Evaluating Treatment for the Eating Disordered Patient: A Case for Greater Access to Residential Care

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By Susan Ice, MD

It’s estimated that as many as 10 million females and one million males in the United States are fighting a life and death battle with an eating disorder.

Affecting both physical and mental health, eating disorders are complex illnesses with biological, genetic, psychological, social and developmental roots. Lifelong recovery is possible; however, the eating disordered patient requires proper professional evaluation, diagnosis and treatment.

Treatment for eating disorders is delivered in a variety of settings such as hospitals, residential treatment facilities, private offices, or licensed therapists you can find online through places such as Regain.us. For the medically and psychiatrically unstable patient, a first critical step is often inpatient treatment. While psychiatric hospitals with a specialty in eating disorders and residential facilities offer inpatient programs, referring healthcare professionals often do not recognize the distinctions in these treatment programs and their approach to recovery. Though both treatment options can provide stabilization of the patient’s symptoms through weight gain and nutrition education, most residential treatment facilities provide additional benefits in terms of a specialized team of experts for each patient, richness in psychotherapeutic services and a support community of like-minded peers that is needed to sustain recovery.

One of the most valuable assets in residential treatment can be the patient’s access to a dedicated treatment team that oversees all aspects of recovery. At The Renfrew Center, this treatment team—which consists of physicians, psychiatrists, therapists, dietitians and 24-hour nursing—will be involved in medical stabilization, helping the patient reestablish physical and nutritional health, as well as assist in exploring the underlying emotional and psychological factors contributing to their behavior. From day one, the patient is able to develop relationships with professionals who concentrate on all aspects of the individual’s health and feel confident that each team member is working collaboratively to ensure progression.

Some residential eating disorder facilities also provide a full range of treatment modalities from traditional psychotherapies like cognitive behavioral and psychodynamic therapy to experiential therapies, such as art, dance and psychodrama. The richness of programming helps the patient delve into the emotional, addressing and making significant changes to their eating disordered thoughts and behaviors. As the patient progresses, residential facilities can also help patients to identify and prepare for everyday situations that may be challenging later in treatment and after discharge. For instance, The Renfrew Center offers patients an opportunity to relearn and practice daily activities such as grocery shopping in order to develop new skills and adapt strategies to manage stressors. Often, residential facilities also boast the strength of offering multidisciplinary treatment. Such facilities are able to customize treatment so that the patient receives support for their eating disorder as well as coexisting concerns such as drug or alcohol dependency, emotional eating, cultural influence or trauma. As residential facilities also tend to carry longer lengths of stay than hospitals, patients are able to fully develop life skills to deal with issues such as self-esteem, anxiety and stress.

Recovery from an eating disorder cannot be accomplished without support and some residential facilities can offer patients a sense of community unlike any other treatment setting. The interaction of like-minded individuals throughout the treatment process offers patients a sense of belonging, a safe haven for sharing thoughts and fears, and a sympathetic network that becomes invaluable in and out of treatment. In comparison to a psychiatric facility, where patients may feel intimidated and frightened by interaction with non-eating disordered cohabitants, residential patients are able to benefit and learn from the experiences, successes and failures of peers as they progress through levels of treatment. In addition, some residential facilities also offer a great opportunity for the family support system to be involved. Through family therapy, workshop sessions and celebratory weekend events, the family members of the patient gain further insight into the disorder and become more educated on treatment and recovery.

Determining the best setting for recovery is an individualized process that often can feel overwhelming. Of utmost importance is for the patient and their healthcare team to understand the value offered in each setting and where the patient will thrive. Unlike hospital or private offices, the right residential treatment can offer an individual a richer experience, where the individual accesses specialized experts dedicated to the treatment of the whole individual in a supportive community environment.

Susan Ice is Vice President of Clinical Services at The Renfrew Center and Medical Director of The Renfrew Center of Philadelphia – the nation’s first residential eating disorder treatment facility that has helped more than 60,000 women with eating disorders and other behavioral health issues. For more information, please visit www.renfrewcenter.com or call 1-800- RENFREW.