Surviving the Storm: A Qualitative Study of Caregivers' Challenges in Family‐Based Treatment for Adolescent Anorexia Nervosa

Abstract

ABSTRACT Objective Family‐based treatment (FBT) is the recommended first‐line outpatient treatment for adolescent anorexia nervosa (AN) in Aotearoa New Zealand (NZ), but places substantial responsibility on parents/caregivers. Although caregiver burden in FBT is increasingly recognized internationally, in‐depth qualitative work situated in the NZ service context is lacking. This study explored how caregivers experienced participating in FBT for adolescent AN in NZ. Method Twelve caregivers participated in semi‐structured interviews between May and July 2025. Interviews were analyzed within an interpretive description framework using reflexive thematic analysis. Results Three themes were developed: confronting a life‐threatening illness within an under‐resourced and often unresponsive healthcare system; implementing an overwhelming, isolating treatment with limited guidance; and living with the lingering psychological toll long after FBT concluded. Caregivers described experiences relating to caring for someone with AN and supporting them through treatment as consistent with trauma‐implicated stressors, although traumatic stress was not formally assessed. Discussion These findings show how systemic, structural, and relational factors intersect to shape caregivers' experiences and highlight the need for better‐resourced, trauma‐informed adaptations of FBT that position caregivers and young people as co‐central partners in care.