Advances in community treatment of eating disorders: home treatment for child and adolescent anorexia nervosa

Over recent decades, for young patients with anorexia nervosa (AN), efforts have been made to develop alternative treatments at home to reduce long hospital stays or to avoid admissions altogether. This article explores the motivation for developing home treatment for this specific patient group as an advance in community treatment. Two main routes of home treatment have been developed: home treatment as an "add-on" to outpatient treatment and "stepped-care" home treatment after short inpatient treatment. Both treatment approaches are discussed in this article. Pilot studies with small sample sizes have provided evidence for the safety, feasibility and success of both home-treatment approaches for AN in children and adolescents with the help of their families. Home treatment is emerging as a promising strategy for avoiding hospital admissions and reducing the duration of hospital stays. However, even though the existing research so far is promising, further validation through rigorous multi-centre, randomised, controlled trials with larger sample sizes and comprehensive follow-up assessments is warranted.