Group family psychotherapy during relapse. Case report of a novel intervention for severe and enduring anorexia nervosa
##plugins.themes.bootstrap3.article.main##
Resumen
Objetivo. Exponer el efecto terapéutico del protocolo para casos graves y duraderos de anorexia nervosa en recaída, de la Clínica de Trastornos de la Conducta Alimentaria (CTA) del Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, cuya base teórica es la terapia sistémica.
Método. Para integrar este caso, realizamos una revisión a fondo del expediente clínico y de los registros asistenciales del caso que aquí presentamos. Se utilizó el formato de reporte de caso de las guías CARE.
Resultados. El caso muestra cómo una joven, con signos clínicos de anorexia nervosa grave y duradera (AN-GD), pudo lograr remisión sintomatológica después de que sus padres, pero no ella, recibieran tratamiento con el protocolo para AN-GD.
Discusión y conclusión. Aquí presentamos un caso emblemático que muestra la importancia de involucrar a los padres en el tratamiento de la anorexia nervosa.
Referencias
Allan, E., Le Grange, D., Sawyer, S. M., McLean, L. A., & Hughes, E. K. (2018). Parental expressed emotion during two forms of family-based treatment for adolescent anorexia nervosa. European Eating Disorders Review, 26(1), 46-52. doi: 10.1002/erv.2564
Bruch, H. (1978). The Golden Cage, (3a. Ed.). Cambridge, Massachusetts: Harvard University Press.
Ciao, A. C., Accurso, E. C., & Wonderlich, S. A. (2016). What do we know about severe and enduring anorexia nervosa? In S., Touyz, D., Le Grange, J. H., Lacey, & P., Hay, (Eds.). Managing Severe and Enduring Anorexia Nervosa. A clinician’s guide, (1st. Ed), (p. 299). New York City: Routledge.
Dawson, L., Rhodes, P., & Touyz, S. (2014). The recovery model and anorexia nervosa. Australian & New Zealand Journal of Psychiatry, 48(11), 1009-1016. doi: 10.1177/0004867414539398
Duclos, J., Dorard, G., Cook-Darzens, S., Curt, F., Faucher, S., Berthoz, S., … Godart, N. (2018). Predictive factors for outcome in adolescents with anorexia nervosa: To what extent does parental Expressed Emotion play a role? PLoS ONE, 13(7), e0196820. doi: 10.1371/journal.pone.0196820
Eisler, I., Dare, C., Hodes, M., Russell, G., Dodge, E., & Le Grange, D. (2000). Family therapy for adolescent anorexia nervosa: The results of a controlled comparison of two family interventions. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 41(6), 727-736. doi: 10.1017/S0021963099005922
Fairburn, C. G., Cooper, Z., & Shafran, R. (2003). Cognitive behaviour therapy for eating disorders: A “transdiagnostic” theory and treatment. Behaviour Research and Therapy, 41(5), 509-528. doi: 10.1016/S0005-7967(02)00088-8
Fonagy, P., & Target, M. (1997). Attachment and reflective function: their role in self-organization. Development and Psychopathology, 9(4), 679-700. doi: 10.1017/s0954579497001399
Golan, M. (2013). The journey from opposition to recovery from eating disorders: Multidisciplinary model integrating narrative counseling and motivational interviewing in traditional approaches. Journal of Eating Disorders, 1, 19. doi: 10.1186/2050-2974-1-19
Goldner, E. (1989). Treatment refusal in anorexia nervosa. International Journal of Eating Disorders, 8(3), 297-306. doi: 10.1002/1098-108x(198905)8:3<297::aid-eat2260080305>3.0.co;2-h
Hamburg, P., Herzog, D. B., Brotman, A. W., & Stasior, J. K. (1989). The treatment resistant eating disordered patient. Psychiatric Annals, 19(9), 494-499. doi: 10.3928/0048-5713-19890901-11
Lafrance Robinson, A., Dolhanty, J., Stillar, A., Henderson, K., & Mayman, S. (2016). Emotion-focused family therapy for eating disorders across the lifespan: A pilot study of a 2-day transdiagnostic intervention for parents. Clinical Psychology & Psychotherapy, 23(1), 14-23. doi: 10.1002/cpp.1933
Le Grange, D., Hoste, R. R., Lock, J., & Bryson, S. W. (2011). Parental Expressed Emotion of Adolescents with Anorexia: Outcome in Family-Based Treatment. Internal Journal of Eating Disorders, 44(8), 731-734. doi: 10.1002/eat.20877
Lecomte, A., Zerrouk, A., Sibeoni, J., Khan, S., Revah-Levy, A., & Lachal, J. (2019). The role of food in family relationships amongst adolescents with bulimia nervosa: A qualitative study using photo-elicitation. Appetite, 141, 104305. doi: 10.1016/j.appet.2019.05.036
Liebman, R., Minuchin, S., & Baker, L. (1974). The role of the family in the treatment of anorexia nervosa. Journal of the American Academy of Child Psychiatry, 13(2), 264-274. doi: 10.1016/S0002-7138(09)61315-7
Lock, J., & Le Grange, D. (2005). Family-based treatment of eating disorders. International Journal of Eating Disorders, 37(S1), S64-S67. doi: 10.1002/eat.20122
Loeb, K. L., Lock, J., Le Grange, D, & Greif, R. (2012). Transdiagnostic Theory and Application of Family-Based Treatment for Youth with Eating Disorders. Cognitive and Behavioral Practice, 19(1), 17-30. doi: 10.1016/j.cbpra.2010.04.005
Minuchin, S., Baker, L., Rosman, B. L., Liebman, R., Milman, L., & Todd, T. C. (1975). A conceptual model of psychosomatic illness in children. Family organization and family therapy. Archives of General Psychiatry, 32(8), 1031-1038. doi: 10.1001/archpsyc.1975.01760260095008
Minuchin, S., Rosman, B. L., & Baker, L. (1978). Psychosomatic Families: Anorexia Nervosa in Context. Cambridge, Massachusetts and London, England: Harvard University Press.
