Table 3 Characteristics of studies included in the meta-synthesis

Baudinet et al., 2024 [24]

How young people perceive change to occur in family therapy for anorexia nervosa: a qualitative study

Explore the perceived change mechanisms of FT-AN from the young person’s perspective; to shed light on possible change processes and treatment mechanisms within FT-AN.

Manualised FT-AN; outpatient

Convenience; YP were eligible if they (a) had a diagnosis of AN including atypical AN, and (b) received FT-AN at the Maudsley during the recruitment period. Potential participants were identified and invited at the point of discharge.

15 YP aged 13–18 at time of treatment and 13–19 at time of data collection. Most identitied as cisgendered female (13/15) and White. One participant identified as male and one as gender fluid. One participant identified as neuordiverse.

White British 9/15, White Other 2/15, Black British 1/15; Hispanic 1/15, Mixed 1/15.

United Kingdom

Interviews

Reflexive thematic analysis

Chan and Joyce [53]

A Feminist Family Therapy Research Study: Giving a Voice to a Girl Suffering from AN

Explore a patient’s experience of treatment by inviting her to review her family sessions.

SyFT; outpatient

Convenience; the participant was recruited within an ED service where the author worked as the family’s family therapist.

One female YP, their two siblings, mother and father. The patient was aged 21 at treatment and data collection.

Chinese

Hong Kong

Video playback and interviews

Case study analysis

Conti et al. [37]

‘Somebody Else’s Roadmap’: Lived Experience of Maudsley and FBT for Adolescent AN

Explore an experience of FBT by one family; how they negotiated their identities, roles, and alliances in a protracted phase 1.

Manualised FBT; outpatient

Purposive; the family responded to an advertisement distributed through HCP networks.

One female YP, their mother, father and male sibling who engaged in FBT for three years. The patient was aged 14 at time of data collection.

NS

Australia

Interviews

Critical discursive analysis

Conti et al. [38]

“I’m still here, but no one hears you”: a qualitative study of young women’s experiences of persistent distress post FBT for adolescent AN

Explore the experiences and identity struggles of adolescents who (1) drop out of FBT and/or (2) continue with substantive psychological distress post-treatment.

Manualised FBT; outpatient

Purposive; participants responded to advertisements on facebook or via clinicians after completing treatment.

14 female YP who engaged in FBT on average four years prior to participation for three to 24 months. Patients were aged 11–18 at treatment and 14–27 at data collection.

NS

Australia, New Zealand and UK

Interviews

Inductive thematic analysis

Krautter and Lock [54]

Is manualized family-based treatment for adolescent AN acceptable to patients? Patient satisfaction at the end of treatment

Assess the perspectives of families who completed treatment using manual-driven FBT for AN.

Manualised FBT; outpatient

Convenience; participants were invited to complete a treatment effectiveness survey at the end of treatment in an ED clinic.

34 families including 35 mothers, 31 fathers and 34 YP (32 female, two male). Treatment completion was defined as attending 80% of an average of 14 sessions over six to 12 months. Patients were aged 12–18 at data collection.

European American (n = 27), Asian (n = 3) Hispanic (n = 2), American Indian (n = 1), ‘Other’ (n = 1).

Northern California

Open ended survey

Phenomenological type content analysis and structural synthesis

van Langenberg, Duncan and Allen [55]

"They don’t really get heard”: A qualitative study of sibling involvement across two forms of FBT for adolescent AN.

Explore families’ experience of sibling involvement in FBT from the perspective of siblings, patients and parents.

Manualised FBT; outpatient.

Convenience; families attending a program within a specialist ED service were eligible to participate if the adolescent had at least one sibling and had completed FBT two to nine months prior.

12 siblings (10 female, one male) aged 10 to 18, 14 parents (one father, 12 mothers) and seven female patients aged 13–17 at data collection.

NS

Australia

Interviews

Thematic analysis

Lindstedt, Neander, Kjellin and Gustafsson [56]

Being me and being us - adolescents’ experiences of treatment for EDs

Investigate how YP with AN experience outpatient treatment for EDs, involving family and individual based interventions.

Flexibly adhered to FBT; outpatient

Convenience; participants were recruited in collaboration with four ED units.

15 YP (14 female, one male) were treated for AN or EDNOS restrictive over one to two years. Three received FBT, 12 engaged in a blend of FBT and individual sessions. Patients were aged 13–19 at treatment.

NS

Sweden

Interviews

Hermeneutic phenomenological approach

Joyce [57]

Patients’ perspective on family therapy for AN: A qualitative onquiry in a chinese context

Assess the perceived treatment effectiveness of family therapy from the perspective of families who have completed treatment.

SyFT; outpatient

Convenience; participants were recruited within an ED service within which the author worked as the families’ family therapist.

