Family Therapy and Family

Dana shows signs of having bulimia. She binges and then purges to rid herself of the extra food consumed. The person involved is Dana and her triggers are comments and conversation made by her mother and her sister, Joanie.

The modality of family therapy used is cognitive behavioral family therapy. Cognitive behavioral therapy is a common treatment strategy for those suffering from eating disorders. While cognitive behavioral family therapy is a recently used modality of family therapy, its original form has been tied to treatment of bulimia for years. Numerous articles state the efficacy of CBT for treatment of bulimia. "CBT was more effective in relieving binging and purging than psychoanalytic psychotherapy and was generally faster in alleviating eating disorder features and general psychopathology" (Poulsen et al., 2014, p. 109). CBT is the most commonly used evidence-based practice. Several clinical trials have noted the efficacy of CBT for the treatment of eating disorders and is regarded as the main form of treatment for those suffering from bulimia and anorexia. (Poulsen et al., 2014).

3. Aside from the family therapy that will focus on Dana's interactions with her mother and sister, for Dana, she must learn to understand the cognitive and behavioral processes she undergoes while attempting to binge and purge. Some cognitive processes she could become aware of is her over-evaluation of shape and weight, negative self-evaluation, and negative body image. Some behavioral factors she may consider are: binge-eating, restriction, and purging behaviors. However, within the family therapy aspect, she and her family must adhere to a set structure that includes mood check in, homework assignments, and homework review. Everyone involved in the sessions must perform certain functions to understand where each person is coming from and understand her own reasons for certain behaviors, to open avenues of communication.

1. A SMART goal for Dana can be: 'By March I want to limit purging to twice a week'. A SMART goal for the family can be: 'By April I want to have at least two discussions with my family about how I feel'.

2. The goals should be aimed towards Dana's recovery from bulimia and Dana's communication with her family. The first goal is to limit the binges and purges Dana has over the upcoming months. The second is to facilitate communication and understanding among Dana and her mother and sister.

3. Intervention goals consist of homework assignments, homework reviews, self-monitoring, and rational analysis. It is important to allow Dana and her family time and ability to self-reflect on their actions and the actions of their family members and see how the feel about them.

4. Behavioral enactment is one means that goes in line with CBT family therapy. It allows for therapist-led intervention that will allow for conceptualization of family dynamic and potential maladaptive patterns.

4. Dana's family is concerned with appearances. Her mother is a successful executive and her father, a lawyer. Her sister is displayed academic success. This culture of high standards has created pressure on Dana to succeed and carry herself to the level of perfection her mother actively promotes. Perfectionism is a prevalent symptom in bulimia and other eating disorders and promotes a stressful mentality surrounding achievements and appearances (Waller et al., 2013).