The experience of siblings attending multi-family therapy for adolescent eating disorders: a mixed-methods study

There is limited research on the involvement and experiences of siblings participating in multi-family therapy (MFT) alongside a brother or sister presenting with an eating disorder (ED). The aim of this study was therefore to explore the experiences of siblings who took part in MFT. Participants were 72 siblings (60% female; age 7–22 years) of adolescents (age 11–18 years) with an ED. These siblings participated in MFT together with their adolescent sibling with an ED and parents at a specialized regional ED unit in Norway. MFT was delivered as a supplement to the primary treatment of the adolescent with an ED, provided by local ED services. At the end of treatment, the siblings without an ED completed a questionnaire about treatment goals and their experiences with MFT. At 6-month follow-up, they completed a separate, shorter questionnaire focusing on their experiences with MFT and their attendance. Both assessments included open- and closed-ended questions. Responses were analyzed using descriptive statistics and thematic analysis. The majority of siblings (62%) reported that the treatment exceeded their expectations, and nearly all (97%) stated they would recommend MFT to other siblings. Qualitative analysis of open-ended responses further indicated that siblings found MFT to be a meaningful and enriching experience, appreciating the multiple conversations, structured therapeutic activities, and the opportunity to connect with others in a similar situation. They also reported improvements in overall family dynamics. These findings contribute to the limited but growing literature supporting MFT as a valuable treatment format for sibling involvement, providing both informational and emotional support. Clinicians are encouraged to actively involve siblings in MFT and to promote their engagement throughout the therapeutic process. Eating disorders can have a serious impact not only on the affected individual but also on their family members. Despite this, the experiences of siblings are often overlooked in both research and clinical services. Multi-family therapy (MFT) for eating disorders—where several families participate together in a group setting led by trained professionals—offers a unique opportunity for siblings of the individual with the eating disorder to feel heard, understood, and supported. This study investigated how these siblings experienced participating in MFT by asking them to complete questionnaires at the end of treatment and again six months later. The findings revealed that siblings valued their involvement in therapy. They gained a deeper understanding of eating disorders, learned strategies for supporting their ill sibling, and reported improved family communication. Most siblings reported that the treatment exceeded their expectations. Our findings suggest that MFT offers a valuable opportunity to engage and support siblings within the treatment process.