Family involvement and family assessment
Where possible, it is highly desirable to have carers or
family involved in the assessment process given they provide
much of the on-going care and share the extensive
burden of the disorder. For younger patients still living at
home, family members may need to be directly involved
as treatment agents [69] as long as they are appropriately
supported and advised, noting that family members can
become entangled with behaviours that maintain the
disorder [70]. For adolescents, the assessment phase may
more directly involve assessment of family functioning.
The inevitable distress about having a family member with
AN may need addressing in its own right and assessment
of family functioning is core where family therapy treatment
models are to be employed. There is no clearly
superior way to assess family functioning: approaches are
likely to reflect the model of family therapy employed and
there are several variants of this. Family therapy models
have been met with enthusiasm although a recent
Cochrane Collaboration review suggests a need to temper
this enthusiasm due to a range of methodological shortcomings
in the small number of published treatment trials
[71]. Such moderation should equally apply to assessment
processes meaning that rigid approaches to assess families
should be avoided.