Cognitive-Behavioral Family Therapy for Eating Disorders in South Korea: A Multiple Case Study

Background and Purpose: Eating disorders are becoming more prevalent as the societal emphasis on thinness pressures individuals to become highly self-conscious of their body shapes, leading to various attempts to lose or control their weight. However, previous evidence-based research has indicated that many individuals with an eating disorder do not show sufficient improvement and end up following a chronic course of illness. Therefore, this study aimed to identify the stages of family therapy intervention and change process in the families, focusing on four family therapy cases of an eating disorder that were based on cognitive-behavioral family therapy.

Methods: We used a case study method to promote an in-depth understanding of the family dynamics and interactions in each family. In addition, we used a thematic analysis to explore and identify the stages of family therapy intervention and the process of change in clients with an eating disorder.

Results: The study identified the stages of family therapy intervention and change in the identified clients with an eating disorder as follows: (1) exploring and recognizing the problem, (2) understanding the system, (3) practicing new communication patterns, (4) changes in the family system, and (5) changes in the clients. The therapist helped the identified clients and their families gain insight into the context of eating disorders through participating in cognitive-behavioral family therapy. Through participation in cognitive-behavioral family therapy, the identified clients and their families became aware of their cognitive distortions. Furthermore, the identified clients and their families attempted honest conversations using alternative, functional communication patterns, leading to improved family relationships. The enhanced awareness of their problems and changes in their communication patterns contributed to reducing or eliminating eating disorder symptoms in the identified clients.

Conclusions and Implications: The significance and implications of the study findings are as follows. First, this study provides a new direction for treating eating disorders by presenting the effectiveness of cognitive-behavioral family therapy and the change process of eating disorders. Second, we recommend family therapists working with clients with eating disorders to address the problem from the family systems perspective, ultimately focusing on promoting alternative, functional communication patterns.