What role does family involvement play in the management of anorexia nervosa in primary care settings?

Role of Family Involvement in Managing Anorexia Nervosa in Primary Care

Family involvement plays a crucial role in the management of anorexia nervosa within primary care settings. It is recommended that family members or carers are involved in the assessment and treatment process unless the person with anorexia nervosa refuses or it is contraindicated, respecting the patient's autonomy and Gillick competence in children and young people under 16 years old. Family members should be provided with appropriate information and support to help them understand the condition and how to support the person effectively.

In children and young people, anorexia-nervosa-focused family therapy (FT-AN) is a key treatment option, typically delivered over 18–20 sessions in a year, either as single-family or multi-family therapy. If FT-AN is not suitable, individual cognitive behavioural therapy (CBT-ED) or adolescent-focused psychotherapy may be considered, both of which include family sessions to educate and engage carers in the recovery process.

For adults, family involvement is encouraged particularly in treatments like Maudsley Anorexia Nervosa Treatment for Adults (MANTRA), which includes family members or carers to help the person understand their condition and support behaviour change. Sharing information such as weight monitoring results with family members can also be beneficial if appropriate.

Family members and carers may experience significant distress and feelings of guilt; therefore, assessing their need for support, including practical help and emergency planning, is important. Encouraging family support during treatment can improve outcomes and help address emotional and social needs related to the disorder.

Overall, family involvement in primary care supports psychoeducation, monitoring, emotional support, and coordinated care between primary and specialist services, enhancing the management and recovery of people with anorexia nervosa.

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