Nervosa Family Therapy

Incidences of Anorexia Nervosa have appeared to increase sharply in the USA, UK and western European countries since the beginning of the 60s (Gordon, 2001). The increasing prevalence of the disease has led the World Health Organisation to declare eating disorders a global priority area within adolescent mental health (Becker et al. 2011). Anorexia has in many ways become a modern epidemic (Gordon, 2000) and with a mortality rate of 10% per decade (Gorwood et al. 2003), the highest of any mental disorder (Bulik et al. 2006), it is an epidemic that social and biological scientists have been working tirelessly to understand.

Eating Disorders are a set of serious disorders with underlying psychiatric foundations. An eating disorder occurs when exercise, body weight and shape become an unhealthy obsession (Stein, Merrick, & Latzer, 2011). People with eating disorders take physical concerns to the extremes that they take on abnormal eating habits. There are a variety of cases that lead to an eating disorder and can affect both men and women, however its prevalence primarily occur in adolescence (Ison & Kent, 2010; Stein et al., 2011). The complexity and challenges that occur during adolescents predisposes teens to developing an eating disorder. The period of adolescence is one of intense change, which can bring with it a great deal of stress, confusion and anxiety (Allen, Byrne, Oddy & Crosby, 2013). According to Wade, Keski-Rahkonen and Hudson (2011) 20 million women and 10 million men suffer from eating disorders, including anorexia nervosa, bulimia nervosa, binge eating disorder, and eating disorders not otherwise specified (EDNOS). There are three main categories of eating disorders, anorexia nervosa (AN), bulimia nervosa (BN), and eating disorders not otherwise specified (EDNOS). Individuals with AN loose more weight than what is considered to be healthy for their particular height, age, gender, and development (Allen et al., 2013). In BN individuals binge eat and purge to compensate for the excessive eating. Purging may include induce vomiting or intake of laxatives that lead to bowel

Around 10-15% of all Americans suffer from an eating disorder. “More than 7 million women suffer from an eating disorder whereas only one million men suffer from an eating disorder” (Mirasol). In modern society, we are surrounded by media and images. Both men and women struggle to meet the expectations set forth in magazines, websites, and on television. The pressure to imitate the ideal body can lead many down unhealthy paths. Teens today face a lot more challenges which leads them to illnesses like Anorexia, Bulimia, and Binge eating. Although there are a lot of similarities in this disease, the differences can also affect people differently, which means different treatments are required.

According to the Mayo Clinic (2016), eating disorders are “conditions related to persistent eating behaviors that negatively impact your health, your emotions, and your ability to function in important areas of life.” One such eating disorder is anorexia nervosa. Not to be confused with anorexia, which is simply a general loss of appetite that can be attributed to many medical ailments, anorexia nervosa is a serious eating disorder and mental illness (Nordqvist, 2015). Anorexia nervosa is estimated to affect about .9% of women and .3% of men in their lifetime (“Eating Disorder Statistics & Research,” n.d.). In general, the disorder is commonly characterized by a distorted body image or self-concept, critically low weight (with respect to the patient’s height and age), and an irrational fear of becoming fat or an intense desire to be thin. There are two subtypes to this eating disorder: restrictive and binge/purge. In the restrictive type, the individual limits caloric intake and may compulsively over-exercise. In the binge/purge type, the individual consumes a considerable amount of food in a short period of time (binging) and then deliberately vomits (purging), takes laxatives, or fasts intensely in order to compensate for the food eaten (“General Information: Anorexia Nervosa,” n.d.). In either case, anorexia nervosa is undoubtedly a dangerous and alarming illness.

Functional Family Therapy. Functional family therapy (FFT; Alexander & Parsons, 1982) is based on the premise that the behaviours of each family member serve a certain function within the family system. In the context of conduct disorders and antisocial behaviours, FFT views these behaviours as serving a necessary function for the child in the family system, which is then the reason why the child continues to engage in those deviant behaviours (Baker, 2012). For example, the antisocial behaviour of the child could function in receiving support and intimacy from other family members. The goal of FFT, then, is to produce an environment of adaptive family functioning by changing the dysfunctional behavioural & cognitive aspects of the family, and also the communication patterns between family members (Baker, 2012).

Anorexia Nervosa is the condition when an individual abstains from food in order to lose weight or prevent more weight gain. In the Diagnostic and Statistical Manual of Mental Disorders IV(DSM-IV) there are four aspects of criteria to be diagnosed with anorexia: a refusal to maintain weight above what is minimally normal for one’s age and height, and extreme fear of weight gain, distorted body image, and (in females) having amenorrhea(missing three or more consecutive menstrual cycles.)(DSM-IV, 2000:589) Anorexia not only affects weight, but also alters bone growth, neurotransmitters and hormones in the brain, and electrolytes.

