ABSTRACT
In the foregoing chapters, we have described the marital relationships of patients with AN or BN, drawing from existing models of marital interaction and relying as much as possible on findings from empirical research. In addition, we have explored the relationship between the marital characteristics of these patients and the occurrence of the eating disorder. From a practitioner’s point of view, however, a description of these phenomena is probably not sufficient; what matters most for clinical practice is how they can be successfully integrated into the assessment and treatment of eating-disordered patients and couples in order to improve the effectiveness of the intervention. This question will be addressed in the remaining chapters of this book. As a preamble, this chapter will present some general guidelines for the clinical assessment and treatment of anorectic and bulimic patients deriving from our own clinical experience. The approach we advocate may be characterized as a family-oriented, cognitive-behavioural one, and is based on the multidimensional process model of eating disorders which takes into account the many somatic, psychological and social factors in the aetiology of these disorders as well as the complex interplay between these factors. It also endorses the principle of the ‘scientistpractitioner’ approach (Barlow et al., 1984) according to which practitioners should base their interventions on empirical findings and should apply research methods whenever possible, to provide for an empirical feedback system during the therapy process and an evaluation of the outcome. More detailed information about this approach can be found in Vandereycken and Meermann (1987) and in Vanderlinden, Norré and Vandereycken (1992). Elements that are specific for married patients will be discussed in the next two chapters.
