In adolescent-onset anorexia, depression appears to be triggered by the eating disorder, and the individual is put at risk for experiencing future depressive episodes (Ivarsson et al, 2000).
Although anorexia affects persons of all ages, adolescence appears to be the developmental period of particular significance in the etiology of eating disorders; hence, identification and clinical intervention during this stage are crucial. This paper aims to synthesise and critically analyse the existing research on the treatment of anorexia nervosa in adolescence from the perspective of evidence based practice, more particularly family therapy systems approach.
The term "evidence-based" is prevalent within the health care setting today. If there is any doubt, a quick glance at the current medical and allied health research literature would remove it. Medical doctors, physical therapists, occupational therapists, speech-language pathologists, music therapists, and many others, have begun to describe their treatment interventions as evidence-based. As with most established theories and concepts, the thoughts and beliefs behind evidence-based medicine have been traced by some to practices of ancient cultures throughout history (Sackett et al, 1996). However, most authors on the subject will credit Archie Cochrane, Scottish epidemiologist, with developing the modern concept behind evidence-based medicine, which was made popular through his landmark text Effectiveness and Efficiency: Random Reflections on Health Services (White, 1997). The most widely known and commonly quoted definition of evidence-based medicine was published in the British Medical Journal in 1996, by David L. Sackett et al. This definition, although altered and "improved upon" by numerous subsequent authors remains the standard for providing a clear explanation of evidence-based medicine. It states: Evidence based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research. (p. 71). Greenhalgh (2006) summarises the relationship among all evidence-based elements (medicine, research and practice) nicely in the following quote: "If you follow an evidence-based approach to clinical decision making, all sorts of issues relating to your patients will prompt you to ask questions about scientific evidence, seek answers to those questions in a systematic way and alter your practice accordingly" (p. 1). Care providers in a variety of disciplines have acknowledged the desire to improve patient care through an approach toward evidence-based research and practice and have followed through by implementing the necessary elements within the facility (Rosenfeld et al., 2000). In addition, leaders of more specialised disciplines within the healthcare arena have acknowledged