent of those in individual therapy. At one year, the numbers were 49 percent and 23 percent, respectively.

"Anorexia nervosa is very difficult to treat, but the important issue is the data are becoming increasingly clear that the long-term outcomes, especially if you can get patients into treatment early, are extremely positive," said Kreipe, who is also medical director of the Western New York Comprehensive Care Center for Eating Disorders and past president of the Society of Adolescent Health & Medicine.

"We would be better off if we defined anorexia as a developmental illness rather than a mental illness," Kreipe added. "This has to do with being an adolescent, [and] issues of autonomy and control and ph
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