Family-Based Treatment + Unified Protocol for Avoidant/Restrictive Food Intake Disorder: An Exploratory Feasibility and Treatment Response Study in a Case Series of Adolescents

Abstract:

Objective: This study explored the flexible use of family-based treatment (FBT) and the unified protocol for the transdiagnostic treatment of emotional disorders in adolescents (FBT + UP-A) to address the diverse needs of those with avoidant/restrictive food intake disorder (ARFID).

Method: Adolescents (n = 13, age range 13-18 years) diagnosed with ARFID were sequentially recruited from a publicly funded eating disorder program and were offered 9 months of outpatient treatment. After achieving initial weight gain using FBT, adolescents were given the option to receive the UP-A to work on self-identified treatment goals.

Results: The study enrolled 100% of eligible participants and all completed treatment. All participants received the minimum required dose of FBT and most chose to engage in UP-A (84.62%). Completion of research measures was inconsistent across participants and those choosing FBT-only were lost to research follow-up. Exploratory analysis of treatment response pre-to post-treatment demonstrated moderate to large treatment effect sizes in terms of weight, ARFID symptoms, and depression, but only small effect sizes for anxiety.

Discussion: The current study explored the sequential use of an eating disorder and a transdiagnostic emotional disorder intervention for the treatment of ARFID and co-occurring emotional concerns identified by adolescents. These findings suggest that FBT + UP-A has the potential to treat ARFID and depression but requires further testing in a larger controlled study.