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Parent-focused treatment for adolescent anorexia nervosa: a study protocol of a randomised controlled trial

Elizabeth K Hughes123*, Daniel Le Grange14, Andrew Court2, Michele SM Yeo2, Stephanie Campbell2, Erica Allan23, Ross D Crosby5, Katharine L Loeb6 and Susan M Sawyer123

Author Affiliations

1 Department of Paediatrics, The University of Melbourne, 50 Flemington Road, Parkville, Melbourne, VIC 3052, Australia

2 Centre for Adolescent Health, Royal Children’s Hospital, 50 Flemington Road, Parkville, Melbourne, VIC 3052, Australia

3 Murdoch Childrens Research Institute, Melbourne, Australia

4 Psychiatry & Behavioral Neuroscience, The University of Chicago, 5841 S. Maryland Ave., MC3077 Chicago, IL 60637, USA

5 Neuropsychiatric Research Institute and University of North Dakota School of Medicine and Health Sciences, 700 First Avenue South, Fargo 57103, North Dakota, USA

6 Fairleigh Dickinson University, 1000 River Road T-WH1-01, Teaneck, Hackensack, NJ 07666, USA

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BMC Psychiatry 2014, 14:105  doi:10.1186/1471-244X-14-105

Published: 8 April 2014



Family-based treatment is an efficacious outpatient intervention for medically stable adolescents with anorexia nervosa. Previous research suggests family-based treatment may be more effective for some families when parents and adolescents attend separate therapy sessions compared to conjoint sessions. Our service developed a novel separated model of family-based treatment, parent-focused treatment, and is undertaking a randomised controlled trial to compare parent-focused treatment to conjoint family-based treatment.


This randomised controlled trial will recruit 100 adolescents aged 12–18 years with DSM-IV anorexia nervosa or eating disorder not otherwise specified (anorexia nervosa type). The trial commenced in 2010 and is expected to be completed in 2015. Participants are recruited from the Royal Children’s Hospital Eating Disorders Program, Melbourne, Australia. Following a multidisciplinary intake assessment, eligible families who provide written informed consent are randomly allocated to either parent-focused treatment or conjoint family-based treatment. In parent-focused treatment, the adolescent sees a clinical nurse consultant and the parents see a trained mental health clinician. In conjoint family-based treatment, the whole family attends sessions with the mental health clinician. Both groups receive 18 treatment sessions over 6 months and regular medical monitoring by a paediatrician. The primary outcome is remission at end of treatment and 6 and 12 month follow up, with remission defined as being ≥ 95% expected body weight and having an eating disorder symptom score within one standard deviation of community norms. The secondary outcomes include partial remission and changes in eating pathology, depressive symptoms and self-esteem. Moderating and mediating factors will also be explored.


This will be first randomised controlled trial of a parent-focused model of family-based treatment of adolescent anorexia nervosa. If found to be efficacious, parent-focused treatment will offer an alternative approach for clinicians who treat adolescents with anorexia nervosa.

Trial registration

Australian and New Zealand Clinical Trials Registry ACTRN12610000216011.

Anorexia nervosa; Eating disorders; Adolescents; Family therapy; Randomised controlled trial