Moskovich, A. A., Timko, C. A., Honeycutt, L. K., Zucker, N. L., & Merwin, R. M. (2017). Change in expressed emotion and treatment outcome in adolescent anorexia nervosa. Eating Disorders, 25(1), 80-91. doi: 10.1080/10640266.2016.1255111
National Institute for Clinical Excellence. (2004). Eating Disorders. Core interventions in the treatment and management of anorexia nervosa, bulimia nervosa, and related eating disorders. UK: National Institute for Clinical Excellence.
Onnis, L., & Di Gennaro, A. (1987). Alessitimia: una revisione critica. Medicina Psicosomatica, 32, 45-64.
Pace, C. S., Cavanna, D., Guiducci, V., & Bizzi, F. (2015). When parenting fails : alexithymia and attachment states of mind in mothers of female patients with eating disorders. Frontiers in Psychology, 6, 1145. doi: 10.3389/fpsyg.2015.01145
Peris, T. S., & Miklowitz, D. J. (2015). Parental expressed emotion and youth psychopathology: New directions for an old construct. Child Psychiatry and Human Behavior, 46(6), 863-873. doi: 10.1007/s10578-014-0526-7
Rausch Herscovici, C. (2013). Family approaches. In B., Lask & R., Bryant-Waugh (Eds.). Eating Disorders in Childhood and Adolescence, (4th. Ed.), (pp. 239-257). London: Routledge.
Rausch Herscovici, C., & Bay, L. (1990). Aspectos generales. In Anorexia nerviosa y bulimia. Amenazas a la autonomía, (1a. Ed.), (p. 198). Buenos Aires: Paidós.
Reich, G., von Boetticher, A., & Cierpka, M. (2016). Terapia familiar psicodinámica de la anorexia nerviosa. Revista de Psicopatología y Salud Mental del Niño y del Adolescente, 27, 69-75. Retrieved from https://www.fundacioorienta.com/wp-content/uploads/2019/02/Reich-G-R27.pdf
Rhodes, P. (2003). The Maudsley model of family therapy for children and adolescents with anorexia nervosa: Theory, clinical practice, and empirical support. Australian & New Zealand Journal of Family Therapy, 24(4), 191-198. doi: 10.1002/j.1467-8438.2003.tb00559.x
Robinson, P. H. (2009). Severe and enduring eating disorder (SEED): Management of Complex Presentations of Anorexia and Bulimia Nervosa. West Sussex, UK: Wiley-Blackwell.
Schmidt, U., & Treasure, J. (2006). Anorexia nervosa: Valued and visible. A cognitive-interpersonal maintenance model and its implications for research and practice. British Journal of Clinical Psychology, 45(3), 343-366. doi: 10.1348/014466505X53902
Schmidt, U., Wade, T. D., & Treasure, J. (2014). The Maudsley Model of Anorexia Nervosa Treatment for Adults (MANTRA): Development, Key Features, and Preliminary Evidence. Journal of Cognitive Psychotherapy, 28(1), 48-71. doi: 10.1891/0889-8391.28.1.48
Selvini-Palazzoli, M., Cirillo, S., Selvini, M., & Sorrentino, A. M. (1998). Ragazze anoressiche e bulimiche. La terapia familiare. Milano: Raffaello Cortina Editore.
Touyz, S., & Hay, P. (2015). Severe and enduring anorexia nervosa (SE-AN): in search of a new paradigm. Journal of Eating Disorders, 3(1), 26. doi: 10.1186/s40337-015-0065-z
Treasure, J., & Cardi, V. (2017). Anorexia Nervosa, Theory and Treatment: Where Are We 35 Years on from Hilde Bruch’s Foundation Lecture ? European Eating Disorders Review, 25(3), 139-147. doi: 10.1002/erv.2511
Treasure, J., Rhind, C., Macdonald, P., & Todd, G. (2015). Collaborative Care: The New Maudsley Model. Eating Disorders, 23(4), 366-376. doi: 10.1080/10640266.2015.1044351
Treasure, J., Stein, D., & Maguire, S. (2015). Has the time come for a staging model to map the course of eating disorders from high risk to severe enduring illness? An examination of the evidence. Early Intervention in Psychiatry, 9(3), 173-184. doi: 10.1111/eip.12170
Uehara, T., Kawashima, Y., Goto, M., Tasaki, S., & Someya, T. (2001). Psychoeducation for the families of patients with eating disorders and changes in expressed emotion: A preliminary study. Comprehensive Psychiatry, 42(2), 132-138. doi: 10.1053/comp.2001.21215
