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Implementation of Family-Based Treatment for Adolescents With Anorexia Nervosa

Published:September 20, 2013DOI:https://doi.org/10.1016/j.pedhc.2013.07.012

      Abstract

      Although the implementation of new treatment models can be a challenging process for health care services, the outcomes can be greatly beneficial to patients and service providers. This article describes the process of change experienced within our multidisciplinary specialist eating disorder service when we implemented a new evidence-based model of care focusing on outpatient family-based treatment (FBT). Clinical outcomes were positive, including a 56% decrease in admissions, a 75% decrease in readmissions, and a 51% decrease in total bed days. Of families referred to FBT, 83% completed treatment and 97% of completers achieved >90% of their expected body weight. Despite these gains, many challenges were experienced, including misgivings about the suitability of FBT and difficulties in adhering to changes in professional roles. We describe these challenges, describe how they were overcome, and review factors perceived to be critical to the program's success, including integration of medical and mental health services, communication, and training.

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      Biography

      Elizabeth K. Hughes, Research Fellow for Eating Disorders, The University of Melbourne Department of Paediatrics and The Royal Children's Hospital Centre for Adolescent Health; Honorary Research Fellow, Murdoch Childrens Research Institute, Melbourne, Australia.

      Biography

      Daniel Le Grange, Professor of Psychiatry, The University of Chicago, Department of Psychiatry and Behavioral Neuroscience, Chicago, IL.

      Biography

      Andrew Court, Consultant Child and Adolescent Psychiatrist, The Royal Children's Hospital Consultant and Liaison Psychiatry Mental Health Team, Melbourne, Australia.

      Biography

      Michele Yeo, Paediatrician, The Royal Children's Hospital Centre for Adolescent Health, Melbourne, Australia.

      Biography

      Stephanie Campbell, Clinical Nurse Consultant for Eating Disorders, The Royal Children's Hospital Centre for Adolescent Health, Melbourne, Australia.

      Biography

      Melissa Whitelaw, Clinical Specialist Dietitian, The Royal Children's Hospital Centre for Adolescent Health and Department of Nutrition and Food Services, Melbourne, Australia.

      Biography

      Linsey Atkins, Senior Clinical Psychologist, The Royal Children's Hospital Integrated Mental Health Program and Centre for Adolescent Health, Melbourne, Australia.

      Biography

      Susan M. Sawyer, Director and Paediatrician, Royal Children's Hospital Centre for Adolescent Health; Chair of Adolescent Health, The University of Melbourne Department of Paediatrics; and Honorary Research Fellow, Murdoch Childrens Research Institute, Melbourne, Australia.