{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T09:07:49Z","timestamp":1785229669894,"version":"3.55.0"},"reference-count":41,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,1,24]],"date-time":"2024-01-24T00:00:00Z","timestamp":1706054400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003206","name":"Alberta Children's Hospital Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003206","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Eating Disorders"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Family\u2010Based Treatment (FBT) is the leading manualized treatment for adolescent eating disorders; however, there is limited research on the adaptation of FBT for diverse families (i.e., families belonging to identity groups subject to systemic barriers and prejudices). The purpose of this qualitative study was to address: (1) adaptations made to the FBT model (if any) by clinicians working with diverse youth and families; (2) the barriers\/facilitators of maintaining adherence (fidelity) to the model for these families; and, (3) the barriers\/facilitators to access and engagement in FBT for diverse families.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Forty\u2010one FBT clinicians were recruited globally using purposive and snowball sampling, and listservs from eating disorder networks. Clinicians participated in individual interviews or focus groups, discussing their experiences delivering and adapting FBT for diverse families. Qualitative data was transcribed verbatim and analyzed using directed content analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Some participants reported making adaptations to every phase of the FBT model, while others did not, when working with diverse families. In Phase 1, participants cited adapting the family meal, length\/number of sessions provided, and addressed systemic barriers. In Phase 2, participants adapted the length of the phase and rate\/level of independence given back to the adolescent. In Phase 3, participants increased or decreased the number of sessions, or eliminated this phase to address barriers to engagement in FBT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>This is the first study to qualitatively examine clinicians' experiences of implementing FBT with diverse families. Results may inform future FBT planning, clinician training, clinical decision\u2010making tools, and opportunities for modifications to the foundational model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Public Significance<\/jats:title><jats:p>This qualitative study examined clinicians' perceptions and experiences implementing FBT with diverse families, specifically what adaptations (if any) were made to the foundational model, and the barriers and facilitators to adhering to and engaging in the model. Results show that some participants reported making adaptations to every phase of FBT, while others did not, with diverse families. Findings may inform future treatment planning, clinician training, clinical decision\u2010making tools, and potential modifications to FBT.<\/jats:p><\/jats:sec>","DOI":"10.1002\/eat.24144","type":"journal-article","created":{"date-parts":[[2024,1,25]],"date-time":"2024-01-25T06:29:25Z","timestamp":1706164165000},"page":"635-647","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Examining clinicians' perceptions and experiences working with diverse families in family\u2010based treatment: Common adaptations and considerations for treatment engagement"],"prefix":"10.1002","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9487-0290","authenticated-orcid":false,"given":"Gina","family":"Dimitropoulos","sequence":"first","affiliation":[{"name":"Faculty of Social Work University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manya","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Sauerwein","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6652-1293","authenticated-orcid":false,"given":"Pardis","family":"Pedram","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1255-8947","authenticated-orcid":false,"given":"Melissa","family":"Kimber","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioural Neurosciences McMaster University  Hamilton Ontario Canada"},{"name":"Offord Centre for Child Studies McMaster University  Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2959-225X","authenticated-orcid":false,"given":"Martin","family":"Pradel","sequence":"additional","affiliation":[{"name":"Department of Pediatrics The Royal Children's Hospital  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0824-4328","authenticated-orcid":false,"given":"Sarah","family":"Eckhardt","sequence":"additional","affiliation":[{"name":"Center for the Treatment of Eating Disorders Children's Minnesota  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Forsberg","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Stanford University School of Medicine  Palo Alto California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helene","family":"Keery","sequence":"additional","affiliation":[{"name":"Center for the Treatment of Eating Disorders Children's Minnesota  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica","family":"Allan","sequence":"additional","affiliation":[{"name":"Department of Adolescent Medicine The Royal Children's Hospital  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsey","family":"Bruett","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, UCSF Weill Institute for Neurosciences University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7293-9496","authenticated-orcid":false,"given":"Daniel","family":"Le Grange","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Neuroscience (Emeritus) The University of Chicago  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,1,24]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1080\/10640266.2017.1330319"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40337-021-00454-0"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2014.1025"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/yco.0000000000000834"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40337-021-00498-2"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1108\/qrom-06-2019-1778"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.22049"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-015-0231-3"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.22042"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/1558689808330883"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.437"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.4324\/9781351252027"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10903-021-01273-w"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psc.2019.01.004"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049732305276687"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.23405"},{"key":"e_1_2_10_19_1","doi-asserted-by":"crossref","unstructured":"Kelemen M.(2011).American pragmatism. InKey Concepts in Critical Management Studies(pp. 20\u201324). SAGE Publications Ltd.https:\/\/doi.org\/10.4135\/9781446289013","DOI":"10.4135\/9781446289013.n5"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.311.7000.299"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.22276"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/hcr\/30.3.411"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.64.9.1049"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2016.05.007"},{"key":"e_1_2_10_25_1","volume-title":"Treatment manual for bulimia nervosa: A family\u2010based approach","author":"Le Grange D.","year":"2007"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2015.08.008"},{"key":"e_1_2_10_27_1","unstructured":"Lin L. Stamm K. &Christidis P.(2018).How diverse is the psychology workforce?American Psychological Association. Retrieved from:https:\/\/www.apa.org\/monitor\/2018\/02\/datapoint"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.chi.0000161647.82775.0a"},{"key":"e_1_2_10_29_1","volume-title":"Treatment manual for anorexia nervosa: A family\u2010based approach","author":"Lock J.","year":"2013"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.22980"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2015.07.015"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1001\/archgenpsychiatry.2010.128"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049732315617444"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.20787"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n1679"},{"key":"e_1_2_10_36_1","doi-asserted-by":"crossref","unstructured":"Rienecke R. D.(2017).Family\u2010based treatment of eating disorders in adolescents: Current insights.Adolescent Health Medicine and Therapeutics 8 69\u201379.https:\/\/doi.org\/10.2147\/AHMT.S115775","DOI":"10.2147\/AHMT.S115775"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11920-018-0938-3"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.22652"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1037\/cfp0000013"},{"key":"e_1_2_10_40_1","unstructured":"Statistics Canada. (2021).Examples of ethnic or cultural origins. Retrieved June 28 2023 from:https:\/\/www12.statcan.gc.ca\/census-recensement\/2021\/ref\/questionnaire\/ancestry.cfm"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1177\/08943184211010471"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-019-0898-y"}],"container-title":["International Journal of Eating Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/eat.24144","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,16]],"date-time":"2024-03-16T06:40:26Z","timestamp":1710571226000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/eat.24144"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,24]]},"references-count":41,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024,3]]}},"alternative-id":["10.1002\/eat.24144"],"URL":"https:\/\/doi.org\/10.1002\/eat.24144","archive":["Portico"],"relation":{},"ISSN":["0276-3478","1098-108X"],"issn-type":[{"value":"0276-3478","type":"print"},{"value":"1098-108X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,24]]},"assertion":[{"value":"2023-07-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-08","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-24","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}