What Happens in Treatment?
Eating disorders are complex illnesses that require complex, skilled treatment. When your child, partner or loved one is in our care, their treatment team will work together to create an individualized care plan that is constantly monitored and updated.
Treatment programming at the inpatient, residential and PHP levels of care includes: nutritional support, psychiatric support, psychotherapy and, at higher levels of care, nursing and medical support. We explain the various treatment options below.
Working with a treatment team
To help your loved one heal, their care will be provided by a multidisciplinary team (psychiatrist, master’s level therapists, and a registered dietitian (RD). At the inpatient level of care, the treatment team will also include registered nurses and medical doctors. Learn more about the different levels of care at ERC.
Your loved one will have nutritional treatment goals to normalize and stabilize their nutritional status and nutritional intake:
- Your loved one will meet with a RD at least once weekly starting on their day of intake or, at latest, the following day. The RD, in conjunction with the entire multidisciplinary team, will create your loved one’s individualized meal plan, designed to help your loved one meet their individual nutritional needs and goals.
- Three meals and two to three snacks are provided each day. These are the key components for helping individuals with eating disorders normalize their eating patterns and to become nutritionally sound. Meals are based on the individual’s meal plan, and are supervised by trained, supportive staff members.
- At ERC, our dietitians run nutrition groups to help your loved one gain a solid understanding of how to meet their nutritional needs. They also run groups to help patients learn to meal plan, grocery shop, cook, plan for and eat well at restaurants.
Your loved one will have individualized psychiatric care while in treatment. A psychiatrist will meet with your loved one upon admission. The psychiatrist really gets to know each patient and will be deeply involved in their care and treatment planning. Your loved one will have set appointments with their psychiatrist (several times a week at the highest levels of care down to one time weekly at the PHP levels of care). The first appointment or two will be a full assessment, approximately an hour in length. Our psychiatrists are employees and full members of the treatment team; other centers may contract with psychiatrists.
Psychotherapy is “talk therapy” and is what most people think of when they consider treatment. Psychotherapy is provided each day during treatment, and includes both group therapy and individual therapy.
Group Therapy is the keystone of the educational offerings in a treatment program. Your loved one will attend psychotherapy groups daily. Along with insight, perspective, validation, and support, the understanding that peers can offer one another can be transformative. Groups differ by site, as they are specifically created by the treatment teams to serve the population of the program. However, most programs include these, or similar, types of groups.
- Emotional regulation and management
- Body image and acceptance groups
- Community meeting groups (learning how to interact with others, deal with conflict effectively, and ask for help when you need it)
- Process groups (small groups where patients can talk more personally about their journey with their peers who provide support, validation, and perspective)
- Recovery skills groups
- Expressive therapies groups (art, music, yoga and more help an individual learn more about themselves and gain awareness in ways that do not use the standard structures of talk therapy)
Your loved one will also be assigned a master’s level therapist, called a primary therapist, who will oversee their treatment and provide family therapy and support (in most programs). One-hour individual therapy sessions will occur once or twice a week. One of the gifts of our treatment program is that the primary therapist is involved with your loved one throughout the treatment day, running groups and supporting meals. The therapists have the opportunity to really see the struggles and the successes of patients. They have many opportunities to help bring guidance, awareness and skills training to your loved one, in the moment that they need it.
Medical and nursing support
At the highest levels of care, your loved one will receive 24-hour nursing care. Medical doctors and nurses will oversee any medical complications and medical assessments are done upon admission. Nursing assessments are done daily.
Meal planning and processing
Meals are a major focus of our therapeutic work and we provide a great deal of structure around mealtimes and snacks. This structure (specified mealtimes, staff joining patients at meals, etc.) is a key component to help your loved one move forward in recovery. We approach meal planning differently for adult patients and child/adolescent patients.
Understandably, many patients find meals to be extremely challenging. During mealtimes and after meals, they will have time to talk about and share experiences, feelings and reactions. This will be a big part of their work here at ERC.
If your loved one has specific diet requests (vegetarian, gluten-free, etc.), our dietitians will assess these on a case-by-case basis.
ERC will work with you to make accommodations for religious dietary practices, such as providing kosher meats for individuals following a kosher diet. We are fully inclusive and want to provide care to anyone in need of our expertise.
For patients with food allergies, we will request documentation of scientifically proven food allergy testing. We may also recommend further food allergy testing during treatment, if needed.
Child/adolescent meal planning
For child/adolescent patients, we use a family-based therapy approach. Parents of our younger patients will be asked to participate in weekly nutrition groups and work on menu selection. They will also receive more education to help their children at home. Some of our older adolescents will be given greater responsibility for portions and meal selections.
Outings at ERC
Treatment provides a much-needed structure to help contain the eating disorder, but once someone is farther along in the treatment process, it is important to practice new skills in life outside of treatment.
Schoolwork and tutoring
If you have a child or adolescent at ERC, they will be able to remain in school during their stay at our center — although this will differ depending on the level of care, the age of the child and center location. At times, due to medical necessity, schoolwork will be suspended. If your child has an Individualized Education Program (IEP), that will be handled individually.
Some of our locations offer a specialized classroom environment and comprehensive academic support with an onsite, licensed teacher. Laptop computers and individual tutoring may also be available. We ask parents to take responsibility for communicating with their child’s school as needed during treatment.
College students (typically 18 and over) are placed in our adult program. Typically, this means that they will have to take a leave of absence from college to participate in full days of clinical work. At this age, they are better able to communicate their experiences and participate in intensive therapy. The most important “work” they can do right now is to work towards their own full and complete recovery.
We support your child’s schooling, but our number one focus is to help your child recover from the eating disorder. Please talk to your team if you have specific questions or concerns about schoolwork while your child is at ERC.
Downtime and communication with family
While weekdays are very structured, patients have opportunities to communicate with friends and family daily. Weekends are intentionally less structured and offer even more time for communication. Some treatment sites offer Family Groups and education on weekends. Patients will have time to relax, socialize and pursue other interests (art, music, writing, etc.) daily as they learn to cope with stress and manage downtime.