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Two models of multiple family therapy in the treatment of adolescent anorexia nervosa: a systematic review

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Abstract

Multiple family therapy (MFT) is a therapeutic method that brings together several families affected by the same pathology. Although from an ideological and conceptual point of view, MFT is often linked to family therapy and group therapy, it is difficult to define it with precision, a weakness which may in turn hinder research on therapeutic effectiveness. This is most notable in the field of eating disorders (ED) where, in spite of MFT’s great popularity, research evidence remains limited. Within the context of a systematic review of the literature on MFT in the treatment of anorexia nervosa, the purpose of this article is to provide a theoretical and clinical framework for describing two MFT models, in an attempt to explore their common and distinct concepts, principles, techniques, and factors of change. The first program is a day treatment adaptation of the Maudsley family-based MFT approach, developed in Belgium at the Therapeutic Centre for Adolescents suffering from Eating Disorders: it focuses on the management of ED symptoms, using a strong cognitive behavioral orientation. The second is an integrated systemic MFT outpatient and inpatient program carried out on the ED unit of a pediatric hospital in Paris, France: it emphasizes intra- and inter-family relationships within a systemic framework. Our effort to describe and compare these two models constitutes a first step toward determining the relative value of different models of MFT. Indeed, each model presents specific characteristics that may make it best suited for specific ED populations and/or types of families.

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Notes

  1. Twice a year, the group may recruit 1–2 new families, while some veteran families may decide to discontinue regular group attendance while remaining available upon request.

  2. This exercise consists of creating a sub-group that sits in the center of the room (inner group), while the rest of the group sits around it and observes the sub-group discuss a topic or work on a task. Members from the outer group then comment on what they have observed. The inner group may consist of patients vs. non-patients, mothers vs. fathers, the younger generation vs. the older one, one specific family.

  3. Both MFT models also share many concepts and principles with Therapeutic Patient Education programs, including those of partnership between the patient and health care providers, self-management, coping processes, skills enhancement, improvement of quality of life, and involvement of the patient’s family in long-term care (Assal J-Ph. 1995. Patient education 2000, New Trends in patient education. International Congress Series 1076. Amsterdam, 1995).

  4. This exercise involves creating and working with a “fictitious” family in which the various family roles are played by members of different families (father from one family, mother from another, etc.).

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Authors and Affiliations

  1. Systemic and Psychodynamic Clinical Psychology Department, University of Mons, 18 Place du Parc, 7000, Mons, Belgium

    Zoé Gelin & Stéphan Hendrick

  2. Child and Adolescent Psychiatry Department, Robert Debré Hospital, 48 bld Sérurier, 75019, Paris, France

    Solange Cook-Darzens

  3. Centre Thérapeutique du Trouble alimentaire de l’Adolescent (CTTA), Le Domaine Centre Hospitalier, Chemin Jean Lanneau 39, 1420, Braine l’Alleud, Belgium

    Yves Simon

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  1. Zoé Gelin
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Gelin, Z., Cook-Darzens, S., Simon, Y. et al. Two models of multiple family therapy in the treatment of adolescent anorexia nervosa: a systematic review. Eat Weight Disord 21, 19–30 (2016). https://doi.org/10.1007/s40519-015-0207-y

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