Family-based treatment with cognitive behavioural therapy for anorexia

Objective To evaluate symptom change among adolescents with anorexia nervosa (AN) receiving a novel program of family based treatment (FBT) combined with a cognitive behavioural therapy (CBT) module on perfectionism (FBT + CBT-P). Methods A cohort study was conducted with 21 adolescents with AN who entered FBT + CBT-P; 19 adolescents completed treatment (an average of 32 sessions). Participants completed four repeated assessments over 1 year, which included measures of eating disorder symptoms and perfectionism, self-orientated perfectionism, and socially prescribed perfectionism (SPP). Results Using intent-to-treat analyses, group means showed significant increases in weight, and decreases in symptoms and perfectionism (except SPP) at the third assessment (following CBT) and at the end of FBT + CBT-P treatment, relative to pre-treatment. Of the completing participants, more than half improved on all measures (except SPP), and all participants improved in weight. Discussion FBT + CBT-P was associated with average declines in adolescents' eating disorder symptoms and perfectionism, and improvements in perfectionism were associated with improvements in eating disorder symptoms. A randomised controlled trial should be conducted to compare the efficacy of FBT to FBT + CBT-P, including follow-up to assess length and rate of symptom remittance or time to relapse.