Family intervention in an eating disorders unit

At the Eating Disorders Unit (UTCA) of the Sant Joan de Déu Hospital in Barcelona, family interventions are carried out, led by social workers and educators.

These interventions are included in the treatment of children and adolescents who present specific characteristics: significantly deteriorated family relationships or persistent conflicts that periodically affect family dynamics. The main objective is to support families in the adaptation process they must undertake following the onset of an eating disorder, taking into account the treatment plan and utilizing all available personal and material resources.

Caring for the emotional health of families in the face of illness

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We work to foster communication and the expression of emotions , offering a safe and appropriate space for dialogue, and encouraging participants to reflect on their relationships in order to reach agreements and strengthen bonds. Furthermore, we promote a systemic approach that includes the entire family unit. Interventions take place in various areas of the hospital or in the families' natural environment, i.e., their homes.

It is important to clarify the type of intervention that will be carried out in order not to create false expectations.

In this case, the aim is not for families to resolve all their conflicts, but to support them so that they can better manage them, and to understand and listen to each other.

It is also reiterated what the role of the professionals is, specifying that it is not family therapy but an intervention where the family members involved decide what actions are taken throughout the process.

Furthermore, at UTCA, all families have the opportunity to attend a multi-family group, where aspects similar to family intervention are addressed, but with many families at once. In this case, the group allows for improved well-being through a group meeting space where all the families can share and exchange their approaches to managing emotions, as well as their experiences and knowledge (Sempere, J; Fuenzalida C, 2017).

Phases of family intervention:

1. The professionals assess each family involved in one of the UTCA programs. This assessment gathers information about aspects related to family dynamics. If a need is identified or the family makes a request, they are offered the opportunity to begin intervention.
2. The team speaks with family members separately to encourage them to express themselves and have individual space. This also allows the professionals to get to know each person better .
3. Joint meetings are held between professionals and families. These meetings may involve two or more people, with or without the child or adolescent, and may include any family member. The number of meetings varies depending on several factors (length of service, family willingness or motivation, among others), and their frequency varies according to each case. If any member or the entire family decides not to continue with the meetings, individual emotional support is offered as an alternative. In this case, the professionals encourage families to communicate and express how they feel about each other. They also encourage families to reach realistic and workable agreements.
4. A final meeting is held with all participants to conclude the intervention. They are encouraged to continue working on their commitments and, if necessary, are referred to external resources specializing in family therapy.

Role of professionals in the intervention:

• Understanding the dynamics of relationships within families is crucial. Every relationship is unique and shaped by numerous factors. Professionals should strive to avoid judgment and instead focus on understanding each relationship individually, taking into account the individual's values and beliefs.
• Establish a supportive and emotionally receptive environment. Always speak with respect, without judgment or opinions. It is essential that families see the professionals as trustworthy individuals and feel comfortable engaging in dialogue.
• Moving away from the traditional expert model, while always prioritizing respect and treatment of families, this approach uses a friendly and informal tone, fostering a relationship between professionals and families based on equality.
• Maintain active and empathetic listening, valuing and validating the efforts and abilities of all family members.
• Show confidence in the possibilities of both the individual and the whole family, and show an attitude of respect towards their difficulties.
• To enhance all personal and material resources to try to ensure that the family's interest and motivation to make changes does not decline.
• Facilitate interaction and communication between the child or adolescent and their family members.

Results of the intervention:

In general, families value these meetings positively, although at the beginning of the intervention, most find it difficult to talk about emotions and express how they feel with their children, parents, siblings, etc. It's also true that it's rare to find families who talk about feelings and emotions in their daily lives. That's why it's important to create a positive emotional climate and promote this type of communication.

Finally, it is observed that the fact that the professionals position themselves as simple facilitators of dialogue, without judging or giving advice, generates a more natural and spontaneous scenario.