{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T02:45:16Z","timestamp":1792032316367,"version":"4.4.0"},"reference-count":31,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Eating Disorders"],"abstract":"ABSTRACT<\/jats:title>\n \n Objective<\/jats:title>\n Family\u2010based treatment (FBT) and Enhanced Cognitive Behavior Therapy (CBT\u2010E) are two leading evidence\u2010based outpatient approaches for adolescent eating disorders, but their strengths and limitations may be partly complementary. This review critically examines both approaches and proposes a structured integration termed Family\u2010Enhanced CBT\u2010E (CBT\u2010FE).<\/jats:p>\n <\/jats:sec>\n \n Method<\/jats:title>\n The theoretical foundations, treatment structures, evidence base, and limitations of FBT and adolescent CBT\u2010E were narratively reviewed, with particular attention to parental involvement, cognitive maintaining mechanisms, weight restoration, treatment engagement, and developmental considerations.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n CBT\u2010FE retains the four\u2010phase structure, personalized formulation, and core intervention strategies of CBT\u2010E as the treatment backbone while incorporating formulation\u2010driven parent and family components adapted from FBT. These include a non\u2010blaming stance, externalization, parental empowerment, structured meal support, and gradual transfer of responsibility for eating. Parental involvement is conceptualized as a flexible \u201cdose\u201d calibrated according to the adolescent's age, insight, weight status, clinical needs, and family capacity, and progressively reduced as treatment advances.<\/jats:p>\n <\/jats:sec>\n \n Discussion<\/jats:title>\n CBT\u2010FE does not alter the first\u2010line status of family therapy: it is intended for adolescents in whom individual treatment is indicated or chosen and structures family involvement within that treatment from the start. It is a conceptual proposal intended to preserve adolescent agency and CBT\u2010E's direct targeting of maintaining mechanisms while mobilizing family resources when clinically indicated. Its feasibility, acceptability, and effectiveness require prospective evaluation in open trials and randomized controlled studies.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/eat.70239","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T02:05:07Z","timestamp":1792029907000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Integrating Family\u2010Based Treatment Components Into\n CBT<\/scp>\n \u2010E for Adolescent Eating Disorders: A Narrative Review and Proposal for Family\u2010Enhanced\n CBT<\/scp>\n \u2010E (\n CBT<\/scp>\n \u2010\n FE<\/scp>\n )"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1325-446X","authenticated-orcid":false,"given":"Hakan","family":"\u00d6\u011f\u00fctl\u00fc","sequence":"first","affiliation":[{"name":"Department of Child and Adolescent Psychiatry University College Dublin Dublin Ireland"},{"name":"Department of Child and Adolescent Psychiatry Cognitive Behavioral Psychotherapies Association Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7588-3871","authenticated-orcid":false,"given":"Simay","family":"\u00c7epni","sequence":"additional","affiliation":[{"name":"Private Practice Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,14]]},"reference":[{"issue":"11","key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"1279","DOI":"10.1001\/jamapsychiatry.2014.1025","article-title":"Comparison of 2 Family Therapies for Adolescent Anorexia Nervosa: A Randomized Parallel Trial","volume":"71","author":"Agras W. 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E.","year":"2015","journal-title":"International Journal of Eating Disorders"},{"key":"e_1_2_11_5_1","doi-asserted-by":"crossref","DOI":"10.1186\/s40337-015-0057-z","article-title":"Time to Restore Body Weight in Adults and Adolescents Receiving Cognitive Behaviour Therapy for Anorexia Nervosa","volume":"3","author":"Calugi S.","year":"2015","journal-title":"Journal of Eating Disorders"},{"issue":"7","key":"e_1_2_11_6_1","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1002\/eat.22513","article-title":"Family\u2010Based Therapy for Young Adults With Anorexia Nervosa Restores Weight","volume":"49","author":"Chen E. Y.","year":"2016","journal-title":"International Journal of Eating Disorders"},{"key":"e_1_2_11_7_1","volume-title":"Cognitive Behavior Therapy for Adolescents With Eating Disorders","author":"Dalle Grave R.","year":"2020"},{"issue":"1","key":"e_1_2_11_8_1","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1186\/s13030-024-00315-7","article-title":"Enhanced Cognitive Behaviour Therapy for Adolescents With Eating Disorders: Development, Effectiveness, and Future Challenges","volume":"18","author":"Dalle Grave R.","year":"2024","journal-title":"BioPsychoSocial Medicine"},{"issue":"1","key":"e_1_2_11_9_1","doi-asserted-by":"crossref","first-page":"R9","DOI":"10.1016\/j.brat.2012.09.008","article-title":"Enhanced Cognitive Behaviour Therapy for Adolescents With Anorexia Nervosa: An Alternative to Family Therapy?","volume":"51","author":"Dalle Grave R.","year":"2013","journal-title":"Behaviour Research and Therapy"},{"key":"e_1_2_11_10_1","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.brat.2015.07.014","article-title":"Transdiagnostic