Self-perceived family functioning in 40 French families of anorexic adolescents: implications for therapy

Family therapy is recognized as one of the most effective treatment modalities in adolescent anorexia nervosa, but family therapists continue to be guided by conflicting models of family functioning that either rely on the notion of a family cause that needs to be remedied or support a more positive view of family factors. Most often, these models are anchored to clinical observations or incomplete self-report assessments. The aim of this study was to determine whether a specific pattern of self-assessed family functioning is associated with adolescent anorexia nervosa. All family members from 40 French families with an anorexic adolescent completed the FACES III and results were compared with a reference population. Findings tend to refute the notion of a specific pathological pattern in these families while also pointing to unique trends in family relationships (flexible distance) and unique areas of dissatisfaction and distress. Overall, results encourage family therapists to hold a more flexible view of family functioning, adapting therapeutic interventions to each family's style and level of functioning, and to acknowledge the voice of all family members living with the anorexic patient.