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Five Types of Treatment Modalities for Anorexia Nervosa: Which Is Most Effective?

Anorexia nervosa is a serious eating disorder involving multiple and complex psychological symptoms. An anorexia nervosa treatment program must be individualized to address the unique needs presented by teens and adults with anorexia nervosa. That is why several evidence-based therapies are available to help anorexia nervosa and bulimia nervosa patients recover from their eating disorder.

Family-Based Treatment

A three-stage treatment for teenage patients diagnosed with symptoms of anorexia nervosa and bulimia nervosa, family-based treatment (FBT) involves patients and their families participating in multiple one-hour sessions over the course of several months. The first phase focuses on the therapist gaining the parents’ trust by complimenting positive aspects of their parenting style while reassuring them the cause of their child’s eating disorder is nobody’s fault.

During stage two of FBT, therapists encourage parents to develop their own anorexia nervosa treatment plan they think would help restore their child’s health and weight. This plan includes educating parents on nutrition, meal planning and what to expect from a teen with anorexia nervosa or bulimia nervosa who is expected to start eating more appropriately.

The third stage of FBT emphasizes establishing a more open and trusting relationship between parents and teens receiving a diagnosis of anorexia nervosa. This phase involves the patient joining in therapy more than the previous two stages of FBT.

Specialist Supportive Clinical Management (SSCM)

SSCM is highly individualized therapy provided by anorexia nervosa treatment specialists. Patients with symptoms of anorexia nervosa and bulimia nervosa receive at least 30 weekly therapy sessions and four follow-up sessions. Combining clinical management protocols (giving advice, encouragement and eating disorder information) with supportive therapy designed to strengthen a positive relationship between the therapist and patient, SSCM endeavors to foster change in the way patients with a diagnosis of anorexia nervosa view themselves and their eating habits.

Maudsley Model of Anorexia Treatment

A cognitive-interpersonal, empirically-based treatment, the Maudsley Model proposes four factors are linked to avoidant/anxious and obsessional traits central to the development of symptoms of anorexia nervosa. These four factors are: 1) thought patterns characterized by perfectionism and extreme attention to detail; 2) impairments involving the ability to interact normally with others; 3) believing that anorexia nervosa somehow “helps” someone be a “better” person; 4) how the patient responds to criticism and/or overinvolvement by parents and close friends. The Maudsley Model treatment method is patient-centered and tailored to address unexpected issues arising during therapy.

Enhanced Cognitive Behavior Therapy

CBT-E is a personalized, transdiagnostic type of cognitive behavioral therapy originally developed to treat adults in outpatient anorexia nervosa and bulimia nervosa programs but was later enhanced to provide therapeutic interventions for teens in residential settings. Eating disorder counselors use CBT-E to develop a mutual understanding of a patient’s eating disorder by helping the patient modify and/or stabilize their eating patterns. CBT-E also focuses on what psychological processes are fueling a person’s eating disorder (i.e. concerns about appearance, low self-esteem and perfectionistic tendencies). CBT-E therapists also show patients how rigid thought patterns prevent them from addressing potential relapse triggers or maintaining positive changes they have made to their behavior.

Focal Psychodynamic Psychotherapy (FPT)

Another patient-centered anorexia nervosa treatment program, FPT emphasizes the therapeutic alliance between a patient and therapist as a way to improve a patient’s self-esteem and discover why the patient views negative behaviors and beliefs as acceptable. The influence that close family relationships and interpersonal relationships have on symptoms of anorexia nervosa or bulimia nervosa is also explored once a therapeutic alliance is established.

While all five of these treatment modalities have been proven effective for helping people overcome a diagnosis of anorexia nervosa, one particular type of therapy may be best for one person and ineffective for another. Eating disorder treatment therapists will thoroughly evaluate a new patient’s physical and psychological condition before determining which therapy would be most effective for addressing that patient’s unique needs.

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