Findings from a systematic review by the Children’s Health Policy Centre highlight promising pathways for treating eating disorders among young people. For anorexia, Multifamily Therapy and Family Therapy led to 78% and 57% of participants, respectively, sustaining positive outcomes by six-month follow-up. Systemic Family Therapy coupled with treatment-as-usual (comprising individual care) also performed well — with 60% of participants sustaining positive outcomes by three-year follow-up. For bulimia, findings were somewhat more muted. Nevertheless, by one-year follow-up, Family-Based Treatment led to nearly 49% of participants sustaining positive outcomes, while Cognitive-Behavioural Therapy (CBT) led to nearly 39% sustaining improvements. While Canadian replication studies are needed, these findings suggest four implications for practice and policy:

• Include parents in the treatment when possible. The most successful treatments involved parents. For anorexia, these treatments included Multifamily Therapy, Family Therapy and Systemic Family Therapy. For bulimia, Family-Based Treatment also involved parents. Consequently, when treating an adolescent with either anorexia or bulimia, practitioners should engage parents whenever feasible.
• Consider CBT when family therapy is not an option. Some parents may not be able to participate in treatment with their children. But CBT for youth with bulimia can still lead to substantial benefits. As well, CBT is an effective treatment for adolescents with binge-eating disorder.
• Teach skills that can endure after treatment ends. Many of the aforementioned interventions led to positive outcomes months, or years, after treatment ended. Examples included Systemic Family Therapy, Multifamily Therapy and CBT, which taught skills young people could use on an ongoing basis. Skills-based interventions should therefore be a priority.
• Evaluate BC outcomes. Canadian replication studies are needed for programs that showed promise in other jurisdictions. So if programs are implemented in BC, they should be accompanied by outcome evaluation — to ensure that they also benefit other young Canadians.

For more information, see Vol. 18, No. 1 of the Children’s Mental Health Research Quarterly.