Modifications to Enhance Outcomes of Family-Based Treatment for Anorexia Nervosa: A Scoping Review

Family-based treatment (FBT) is recommended for anorexia nervosa (AN) in young people (YP). However, a substantial proportion of YP undergoing FBT do not recover. Several modifications to standard FBT have been tested to improve recovery rates. This review provides an updated overview of empirically tested modifications to FBT for AN in YP and estimates whether such modifications increase the percentage recovering. Computerized searches performed in five databases resulted in the inclusion of 43 papers (representing 40 original studies), highlighting that a variety of modifications to standard FBT have been tested and appear promising. However, only 11 studies compared the results of a modification to standard FBT. In conclusion, some modifications, such as parent-focused treatment, the addition of home treatment, or interventions for families at risk of non-response, appear to have the potential to improve the recovery rate, either at the group or subgroup level. Other modifications, such as FBT-based guided self-help, virtually delivered FBT, or FBT delivered during in- or day-patient stays, enable the dissemination of FBT principles to other contexts and to patient groups with limited access. Small additions to FBT, such as a workshop or parent-to-parent consultation, do not seem to improve the recovery rate.