Cognitive Behaviour Therapy for Adolescents With an Eating Disorder Who Are Not Underweight","volume":"73","author":"Dalle Grave R.","year":"2015","journal-title":"Behaviour Research and Therapy"},{"key":"e_1_2_11_11_1","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1186\/s40337-019-0275-x","article-title":"A Conceptual Comparison of Family\u2010Based Treatment and Enhanced Cognitive Behavior Therapy in the Treatment of Adolescents With Eating Disorders","volume":"7","author":"Dalle Grave R.","year":"2019","journal-title":"Journal of Eating Disorders"},{"issue":"9","key":"e_1_2_11_12_1","doi-asserted-by":"crossref","first-page":"1042","DOI":"10.1002\/eat.23122","article-title":"Enhanced Cognitive Behavioral Therapy for Adolescents With Anorexia Nervosa: Outcomes and Predictors of Change in a Real\u2010World Setting","volume":"52","author":"Dalle Grave R.","year":"2019","journal-title":"International Journal of Eating Disorders"},{"issue":"7","key":"e_1_2_11_13_1","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1002\/eat.20764","article-title":"Early Response to Family\u2010Based Treatment for Adolescent Anorexia Nervosa","volume":"43","author":"Doyle P. M.","year":"2010","journal-title":"International Journal of Eating Disorders"},{"key":"e_1_2_11_14_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/16506073.2026.2702384","article-title":"Cognitive\u2010Behavioural Therapy for Anorexia Nervosa (CBT\u2010AN\u201020): Feasibility, Acceptability, and Preliminary Effectiveness","author":"Duggan H. C.","year":"2026","journal-title":"Cognitive Behaviour Therapy"},{"key":"e_1_2_11_15_1","volume-title":"Cognitive Behavior Therapy and Eating Disorders","author":"Fairburn C. G.","year":"2008"},{"issue":"5","key":"e_1_2_11_16_1","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1016\/S0005-7967(02)00088-8","article-title":"Cognitive Behaviour Therapy for Eating Disorders: A \u201cTransdiagnostic\u201d Theory and Treatment","volume":"41","author":"Fairburn C. 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G.","year":"2003","journal-title":"Lancet"},{"issue":"9","key":"e_1_2_11_18_1","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1001\/archpsyc.64.9.1049","article-title":"A Randomized Controlled Comparison of Family\u2010Based Treatment and Supportive Psychotherapy for Adolescent Bulimia Nervosa","volume":"64","author":"Le Grange D.","year":"2007","journal-title":"Archives of General Psychiatry"},{"issue":"13","key":"e_1_2_11_19_1","doi-asserted-by":"crossref","first-page":"2520","DOI":"10.1017\/S0033291720004407","article-title":"Enhanced Cognitive\u2010Behavior Therapy and Family\u2010Based Treatment for Adolescents With an Eating Disorder: A Non\u2010Randomized Effectiveness Trial","volume":"52","author":"Le Grange D.","year":"2022","journal-title":"Psychological Medicine"},{"issue":"8","key":"e_1_2_11_20_1","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1016\/j.jaac.2016.05.007","article-title":"Randomized Clinical Trial of Parent\u2010Focused Treatment and Family\u2010Based Treatment for Adolescent Anorexia Nervosa","volume":"55","author":"Le Grange D.","year":"2016","journal-title":"Journal of the American Academy of Child & Adolescent Psychiatry"},{"key":"e_1_2_11_21_1","volume-title":"Treating Bulimia in Adolescents: A Family\u2010Based Approach","author":"Le Grange D.","year":"2007"},{"issue":"11","key":"e_1_2_11_22_1","doi-asserted-by":"crossref","first-page":"1162","DOI":"10.1016\/j.jaac.2014.07.014","article-title":"Relapse From Remission at Two\u2010 To Four\u2010Year Follow\u2010Up in Two Treatments for Adolescent Anorexia Nervosa","volume":"53","author":"Le Grange D.","year":"2014","journal-title":"Journal of the American Academy of Child & Adolescent Psychiatry"},{"issue":"11","key":"e_1_2_11_23_1","first-page":"886","article-title":"Randomized Clinical Trial of Family\u2010Based Treatment and Cognitive\u2010Behavioral Therapy for Adolescent Bulimia Nervosa","volume":"54","author":"Le Grange D.","year":"2015","journal-title":"Journal of the American Academy of Child and Adolescent Psychiatry"},{"key":"e_1_2_11_24_1","volume-title":"Treatment Manual for Anorexia Nervosa: A Family\u2010Based Approach","author":"Lock J.","year":"2013"},{"issue":"4","key":"e_1_2_11_25_1","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1002\/eat.22980","article-title":"Family\u2010Based Treatment: Where Are We and Where Should We Be Going to Improve Recovery in Child and Adolescent Eating Disorders","volume":"52","author":"Lock J.","year":"2019","journal-title":"International Journal of Eating Disorders"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2015.07.015"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1001\/archgenpsychiatry.2010.128"},{"key":"e_1_2_11_28_1","unstructured":"National Institute for Health and Care Excellence [NICE].2017.\u201cEating Disorders: Recognition and Treatment.\u201d(NICE Guideline NG69).https:\/\/www.nice.org.uk\/guidance\/ng69."},{"issue":"8","key":"e_1_2_11_29_1","doi-asserted-by":"crossref","first-page":"1284","DOI":"10.1176\/appi.ajp.159.8.1284","article-title":"The Outcome of Anorexia Nervosa in the 20th Century","volume":"159","author":"Steinhausen H. 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