ABSTRACT
This chapter presents a coding manual and rating scale for therapists fidelity to the treatment model and techniques, specifically in the early sessions of family-based therapy (FBT), which are presumed to carry the majority of the active mechanisms of treatment. It functions as a companion piece to the FBT treatment manual for anorexia nervosa (AN), making concepts and directions 'come alive'. In the eating disorder (ED) literature, for example, better adherence is associated with enhanced alliance. Agnosticism involves the redirection toward current eating behaviors and renourishment efforts as well as avoiding discussions regarding causality. For maximum effectiveness, therapists should continue to be overt in their efforts to address causal concerns raised by family members. Patient-directed externalization of the illness should be brief and only provided when 'speaking to the healthy part of the patient' rather than devolving into 'AN arguments' between the therapist and the patient.
