Systemic Relational Therapy for Eating Disorders: analysis of family characteristics by means of the Score-15

Amanda Bellocci¹Giulia Monnetti¹Luigi Schepisi²Emanuele Basili³Gianmarco Manfrida¹Daniela Tortorelli^1*

• ¹CSAPR - Centro Studi Applicazione della Psicologia Relazionale, Prato, Italy
• ²Istituto Italiano di Psicoterapia Relazionale, Rome, Italy
• ³Istituto di Psicoterapia Relazionale - I.P.R., Roma, Italy

The present study explored and compared family functioning and therapeutic progress in two clinical groups using the SCORE-15 assessment tool. Group A included families with adolescents diagnosed with eating disorders (EDs), while Group B consisted of families with adolescents presenting other forms of psychopathology. The aim was to analyze the evolution of family functioning during therapy and identify specific patterns and differences between the groups. We hypothesized that Group A would show significantly higher initial SCORE-15 scores, indicating greater difficulties in communication, relationships, and problem management, and that greater intra-family variability would be observed, particularly between parents and adolescents. Therapists’ perceptions of therapeutic usefulness and family change were also assessed. A retrospective analysis was conducted on 21 families who received systemic family therapy at CSAPR in Prato between 2014 and 2024. Group A comprised 11 families seeking therapy for EDs, while Group B included 10 families with adolescents experiencing other psychopathological conditions. Family functioning was assessed using the SCORE-15. Data were analyzed with SPSS v23.0. Descriptive statistics were followed by Student’s t-tests to compare groups and Friedman tests to assess changes over time. Results showed that both groups improved over the course of therapy, with decreasing SCORE-15 scores. Initially, adolescents in Group A perceived family functioning as more problematic than their fathers, especially on the Family Difficulties subscale, and reported more severe difficulties than peers in Group B across all SCORE-15 dimensions. In Group B, improvement was more balanced among family members. Parental and adolescent satisfaction with therapy increased in both groups, particularly among fathers and adolescents. Mothers, while expressing higher initial expectations, showed less consistent changes. Therapists evaluated the therapeutic process positively in both clinical contexts. In conclusion, families with adolescents diagnosed with EDs perceived more problematic functioning at therapy onset, particularly from the adolescent’s perspective. Nevertheless, both groups benefited from therapy. Findings highlight the relevance of systemic-relational approaches in treating adolescent psychopathologies, especially EDs, and support the use of SCORE-15 as a sensitive tool for tracking family change and informing clinical interventions.