Exploring Outpatient Treatment Options
Contributed by Karen Trevithick, PsyD, Clinical Director of Outpatient Programs Professionals must manage the competing tensions between their patient’s awareness that his or her illness interferes with daily life and their fear that treatment might disrupt their personal, professional and social lives. Understanding the function of outpatient treatment for eating disorders and for whom it is appropriate can help healthcare professionals ease patients into this higher level of care, which often represents an integral step toward lasting recovery. Outpatient programs offer comprehensive eating disorders treatment options with the goal of teaching the skills necessary for sustainable recovery. Administered in a flexible setting by a team of psychiatrists, registered dieticians, family clinicians and individual clinicians, an increasingly common delivery of outpatient treatment is the Evening Intensive Outpatient Program (EIOP). EIOP involves four hours of intensive outpatient programming three evenings per week and allows patients to work, go to school or care for children during the day and sleep at home at night, and can be a meaningful next step in a patient’s treatment continuum or a valuable adjunct to individual therapy. While all patient cases are unique and require individual consideration within the context of general evaluative criteria, candidates for EIOP treatment are generally characterized as: • Having healthy systems of support, including supportive friends, family and/or colleagues; • Not being medically compromised by their eating disorder; and • Not exhibiting overwhelming symptoms of depression or anxiety. Furthermore, EIOP is particularly effective in helping patients confront common “triggers” for harmful thoughts or behaviors related to their eating disorder, including: • Challenging and confronting daily patterns—EIOP provides a safe, supportive environment for patients to address behaviors and feelings relating to destructive daily patterns—including struggles with disordered eating patterns, complete weight restoration or fully connecting with relationships and experience—which is critical to lasting recovery. • Addressing stressors or crises when they arise—Stressors or crises in a patient’s life have the potential to derail recovery. EIOP can provide the structure and support necessary to help patients confront and manage these unanticipated challenges that emerge on the path to lasting recovery. • Stepping down from a higher level of care—EIOP can help to foster a positive transition into activities of daily living for adults returning from facilities providing a higher level of care, including intensive inpatient and partial hospitalization programs. Because EIOP is a group- and skills-based program, it offers an excellent treatment option for men and women who would benefit from intensive recovery services while remaining engaged in their daily lives. Professionals exploring treatment options with patients should start a dialogue about the role the eating disorder has played in his or her life; by identifying data that shows how disruptive an eating disorder has become and taking a firm yet compassionate stance, you can help ease an individual into the recovery process, enabling patients to truly feel successful in their lives again – or to honestly feel success for the first time.