My daughter is 20 and has anorexia nervosa. So far, counseling hasn't helped. She was too sick and depressed to stay at college so we brought her home. We'd like to try family-based treatment and she says she doesn't want to go to a treatment center. Is she too old for this to work?
Angela Celio Doyle, PhD responds:
There is no clear
first-line treatment for adults with anorexia at this point in time.However, there is initial support for
the Maudsley approach with college-aged individuals.The National Institute of Mental Health highlights three important components in treatment
treating the psychological issues related
to the eating disorder
reducing or eliminating the behaviors or
thoughts related to the eating disorder, along with relapse prevention
The Maudsley approach for young adults
fits these criteria and is based on the premise that parents continue to play a
major role in their child’s life even when their child is a young adult; this
role might involve emotional support and guidance or it could be financial (i.e., parents pay for college).This situation provides an opportunity for parents to help
their child recover, although careful attention needs to be paid to their
healthy psychosocial development as an increasingly independent young adults.
In a recent case series at The
University of Chicago, a small number of young adults were provided the
Maudsley approach with some modifications based on their age.The results were positive, overall,
with the majority of the patients recovering and returning to school at
the patients and their families reported positive feelings towards the
treatment approach.(1)Because this form of the Maudsley
approach is still being developed and refined, your best bet would be to seek
out treatment with a trained and experienced Maudsley therapist who would be willing to adapt the treatment to an older
individual.Additional research using
randomized controlled trials will need to be done to determine whether this
approach is the best treatment for young adults, however.For one family’s experience with the
Maudsley approach with their young adult daughter, click here.
(1)Chen EY, Le Grange D, Doyle AC, Zaitsoff S, Doyle P, Roehrig JP, Washington B. A Case Series of Family-Based Therapy for Weight Restoration in Young Adults with Anorexia Nervosa.Journal of Contemporary Psychotherapy. April 2010
Abstract: This case series aims to examine the preliminary efficacy, acceptability and feasibility of Family-Based Treatment to promote weight restoration in young adults with anorexia nervosa. Four young adults with sub/threshold anorexia nervosa were provided 11–20 sessions of Family-Based Treatment for young adults with pre-, post- and follow-up assessments. At post- and follow-up, 3/4 participants were in the normal weight range, 3/4 were in the non-clinical range on the Eating Disorders Examination and reported being not/mildly depressed. At post-treatment, 2/4 were in the good psychosocial functioning range and by follow-up, 3/4 were in this range. These results suggest that Family-Based Treatment for young adults with anorexia nervosa is a promising treatment.