Section of Eating Disorders, Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK.
South London and Maudsley NHS Foundation Trust, Adult Inpatient Eating Disorders Service, Tyson West 2, Bethlem Royal Hospital, Beckenham, UK.
Eur Eat Disord Rev. 2021 May;29(3):393-401. doi: 10.1002/erv.2816. Epub 2020 Dec 22.
The aim of this paper is to consider family and wider carer involvement in the treatment of anorexia nervosa, and how this can be used to add value to services. We discuss widely adopted interventions involving the family that have been manualised and studied in trials that have outcome measures that are of relevance to illness costs. The therapeutic targets of these interventions range from a focus on feeding to the wellbeing of the whole family. The theoretical models that underpin interventions involving the family/wider carers include both intra and interpersonal processes, with the exception of family-based therapy, which in its original form holds an agnostic stance towards aetiology. Although formal evaluation of the cost effectiveness of these interventions is minimal, there is evidence that involving the family can reduce bed use and improve the wellbeing of both patients and family members. Moreover, for the most part, these interventions are acceptable to patients and carers. Finally, we consider how these approaches can be disseminated and scaled up more widely into services.
本文旨在探讨家庭和更广泛的照顾者在治疗神经性厌食症中的参与，以及如何利用这种参与为服务增值。我们讨论了广泛采用的涉及家庭的干预措施，这些措施已经被规范化，并在具有与疾病成本相关的结果测量的试验中进行了研究。这些干预措施的治疗目标从关注喂养到整个家庭的健康。涉及家庭/更广泛照顾者的干预措施的理论模型包括内部和人际过程，家庭治疗除外，其原始形式对病因持不可知论立场。尽管这些干预措施的成本效益的正式评估很少，但有证据表明，让家庭参与可以减少住院使用并改善患者和家庭成员的健康状况。此外，在大多数情况下，这些干预措施是可以被患者和照顾者接受的。最后，我们考虑如何将这些方法更广泛地传播和推广到服务中。
