Maudsley approach to adolescent eating disorders

By: Thinking Families  11-Sep-2012
Keywords: Eating Disorders

The Maudsley Approach for the treatment of anorexia nervosa was developed by Dr Christopher Dare, in 1985, and was subsequently manualised by James Lock, Daniel LeGrange, W. Stewart Agras and Christopher Dare in 2001. It is an outpatient based treatment that aims to assist parents in the process of their child’s recovery.

There are relatively few studies of interventions for anorexia nervosa, however, for adolescents, of the outpatient interventions studied, the Maudsley Model, has the greatest evidential support. The evidence indicates that this treatment is effective for 68 – 70 percent of cases. Continued research has demonstrated that this model of treatment is also applicable to adolescents with bulimia nervosa.

The Maudsley approach addresses the common observation that anorexia can become a chronic illness involving multiple hospitalizations and prolonged treatment. It is applied to adolescents, aged 18 years and under, who are living with their families. The treatment involves the family from the outset of treatment and relies heavily on parent involvement in re-feeding the child with the eating disorder.

Central to this approach is the view that family dysfunction is not a causal factor in the development of the eating disorder. It also differs from other family therapy interventions as the treatment does not address family problems, rather it focuses specifically on mobilizing the resources of the family to overcome the illness.

The Maudsley Approach has three phases of treatment:

Phase One: Intensive Re-feeding.

During this phase the sessions are weekly and its duration is approximately 15 sessions. The aim is to get the young person to 90 - 95% of their ideal body weight. The focus of this phase is establishing and maintaining parent control of re-feeding.

Phase Two: Transition to Adolescent Control.

During this phase sessions are fortnightly and its duration is approximately 15 - 20 weeks. This phase focuses on shifting the control over food choices from the parent to the adolescent, consistent with the adolescent's developmental stage.

Phase Three: Adolescent Issues

During this phase the sessions are monthly. In this phase the adolescent's weight has returned to 100% of ideal body weight. The focus of this phase to return the family life cycle to that normally experienced during the adolescent development phase. Relapse prevention and other remaining issues for the young person or family are addressed.

The treatment is designed to intervene aggressively in the first stages of illness, and the duration of treatment may be as short as 20 sessions or six months. However, in some cases it may be of longer duration. Recovery is most optimally achieved when the eating disorder is treated in its earliest stages and long term chronic illness is prevented.

Keywords: Eating Disorders

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