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Adolescent-Focused Therapy (AFT) 

Developed in the 1990s, Adolescent-focused therapy (AFT) is an intensive relationship-based therapy aimed at promoting change. Treatment lasts up to 12-18 months and is effective for individuals up to 24 years. It works best for those capable of some self-reflection and abstract reasoning. Parents and other significant family members are usually seen separately to learn how to support the individual’s recovery process. 

AFT’s primary driver is the relationship between adolescent and therapist. Although developing a relationship with a teenager with anorexia can be challenging, there’s evidence it can happen and be strong. 

The therapeutic alliance requires balancing limit-setting related to risky behaviors (starvation, overexercising, purging), while exploring alternative behaviors that help the teen manage uncomfortable emotions, take up normal adolescent tasks and form an identity separate from parents and others.

In forming an AFT treatment plan, therapists may seek to understand factors maintaining anorexia, such as: how the teen learns and solves problems or how anorexia fits within the teen’s social and cultural context. Parents can provide information about their relationship with their child and their perception of how anorexia is affecting him/her. 

AFT treats 4 main types of anorexia that help the teen:

    • Avoid taking up tasks of separation (individuation)
    • Manage anger and control issues
    • Manage depressive states and poor self-esteem
    • Serve as a pseudo- or substitute identity

The therapeutic alliance tends to focus AFT on:

    • Therapeutic relationship building
    • Emotional management
    • Eating and weight recovery
    • Peer and family relationships

Learn more about Evidence-Based Treatments for Eating Disorders offered at CFI…



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