A controlled comparison of family versus individual therapy for adolescents with anorexia nervosa

Objective: To compare the effectiveness of behavioral family systems therap y (BFST) with that of ego-oriented individual therapy (EOIT) as treatments for adolescents with anorexia nervosa. Method: Thirty-seven adolescents mee ting DSM-III-R criteria for anorexia nervosa were randomly assigned to rece ive BFST or EOIT, in addition to a common medical and dietary regimen. In B FST, the family was seen conjointly, the parents were placed in control of the adolescent's eating, distorted beliefs were targeted through cognitive restructuring, and strategic/behavioral interventions were used to change f amily interactions. In EOIT, the adolescent was seen individually, with an emphasis on building ego strength and uncovering the dynamics blocking eati ng; parents were seen collaterally. Measures administered before, after, an d at I-year follow-up tapped body mass index, menstruation, eating attitude s, ego functioning, depression, and family interactions. Results: BFST prod uced greater weight gain and higher rates of resumption of menstruation tha n EOIT. Both treatments produced comparably large improvements in eating at titudes, depression, and eating-related family conflict, but very few chang es occurred on ego functioning. Conclusions: BFST and EOIT proved to be eff ective treatments for adolescents with anorexia nervosa, but BFST produced a faster return to health.