Family and family therapy in adolescent girls with anorexia

Uvod: Anoreksija je motnja hranjenja, ki se kaže kot pretirana obsedenost s svojo telesno težo in z zaužito hrano. Mladostnice zaradi nenehnega občutka, da ne zmorejo ustrezno braniti svojih meja in uveljavljati svojih potreb, vzpostavijo nadzor nad edinim območjem, ki je drugim nedostopno – svojim telesom. Izgubo telesne teže pri tem pričnejo enačiti z lastno vrednostjo. Skupaj z medicinskimi pristopi se pri zdravljenju anoreksije vse bolj uveljavlja družinska terapija, ki se ukvarja z iskanjem simptomatike v dinamiki družinskih (konfliktnih) odnosov, družino pa se skupaj z mladostnico obravnava kot celoto. V terapijo so vključene dinamike družin, ki zaradi svojih nerazrešenih psihičnih vsebin ustvarjajo simptomatiko nastanka anoreksije. Namen: Namen diplomskega dela je s pomočjo pregleda literature ugotoviti, kako družina in medsebojni družinski odnosi vplivajo na razvoj anoreksije pri mladostnici. Poudarek pa je na družinskih odnosih ter uveljavljanju družinske terapije pri zdravljenju. Metode dela: V diplomskem delu smo uporabili deskriptivno metodo dela s sistematičnim pregledom literature. Pri iskanju je bil uporabljen časovni okvir od leta 2007 do 2017. Iskanje je potekalo v podatkovnih bazah CINAHL, Medline (PubMed), COBIB.SI, Web of Science in v bazi revije Obzornika zdravstvene nege. Uporabljena je bila prosto dostopna literatura, ki je vsebinsko ustrezna in aktualna. Rezultati: Anoreksija je pri mladostnicah najbolj razširjena v družinah z določeno psihopatologijo. Starši oz. celotna družina imajo pri razvoju, obstoju in zdravljenju pomembno vlogo. Večina avtorjev navaja, da sta družinska terapija in vključevanje celotne družine v postopek zdravljenja primarnega pomena za hitro okrevanje. Pred uveljavljanjem družinske terapije je po mnenju večine avtorjev potrebno, da se terapevt temeljito seznani z vsemi značilnostmi družine (hierarhijo, raso, spolom, običaji, navadami, medsebojnimi odnosi itd.), saj bo ta lahko učinkovita le z natančnim poznavanje družine.Introduction: Anorexia is an eating disorder, manifesting as an excessive obsession with one’s own weight and with the food ingested. Due to a constant feeling that they cannot properly protect they own limits and enforce their needs, adolescent girls establish controll over the only area, which is inaccessible to others – their own body. In doing so, they start to confuse their weight loss with their own value. Along with medical approaches, family therapy, which is focusing on finding the symptoms in the dynamic of domestic relationships (conflicts) and is considering the family together with the adolescent girl as a whole, is increasingly gaining ground in the treatment of anorexia. Therapy includes family dynamics, which due to their unresolved psychic matters create the symptoms for the development of anorexia. Purpose: The purpose of the thesis is to review literature and identify, how the family and mutual relationships within the family affect the development of anorexia in adolescent girls. The emphasis is on family relationships and the enforcement of family therapy in the treatment. Methods: In the thesis we have used the descriptive work method with systematic literature review. The searching for facts considered the timeframe from the year 2007 until 2017. The search took place in the databases CINAHL, Medline (PubMed), COBIB.SI, Web of Science and in the base of the journal Slovenian Nursing Review. We used freely available literature, which is contextually relevant and topical. Results: Among adolescent girls, anorexia is mostly spread in families with a certain psychopathology. Parents or the entire family play an important role in the development, existence and treatment of anorexia. The majority of authors state that family therapy and the inclusion of the entire family into the treatment process are of primary importance for fast recovery. Before the enforcement of family therapy it is, according to the majority of authors, necessary that the therapist gets thoroughly acquainted with all the family features (hierarchy, race, gender, traditions, habits, mutual relationships etc.), since therapy will only be successful with precise understanding of the family