24 female YP and their parents treated over two and a half years. Patients were aged 14–23 at treatment.

Chinese

Hong Kong

Interviews

Content analysis

McMahon, Stoddart and Harris [58]

Rescripting—A grounded theory study of the contribution that fathers make to FBT when a young person has AN

Present a grounded theory of the contribution that fathers make to FBT when a young person has AN.

Manualised FBT; outpatient

Convenience; participants were recruited from eight CAMH services through HCPs delivering FBT.

15 fathers to a YP with AN (two male, 13 female) who had engaged in FBT. Patients were aged 11–17 at treatment.

NS

Scotland

Interviews

Classic grounded theory

Medway et al. [59]

Adolescent development in FBT for AN: Patients’ and parents’ narratives

Explore the perspectives of young people and their parents regarding the developmental impact of AN, and the role of FBT in addressing developmental challenges.

Manualised FBT; outpatient

Convenience; participants were identified from records of families who had received outpatient FBT at an ED service and had completed an adequate number of sessions of phases two and three and were weight restored.

12 young people (11 female, one male) who ceased FBT a minimum one year prior, and one of their parents (n = 12; 10 mothers, two fathers). Patients were aged 12–16 at onset and 16–24 at data collection.

NS

Australia

Interviews

Narrative inquiry method

Nilsen, Hage, Rø, Halvorsen and Oddli [60]

External support and personal agency - young persons’ reports on recovery after family-based inpatient treatment for AN: a qualitative descriptive study

Investigate the reflections of young persons with a lived experience of AN, and what factors they consider important for the recovery process.

Flexible adhered to FBT; Inpatient

Convenience; former inpatients were invited to participate following completion of family based inpatient treatment at an ED unit. Without adhering to manualised FBT, the guiding treatment principles were inspired by outpatient FBT. The over-arching treatment focus for the majority of participants corresponded to the first phase in outpatient FBT.

33 females and four males who were offered two family therapy sessions per week during their admission. Average length of stay was 20.8 weeks. The average time from discharge to data collection was four and a half years. Patients were aged 12–19.5 at admission and 15.8–25.3 at data collection.

NS

Norway

Interviews

Thematic analysis

Socholotiuk and Young [61]

Weight restoration in adolescent anorexia: parents’ goal-directed processes

Describe how parents participated in the weight restoration of their adolescent while engaged in FBT for AN.

Manualised FBT; outpatient

Purposive; participants responded to advertisements at local child/youth mental health centres or online. Adolescents could be in the early, middle, or late stages of weight restoration.

Three mothers and one mother-father dyad who were actively engaged in FBT. Patients were aged 13–16 at treatment.

Caucasian (n = 4), indigenous (n = 1) Parents were born in Canada (n = 3) and Western European countries (n = 2).

Canada

Video playback and systematic analysis of video recorded conversations.

Qualitative action project

Wallis et al. [29]

Relational containment: Exploring the effect of FBT for AN on familial relationships.

Investigate the process of familial relationship change for adolescents with AN and their parents who participated in FBT.

Manualised FBT; outpatient

Purposive; families who completed a 20-session protocol within an ED service at least six months before an interview with weight greater than 85% expected body weight were invited to participate.

16 female adolescents, 28 parents (15 mothers, 12 fathers) who completed a mean of 33 FBT sessions on average 12.11 months prior to data collection. Patients were 12–18 at treatment and 14–20 at data collection.

NS

Australia

Interviews

Constructionist grounded theory

Williams, Wood and Plath [62]

Parents’ experiences of family therapy for adolescent AN

Examine parents’ experiences of family therapy for adolescents with AN.

Manualised FBT (n = 6) or SyFT (n = 3); outpatient

Purposive; parents were eligible to participate if they had received or were undergoing FBT or SyFT in CAMHS, their YP was aged 12–18 years at diagnosis, their BMI was in the healthy weight range at data collection, and illness duration was less than three years prior to treatment.

Six mothers and three fathers of seven YP (six females, one male). Treatment duration ranged from 0–6 to > 36 months. Patients were 13–18 at treatment.

NS

Australia

Interviews

Interpretative phenomenological analysis

Wufong, Rhodes & Conti [39]

"We don’t really know what else we can do”: Parent experiences when adolescent distress persists after the MFT/FBT for AN.

Exploration of parents’ experiences of FBT in cases where treatment was discontinued and/or their child continued to experience psychological distress post-treatment.

Manualised FBT; outpatient

Purposive; participants responded to advertisements distributed through HCP networks.

Nine mothers and four fathers of 11 female YP who completed FBT at least one year prior. Patients were aged 12–17 at treatment.

NS

Australia

Interviews

Critical discursive analysis