title: Just one more bite: a qualitative analysis of the family meal in family-based treatment for anorexia nervosa.
abstract: OBJECTIVE
  The family meal is an integral component of Maudsley family-based treatment for anorexia nervosa. The aim of this study was to determine whether there are different types of family meal, as suggested in the treatment manual, and whether within session processes differ according to meal type.
  
  
  METHODS
  Thirty video-recorded family meal sessions from a randomised controlled trial were transcribed and analysed using thematic analysis.
  
  
  RESULTS
  Analyses revealed two types of family meal. In the first, the patient ate one mouthful more than they were willing to eat. This meal type was characterised by processes that were consistent with the Maudsley model. In the second, the patient ate what was asked of them with little to no difficulty. Therapist and family avoidance differentiated this meal type from the first.
  
  
  CONCLUSIONS
  The current findings, along with the existing theory, suggest that avoidance may have reduced the therapeutic impact of the meal for many families. Strategies to challenge therapist and family avoidance are suggested. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.
authors.affiliation: Clinical Psychology Unit, The University of Sydney, Sydney, NSW 2006, Australia.
authors.forename: Kate
authors.initials: K
authors.lastname: Godfrey
authors.forename: Paul
authors.initials: P
authors.lastname: Rhodes
authors.forename: Jane
authors.initials: J
authors.lastname: Miskovic-Wheatley
authors.forename: Andrew
authors.initials: A
authors.lastname: Wallis
authors.forename: Simon
authors.initials: S
authors.lastname: Clarke
authors.forename: Michael
authors.initials: M
authors.lastname: Kohn
authors.forename: Stephen
authors.initials: S
authors.lastname: Touyz
authors.forename: Sloane
authors.initials: S
authors.lastname: Madden
mesh_terms: D000553:Ambulatory Care; D000856:Anorexia Nervosa / Q000523:psychology / Q000628:therapy*; D004435:Eating; D005196:Family Therapy; D001068:Feeding and Eating Disorders / Q000523:psychology / Q000628:therapy; D005260:Female; D006282:Health Personnel; D006801:Humans; D008297:Male; D011613:Psychotherapy / Q000379:methods*; D036301:Qualitative Research; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
keywords: Maudsley family-based treatment; anorexia nervosa; eating disorders; family meal; qualitative methodology