Family life and caregiving during family-based treatment (FBT) for anorexia nervosa: parent, patient, and clinician perspectives

Family-based treatment (FBT) is the treatment of choice for adolescent anorexia nervosa (AN). Although effective, caregivers often experience significant emotional strain, uncertainty, and distress whilst undergoing FBT. This study aims to explore how parents, adolescents, and clinicians experience challenges of family life and caregiving during FBT. A qualitative design was employed using focus groups with parents (N = 10), individuals recovered from adolescent-onset AN (N = 4), and clinicians (N = 8). Reflexive thematic analysis was applied to identify themes. Four overarching themes were identified: 1) AN as an intrusive force disrupting family life, 2) shared experiences of guilt, doubt, and isolation, 3) the evolving parental role within treatment, and 4) the reorganization of family dynamics around the illness. Parents described significant ambivalence toward treatment responsibilities, while adolescents struggled with isolation. Clinicians noted discrepancies in how different stakeholders understood and engaged with treatment. Our findings highlight the importance of addressing both the practical and emotional aspects of caregiving to enhance treatment outcomes, as FBT remains an essential intervention for adolescent AN. Further research should investigate ways to strengthen caregiver empowerment and mitigate distress while maintaining the core principles of FBT. FBT is a leading treatment for young people with anorexia nervosa, but it can be very challenging for families. In this study, we conducted focus group interviews with parents, young people who had recovered, and clinicians to understand their experiences. Families described how the illness disrupted everyday life and caused feelings like guilt, doubt, and isolation. Parents often felt unsure about their role in treatment and struggled with the responsibility of managing eating. We suggest that clearer communication and more emotional support for parents could help families feel more confident and supported during FBT.