Development and Preliminary Evaluation of a Behavior-Analytic Family Intervention for Adolescents with Anorexia Nervosa and Their Parents: A Four-Case Series

Anorexia nervosa (AN) in adolescence is associated with substantial morbidity and complex family processes. Family-based approaches are the best-established psychosocial treatments, but remission rates remain modest and broader family and emotional processes are often only partly addressed. This case series describes the development and preliminary evaluation of a behavior-analytic family intervention combining parent-led refeeding with structured work on parental socioemotional and educational skills. Eight families were screened, five entered treatment, and four completed a 20-session outpatient protocol delivered weekly over approximately six months, with assessments at baseline, post-treatment, and three-month follow-up. Outcomes included anthropometric indicators, menstrual status, eating-disorder psychopathology, adolescent and caregiver functioning, parenting style, perceived family support, and parent satisfaction. Among completer families, attendance was 100%. Mean BMI increased from 16.72 at baseline to 18.91 post-treatment and 19.03 at follow-up; mean EDE-Q total score decreased from 4.25 to 1.40 and 0.73, respectively. All four adolescents achieved physiological remission and reliable EDE-Q improvement by follow-up; three also met multidimensional remission criteria. The intervention was feasible, acceptable, and clinically promising, but larger studies with independent assessment and comparison conditions are needed.