Fighting It From Both Angles: A Qualitative Study of Adolescents, Parents, and Clinicians Involved in Adolescent & Parent Treatment for Anorexia Nervosa

Abstract

Background: Anorexia Nervosa (AN) is an eating disorder that has the highest mortality rate among all mental disorders. It is referred to as having a significantly low body weight due to restricting one’s energy intake (American Psychiatric Association, 2013). Family-Based Treatment (FBT) is recognised as the first-line approach for young people with this illness, despite only 38% of all patients achieving full remission. Therefore, there is a need for alternative treatments for individuals who do not benefit from this approach which focuses primarily on refeeding. Adolescent and Parent Treatment (APT) is a new intervention that simultaneously addresses the physical aspects of recovery through refeeding and the psychological aspects of recovery through individual treatment modules. Aim: This study aims to investigate the experiences of patients, parents, and clinicians about APT in the recovery from AN. This was explored by identifying what specific components of APT participants found helpful or unhelpful, as well as how they viewed APT compared to other treatments for AN. Method: Participants were recruited from private outpatient settings in Melbourne, Australia and in Auckland, New Zealand. The sample consisted of eighteen participants, all of whom had been involved in APT. This included six patients who either had AN or had already recovered, six parents of children with AN, and six clinicians practising APT. Semi-structured interviews were individually conducted with each participant and recorded using Zoom software. Qualitative data analysis was performed using the General Inductive Approach. Results: Three key themes were gleaned from the data, representing participants’ perceptions of what they considered helpful or unhelpful in APT. These themes are 1.) APT delivers an effective therapy through therapeutic rapport, 2.) APT provides a tailored treatment experience for each patient and their family, and 3.) Dietetic input is essential for recovery from AN. Conclusions: Results revealed that APT provides patients with a holistic treatment experience with an emphasis on psychological recovery, which was essential for patients who did not recover under the FBT framework. Considering this study is the first of its kind, further qualitative and quantitative research is required on this treatment.