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Cognitive behavioral therapy (CBT) is considered for children and adolescents with eating disorders (ED) when family-based treatment (FBT), the first-line treatment, is unacceptable to patients and families, is contraindicated for some reasons, or is ineffective. Evidence is accumulating on the use of enhanced CBT (CBT-E), which was designed to treat patients with ED. CBT-E is based on a transdiagnostic perspective that patients with anorexia nervosa and bulimia nervosa have a core common psychopathology of over-evaluating eating, shape, weight, and their control. This psychopathology is expressed through restricted food intake, low body weight, overeating, over-exercise, and vomiting. Although CBT-E was designed for treating adults with ED, some recent studies have reported the effectiveness of CBT-E in children and adolescents with ED. The aim of this paper is to give a brief overview of the theoretical background of CBT-E, examine previous studies that demonstrate the effectiveness of CBT-E for children and adolescents with ED, provide an outline of CBT-E, and present a case study using a CBT-E approach in an inpatient setting. [ABSTRACT FROM AUTHOR]

Anorexia nervosa (AN) is a serious mental disorder with the highest mortality rate among all mental disorders. Family based treatment (FBT) is a manualized, outpatient treatment for AN developed by Lock and Le Grange. FBT considers parents the most important treatment resource, involves all family members living together, and focuses on early weight restoration. Currently, FBT is the most evidence-based treatment for AN in children and adolescents and is considered first-line treatment by major guidelines, including the NICE guideline. FBT is considered the best treatment for children and adolescents under the age of 19 and with duration of illness of less than 3 years. The duration of treatment varies from 6 to 12 months, divided into three phases. In the first phase, parents are responsible for refeeding and weight restoration. In the second stage, parents return control of eating back to the adolescent. The third phase promotes the adolescent’s developmental path. This paper outlined the procedures for implementing FBT. In addition, taking into consideration the Japanese medical system and gender role culture, where it is difficult to secure time for family therapy in an outpatient setting, we discussed the possibility of starting FBT during hospitalization, allowing for some non-participation of the father, and shortening the session time to make it easier to implement FBT in Japan. [ABSTRACT FROM AUTHOR]

Eating disorders have a high prevalence and high risk of death from anorexia nervosa. In addition, although it is desirable to prevent extreme malnutrition and chronicity, it is difficult to establish therapeutic relationships to the degree necessary for effective psychiatric treatment. Although it is difficult to establish therapeutic relationships to the degree necessary for effective psychiatric treatment. and for understanding and treating eating disorders, either in childhood or adulthood. In addition, consistency in understanding and dealing with children’s mental states, itself, is necessary. This paper addresses the differences between, and precautions with children, adolescents and adults in the treatment of eating disorders, especially around establishing therapeutic relationships with patients and families, and addressing personality disorders, substance use disorders, autism spectrum disorder (ASD), avoid and/restrictive food intake disorder (ARFID), and the empirical evidence for treatment. In the treatment of eating disorders, regardless of age, the patient’s efforts are viewed from the perspective of what the patient is experiencing and what he or she can do to recover. While therapists may ultimately wish to establish a caring and helpful relationship, it is important to resolutely confront the symptoms of eating disorders in order to save lives. [ABSTRACT FROM AUTHOR]

This paper reports on a girl with anorexia nervosa in long-term hospitalization. Treatment progress fluctuated greatly due to severe psychopathology of anorexia nervosa and perfectionism. However, she gradually regained both mental and physical health, and an independence of spirit befitting her age. The process of symptom formation are discussed alongside the psychopathology that underlay the need for extensive hospitalization. Furthermore, the significance of multiple functional child and adolescent psychiatric wards are discussed, not only in terms of physical management and life protection, but as an environment for nurturing basic trust with medical staff, and interacting with peer-groups. Moreover, the implementation of family therapy allowing the therapist to evaluate the child's symptoms from diverse and multi-layered perspectives, and enabling the parents to resume their supportive functions, in particular, through vivid restoration of emotional availability in the patient's mother, were noted as the keys to the child's recovery. [ABSTRACT FROM AUTHOR]