Categorically, adolescents with anorexia nervosa have a chronic low body weight and are below 85 percent of their expected body weight (Lock, & Fitzpatrick, 2007). Anorexia nervosa is most commonly diagnosed in adolescents, an age that can increase the risks of malnutrition, weight loss, osteoporosis, growth arrest, and absent puberty. Anorexia nervosa can damage an adolescent’s identity, and has the highest death rates of any psychiatric illness (Aspen & Boutelle, 2013; Grave et al., 2014). Adolescents that suffer from anorexia nervosa tend to be perfectionists causing them to focus on negative beliefs, fear of failure, and fear of disapproval. They are often high achievers, are inflexible and rigid in their thinking, and see their symptoms as achievements (Hurst & Zimmer- Gembeck, 2015; Westwood & Kendal, 2012).

Suppose I am working for a community mental health agency, and I have assigned cases about 14-16 year- old male adolescents with conduct disorder. I have been asked by my director of clinical training to answer one question: “What family treatment modes have been found to be effective for treating this population?” In order to answer this question, I did some research online and found several appropriate articles. Thus, I will use those researches to illustrate this question in this paper. In addition, I will talk about three effective family treatment modes which including brief strategic family therapy (BSFT), multisystemic therapy (MST), and functional family therapy (FFT).

Typically this is achieved by working with the individual (Judy) separately from the parents (Tammy and Kyle). Phase three can only be accomplished when parental monitoring is no longer needed in Tammy’s eating habits. Judy’s eating habits and weight is in an acceptable healthy range. At this time, I would focus more on the psychological issues within Judy. Most people who suffer from Anorexia Nervosa also suffer from depression, Judy is no exception. Judy expresses her concern over her parents’ marriage and how they fight all the time. She is afraid that her parents will soon one day decide to get a divorce. Judy blames a lot of the stress her parents have upon herself and her disorder. Judy must understand that she cannot take fault for her parent’s actions. While working with Kyle and Tammy, I inform them how their fighting is affecting Judy. Both were unaware that it was affecting her to this point. I would continue to work with Kyle and Tammy on their marriage and relationship problems in an effort to help establish a better relationship between them and Judy. With working with Judy and her parents separately I am able to better repair the psychological issues within the marriage, Judy’s relationship with her parents, and help them all build better communication

Family-Based Treatment (FBT), implements the plan for the entire family to be present in treatment sessions. In comparison, Parent-Focused Treatment (PFT), demands that the adolescent in treatment attends a brief meeting with a nurse prior to the session with their parents to measure their weight, share information with one another, assess medical stability, and support for the adolescent. This study compared the efficiency of FBT and PFT while forming the path to remission for the adolescent with AN in an inpatient facility. Findings in this study support the hypothesis, that predicted that PFT would lead FBT on rates to remission by the end of treatment. This would follow up findings in the Dimitropoulos and Freeman (2015) study, implying

Anorexia nervosa is an eating disorder that consists of self-regulated food restriction in which the person strives for thinness and also involves distortion of the way the person sees his or her own body. An anorexic person weighs less than 85% of their ideal body weight. The prevalence of eating disorders is between .5-1% of women aged 15-40 and about 1/20 of this number occurs in men. Anorexia affects all aspects of an affected person's life including emotional health, physical health, and relationships with others (Shekter-Wolfson et al 5-6). A study completed in 1996 showed that anorexics also tend to possess traits that are obsessive in nature and carry heavy emotional

As a person who personally was diagnosed with Anorexia (AN), I’ve experienced just how detrimental it can be to one’s family. “With 2,000,000 adolescents and young adults affected, AN is the third most common chronic condition among adolescent girls, behind obesity and asthma” (Carlton & Pyle, 2007, pg. 9). Not only does this disease affect women, it also affects men. Through the Parent Education and Support Program, COPE intervention, and accepting the many environmental, psychological, and sociocultural influences, the number of cases of AN can dramatically decrease. In addition, many lives can be saved because of these three interventions.

Eating disorders are severe disturbances in eating behaviors, such as eating too little or eating too much. “Anorexia nervosa affects nearly one in 200 Americans in their lives (three-quarters of them female)” (Treating anorexia nervosa). Anorexia, when translated into Greek means “without appetite” which is not true for all suffering from anorexia most people with this disorder have not lost their appetite they simply have to ignore it. People with anorexia have an intense fear of gaining weight and have convinced themselves that they are overweight even if they are the opposite of overweight. Since the way that they view themselves is in a negative light they starve themselves and put their lives at risk. “In the most severe

How many of you have ever battled an eating disorder or known someone with an eating disorder? One or two of every 100 students will struggle or have struggled with an eating disorder. An anonymous quote from someone who struggled an eating disorder once said “Nothing matters when I’m thin”. Anyone of us in this room is at risk of an eating disorder. Females have to maintain that ‘normal’ look to fit in with society. More guys are seeking help for eating disorders as well. Guys with eating disorders tend to focus more on athletic appearance or success than just on looking thin. I’m going to inform you today about anorexia; what it is, signs, causes, effects, and possible treatments to help it.

Anorexia is the third most common chronic illness among teenagers. With 80% of teen females and 15% of teen males being or attempting to be anorexic, it is surprising