Comparison of cognitive-behavioural therapy and family-therapy in the treatment of young people with eating disorders


For children and adolescents with bulimia nervosa (BN) and anorexia nervosa (AN), family -based therapy (FBT) is currently the first recommended intervention by National Health Institute for Health Care and Excellence’s (2018) guideline. However, there is increasing evidence for the efficacy of cognitive-behavioral therapy (CBT) in the treatment of young people with eating disorders. In addition, in some circumstance family therapy can be ineffective or unacceptable for the patient; or patient may prefer a largely individual treatment. For those circumstances, CBT has been recommended evidence-based, second-line treatment method for children and adolescents with BN and AN by NICE (2018). However, anorexia nervosa has the highest morality rate of any mental disorder. Although bulimia nervosa is much less lethal than anorexia nervosa, mortality rates have been increased patients with bulimia nervosa (Westmoreland et al., 2016). Therefore, there is a need to develop an improved understanding of interventions to be able improve outcomes for young people with BN and AN. The aim of this study is to identify which treatment method is more effective in reducing eating disorder behaviors as well as associated psychological symptoms of BN and AN for young people. Four major data bases (Pubmed, PsychInfo, Scopus and PsycARTICLES) were searched using a combination of key words and headings.  The selected fifteen randomised controlled trials (RCTs) were assessed using the Critical Appraisals Skills Programme (CASP). Due to heterogeneity in methods of the papers, findings are represented in narrative form. The results show that FBT and its umbrella forms superior to other psychological interventions in terms of remission of eating disorder symptoms. However, CBT remains an important alternative approach for particularly some patients who has no available family member to help or may prefer an individual form of treatment. The findings from the present review can conclude that, the most successful interventions of young people with AN and BN provide flexible and coherent model of treatment in which specific needs of patients can be addressed.

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