Background <p>Family-based therapy is an outpatient treatment model strongly recommended as a first-line intervention for adolescents with anorexia nervosa. A central feature of the model is the active involvement of parents in meal support and in the treatment process as a whole. Although outpatient Family-based therapy is effective for many families, a substantial proportion of young people require inpatient treatment. While several specialized inpatient units have adopted core principles from outpatient Family-based therapy, empirical knowledge about how these adaptations are experienced by inpatient staff remains limited. The aim of the present study was therefore to explore inpatient staff’s experiences of working in accordance with core principles of family-based therapy within a specialized inpatient setting.</p> Methods <p>The study employed an exploratory qualitative design. Data consisted of two focus group interviews with fourteen healthcare staff from a specialized inpatient unit and were analyzed using reflexive thematic analysis.</p> Results <p>An overarching theme was generated: The core principles function as a dynamic compass in clinical work. Three main themes were generated: (1) Unifying around a shared professional language provides multiple advantages; (2) The treatment model increases awareness of the helper’s responsibility and therapeutic position; and (3) Adaptations are always necessary in an inpatient context.</p> Conclusions <p>From the perspective of inpatient staff, the core principles of outpatient family-based therapy can be meaningfully adapted to an inpatient setting. The model appears to function as a guiding and flexible framework for therapeutic work, supporting professional coherence while allowing for necessary local adaptations. These findings highlight the potential value of principle-driven, family-based approaches within inpatient treatment for adolescents with anorexia nervosa.</p>