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Family Therapy for Eating Disorders and Non-suicidal Self-Injury

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Non-Suicidal Self-Injury in Eating Disorders

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Abstract

Non-suicidal self-injury (NSSI) and eating disorders frequently co-occur, especially during adolescence. Several family factors have been associated with risk for NSSI and eating disorders including lack of cohesion and communication, greater conflict and criticism and physical or sexual abuse. Few studies have examined protective factors within the family, and this is an area in need of greater research investment. Overall, research on relationships between family characteristics and NSSI and eating disorders is limited. Currently, family factors are thought to be better understood as risk factors for psychopathology generally, rather than NSSI and eating disorders specifically, and to interact with other biological, psychological and environmental factors. Moreover, family dysfunction may be a consequence of disruption caused by illness behaviours, rather than a cause of the illness itself. Family-based treatment (FBT) for eating disorders does not attribute blame to the family but instead focuses on the family, especially parents, as a resource for recovery. FBT has the strongest evidence base for treatment of eating disorders in adolescents; however, NSSI can make the treatment process challenging for the family and treating team. In this chapter, we describe how NSSI and suicidal behaviour should be addressed in the context of FBT and provide case examples to illustrate three types of situations that may arise (i.e. suicidal patients, patients who engage in low-level NSSI and patients who engage in severe or high-risk NSSI) and how these can be managed while working towards the goals of recovery.

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Authors and Affiliations

  1. University of Melbourne, Melbourne, Australia

    Elizabeth K. Hughes

  2. Murdoch Childrens Research Institute, Melbourne, Australia

    Elizabeth K. Hughes & Erica Allan

  3. Royal Children’s Hospital, Melbourne, Australia

    Elizabeth K. Hughes & Erica Allan

  4. University of Chicago, Chicago, USA

    Daniel Le Grange

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  1. Elizabeth K. Hughes
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  2. Erica Allan
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  3. Daniel Le Grange
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Correspondence to Elizabeth K. Hughes .

Editor information

Editors and Affiliations

  1. Department of Psychology, KU Leuven, Leuven, Belgium

    Laurence Claes

  2. Department of Psychology, University of Wisconsin-Eau Claire, Eau Claire, Wisconsin, USA

    Jennifer J. Muehlenkamp

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Hughes, E.K., Allan, E., Le Grange, D. (2014). Family Therapy for Eating Disorders and Non-suicidal Self-Injury. In: Claes, L., Muehlenkamp, J. (eds) Non-Suicidal Self-Injury in Eating Disorders. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-40107-7_9

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  • DOI: https://doi.org/10.1007/978-3-642-40107-7_9

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