The first thought many people have when they hear the phrase “eating disorder treatment” Is a residential situation. The image of clients living in a highly focused facility and devoting 24 hours a day to recovery comes to mind. Residential treatment is certainly an option for recovery, but it’s not the only one. Outpatient, or day treatment options are also highly effective and are often more accessible. They also accommodate a person’s schedule and needs with more flexibility than a residential facility can offer.
When determining the best course of action for recovery, it’s important to remember that eating disorders are psychiatric conditions that require specialized treatment.For this reason, some people who need help (or their loved ones trying to get them help) might think that a residential or inpatient facility is the only realistic path to recovery. However, in some cases, a residential program is an impossibility, such as a person responsible for the care of a young child, or a professional who cannot take off 30 days from work. In other cases, the stress and expense of a residential facility are counterproductive or unnecessary; unless a client needs round-the-clock medical or psychiatric supervision, it might be wiser to consider a day treatment option.
In fact, many of the treatment methods used in residential treatment apply just as well to a day treatment setting. A variety of mindfulness, psychotherapy, and nutritional programs can be instituted just as well in regular sessions as in day-to-day residential treatment. Because of this eating disorder treatment centers usually offer both residential and day treatment opportunities for their clients.
What Are the Differences Between Residential and Day Treatment?
As treatment options go, it’s natural to assume the highest level of care is always the best one. However, an examination of the client’s needs will show that this isn’t always the case.The major difference is that day treatment programs tend to provide a lower level of medical and psychiatric care than residential programs. Eating disorders like anorexia nervosa or binge eating disorder can leave a person in need of medical attention to resolve extreme weight loss, high or low blood pressure, anemia, lanugo, or other medical complications. Eating disorders also often co-occur with other psychiatric conditions such as clinical depression, bipolar disorder, borderline personality disorder, and PTSD. Both medical and psychiatric disorders like these can require supervision by professionals.
However, an extended stay in a facility is not a fait accompli. For people at medical risk due to malnutrition or other symptoms of an intense eating disorder, an initial stay at a medical hospital might be followed by day treatment, partial hospitalization, or an intensive outpatient program. The follow-up therapy and nutritional education can be just as effective on a part-time basis, In a similar fashion, day treatment programs are often employed as step-down” care following a stint in residential treatment. Stepdown care helps to further the individual’s recovery and help prevent relapses, and it has the added benefit of allowing them to return to their routines of work and/or school.
Throughout the individual’s time in an eating disorder day treatment program, they’ll have regular sessions with psychiatric professionals who can facilitate more intensive medical services (which studies have shown can be equally effective)if needed. Once the medical and psychiatric risks have been stabilized, a day treatment center will focus on talk therapy with an individual focus.Other than the highest levels of medical and psychiatric, the differences in day treatment and residential treatment are negligible. They both put their focus on restoring a person’s relationships with food, their own body image, and their behaviors.
Individualized Treatment Programs Are Essential in Day Treatment As Well As Residential Treatment
Although the science behind evidence-based day treatment programs recognizes that eating disorders often have many of the same characteristics, each person is an individual in their own right. The individualized treatment plan recognizes that despite the many similarities, each individual in treatment has unique characteristics that can’t be effectively addressed by a cookie-cutter program. To put it more simply, not every treatment method will work for every individual.
As an example, a treatment program that is designed for an adolescent boy struggling with binge eating disorder would necessarily be different from one designed for an adult woman dealing with ARFID. The former’s growth stage would necessitate a different approach to nutrition and therapy than the latter’s, not to mention that the symptoms of these disorders are quite different. Thus a strategy for the adolescent would be centered around restoring body image and behavioral therapy, the woman’s might include exposure therapy for their “fear food” and Dialectical Behavior Therapy to address the strong emotions about that food.
Though they both share a diagnosis of an eating disorder, each of those people will have different life experiences that must be acknowledged and respected in order to regain their healthy selves. The therapeutic Team will thusly conduct extensive interviews with their client prior to implementing their treatment plan. They will ascertain the root causes and current symptoms of their client’s disorder, and match the treatments provided accordingly.
Other Often-Used Components of Day Treatment Programs
The core aspects of eating disorder treatment are similar in both day treatment and residential settings. Within the individualized treatment plans, there are several methodologies that can be found in almost every plan.Group and family counseling sessions with an eye toward providing support to people with eating disorders are often part of a complete program, and available on a day treatment basis. These are often foregrounded in day treatment plans being used as a step-down from residential treatment, as the client has returned to daily life with their loved ones. They also provide a chance to build a recovery support system (an important factor when there is a possibility for relapse).
Because eating disorders often result because of perceptions surrounding food, working closely with a dietitian or nutritionist and developing a nutritional plan is essential. While meals are planned and provided by the facility in a residential treatment center, in a day treatment program, responsibility for the large majority of meals falls on the individual. Nutritional education and strategies for meal planning, therefore, become core components of a day treatment recovery plan. Cooking classes, grocery store outings, group meals, and visits to area restaurants allow participants to reintegrate healthy eating habits into their life as therapy progresses.
Although the common perception of eating disorder treatment involved things like weigh-ins and control of body shape, it’s more common to see the program embrace HAES (Healthy At Every Size) philosophies. These attitudes understand that all bodies are good bodies, and that weight is simply a number that doesn’t reflect an individual’s health. In eating disorder recovery, it’s important to deemphasize focus on weight and judgment about one’s body, and instead put the focus on a healthy relationship with food, eating, and one’s body.
Lastly, although medications are available for some psychiatric conditions such as anxiety or bipolar disorder, there are none approved by the FDA or APA for eating disorders. Therefore, when receiving day treatment for one of these disorders, self-maintenance through talk therapy becomes even more essential. Regular sessions with a therapist help the client to continually reaffirm their recovered self.
Day Treatment or Residential Treatment? It’s a Personal Choice
A modern, compassionate day treatment program focuses on helping individuals become fully recovered and embrace their healthy selves while allowing them the freedom to continue working, attending school, or providing childcare. In many cases, the staff is also recovered and knows firsthand what it’s like to repair their thoughts and actions in a healthy, food-positive way. People going into treatment for an eating disorder should talk with their care team extensively before starting treatment, and decide together whether they would be better served with residential or day treatment.
Recovery from eating disorders isn’t always the way it’s sometimes portrayed in the media – it doesn’t have to be in-house, residential, or clinical. Day treatment options that provide the necessary levels of care, balanced with medical and psychiatric ways, are a perfectly viable option for a full recovery from any eating disorder. If you or a loved one is struggling with an eating disorder such as bulimia nervosa, binge eating disorder, anorexia nervosa, or ARFID, please don’t lose hope. Whether it’s residential or day treatment, a treatment program is available for you. Reach out today to get started on the path to recovery.