Multi-Family Therapy and Eating Disorders

Family working on eating disorders in Weight Obsessed Culture

Family can be incredibly complicated and, at different times, you might feel like yours is a blessing or a curse. When it comes to eating disorder treatment, however, research indicates it and Multi-Family Therapy is predominantly a blessing.

Studies have long shown that having recovery-focused, supportive families that are engaged in an individual’s treatment leads to improved outcomes and long-term recovery [1].

This is likely beneficial for many reasons. The most obvious is that the more positive support one has, the more likely they are to succeed at, honestly, anything.

Additionally, even if your family struggled with their own harmful beliefs about body image, food, exercise, etc., engaging in your treatment can help them to learn and grow a more helpful belief system in these areas just as you are.

With these benefits in mind, Multi-Family Therapy (MFT) for eating disorder treatment was developed. This treatment, simply put, is exactly what it sounds like – multiple families engaging in family and group therapy sessions throughout an individual’s treatment.

The idea in developing this model was that it “would allow the families to meet in a group situation with space for learning, inquiry, and sharing of experiences. The MFT group setting would provide opportunities for gaining a new understanding of, and perspectives on, oneself, the members of one’s family and their interactions [1].”

How this goal is achieved occurs through various components of the group, in which a recent study broke down in order to show how they created an MFT program with successful results.

Objective of Multi-Family Therapy

This study discussed the main objective of their Multi-Family Therapy program is to help the struggling individuals gain autonomy in their fight against their disorder, allowing them to take responsibility for their own lives and reducing the dependence on their family.

As mentioned above, some families are under-involved. Therefore, treatment might work to foster individual autonomy while helping the family learn a balance between participation and support and dependence.

On the other side of the spectrum, families that were over-involved might have been engaging in behaviors that either had them doing the bulk of the recovery work or enabling their loved one’s disorder.

The program also helped move beyond the “dinner plate” at family meals to focus more on the interactions and communications within the family. All of this helps the family to learn how they can best support their loved one in recovery-focused interactions without over-engaging.

Framework

The framework of the group involved 6 to 8 families at a time, each of them having their own therapist.

Participation involved “6 gatherings, the first lasting three days and the other five 2-days, over the course of 12 months, totaling 13 days [1].” The program also included an “initial half-day information meeting [1].”

The group begins with a great deal of psychoeducation to allow for all families and their members to get on the same page in understanding the more technical aspects of disordered eating thoughts and behaviors.

Later gatherings then begin to look at “more emotionally demanding” aspects such as guilt or shame and how they are related to eating disorders. This particular program also found greater success when each gathering focused on a specific theme and organized their gatherings as such:

Family in Multi-Family Therapy1) Establishing the group – about eating disorders – how to understand them, and what they do to a family – motivation and change and ambivalence.

2) Communication and communication styles (relationship and interaction within the family – how we relate to each other).

3) Care and patterns of caring – how best to be supportive – belonging.

4) Siblings – focus on their situation – how is it for them? (All participants taking part in this gathering.)

5) ‘Mind the gaps’ – concerning transitions (the ‘home’ therapists of the patients are invited to this).

6) Summing up and ending – the way forward [1].”

The therapy ranged in modality with interventions such as psychoeducation, group therapy, art therapy, genograms, roleplaying, panel debates, etc. being used to create an eclectic but well-rounded interaction with families.

Results

Creating a therapeutic program is all good-and-well. However, if it isn’t effective in practice, it doesn’t have much promise to be adapted in the future.

Thankfully, the program above has seen positive results with a low drop-out rate, significant weight-gain for those with underweight BMIs at the beginning of treatment, and most participating individuals continuing in other forms of treatment to continue their recovery journey afterward [1].

The study examining this program concluded that “including family members and others close to the patient in the treatment can help young adult patients to engage positively in and stay in a necessary treatment process [1].”


Resources:

[1] Skarbo, T., Balmbra, S. M. (2020). Establishment of a multifamily therapy (MFT) service for young adults with a severe eating disorder – experience from 11 MFT groups, and from designing and implementing the model. Journal of Eating Disorders, 8:9.


About the Author:

Image of Margot Rittenhouse.Margot Rittenhouse, MS, PLPC, NCC is a therapist who is passionate about providing mental health support to all in need and has worked with clients with substance abuse issues, eating disorders, domestic violence victims, and offenders, and severely mentally ill youth.

As a freelance writer for Eating Disorder Hope and Addiction Hope and a mentor with MentorConnect, Margot is a passionate eating disorder advocate, committed to de-stigmatizing these illnesses while showing support for those struggling through mentoring, writing, and volunteering. Margot has a Master’s of Science in Clinical Mental Health Counseling from Johns Hopkins University.


The opinions and views of our guest contributors are shared to provide a broad perspective on eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published April 19, 2020, on EatingDisorderHope.com
Reviewed & Approved on April 19, 2020, by Jacquelyn Ekern MS, LPC