After undergoing thirty days or more of residential treatment at an eating disorder treatment center, reaccelerating to the usual routine of work, school, or family life can be overwhelming. Many graduating clients’ emotional states have been torn down and built up again during treatment, leaving the potential for vulnerability in the “real world.” That’s why it’s essential for a plan to be set in place for the continuation of recovery after the individual goes home.
Although any worthwhile eating disorder facility will begin to prepare clients for graduation as they progress through the steps of treatment,this preparation should be ramped up as the discharge date approaches.As with the initial treatment plan, this post-discharge aftercare plan should also be individualized to the client’s needs. With this extra level of support, recovered individuals can maintain their recovery even without the benefit of 24/7 assistance.
Understanding what to expect before and after graduating from a residential eating disorder treatment program is the best way to start a recovered life. Here are some ways to continue recovery following graduation.
Create an Aftercare Plan BEFORE Graduating
When properly designed, an aftercare plan will act as a map or guide for each individual person leaving treatment. In the weeks prior to graduating, the staff and therapists will take their client’s personal recovery into account as they consider aftercare. For example, a person recovering from binge eating disorder’s aftercare plan might contain provisions to help set regular mealtimes. This provides people with comfort and support as they navigate the demands of their daily lives and handle the stressors that arise.
In the case that the treatment facility employs a level system, individuals may learn new coping skills and behavioral therapy methods to help facilitate recovery. These can also be applied upon the return to the “real world.” Aftercare plans can use these new skills as a base for the continuation of recovery, and even encourage the person to design their own recovery techniques. Aftercare programs can also provide resources and information about ED recovery for the client and their families, including:
- Social network stability
- Family dynamics
- Eating disorder triggers
- Stress management
All of these bullet points can be a source of stress or trepidation, and they can act as triggers for relapse. That’s why the support provided by the facility and the resources available online are so key.The simple knowledge that there is a plan can help maintain the motivation for recovery.
Identifying Challenges and Planning for Them
While creating the aftercare plan, every client’s unique challenges should take the forefront. These challenges will differ depending on the disorder being treated (such as eating in public for someone recovering from anorexia nervosa) to more universal ones, like dealing with a breakup without resorting to disordered eating behaviors.
Preceding the individual’s re-entry into daily life, the treatment staff and the client will discuss their unique challenges as they relate to their life aside from ED and their specific eating disorder recovery needs. They’ll work together to anticipate what challenges may provoke a disordered eating response and what steps to take to avoid them.
Possible challenges to identify may include:
- How to deal with negative emotions
- Normalizing food and eating
- Reacting to stress
- Managing relationships
- Remaining mindful during difficult situations
- Communication and openness
- Work/life/recovery balance
- Co-occurring disorders like depression or anxiety
Each potential pitfall can be planned for if faced clear-eyed and open-minded. As an example, a person with body dysmorphia may be used to seeing their body as flawed or “fat.” A simple mindful meditation technique that allows that person to identify this as a distorted, subjective thought can help them put it behind them.
More Techniques for Managing and Maintaining Recovery
Many of the tools provided by a well-designed aftercare plan can be practiced without the direct help of an eating disorder therapist or counselor. These gain importance as the person spends more time out of residential therapy and becomes self-sufficient in their recovery. These solo exercises promote self-reflection and maintaining a form of equilibrium, balancing action, and emotion to alleviate urges to relapse and return to disordered eating behaviors.
- Mindful Meditation
Perhaps the most commonly taught therapeutic technique at eating disorder treatment centers, mindful meditation serves as an important coping tool after graduation. This practice combines the essential aspect of objectivity about one’s self with a sense of spiritual stillness. Mindfulness is the central component of many mental health treatment programs, and not only eating disorders.
Keeping a journal provides both an emotional catharsis (it’s surprising to many individuals in therapy to see their emotions written down) and a sense of perspective. Thoughts that may seem rational and correct are often exposed as distorted when they are read back. The journal also provides a way to track progress (and setbacks) which can add motivation.
- Mindful Movement
Many eating disorders include an aspect of excessive or obsessive exercising, often past the point of pain or injury. Mindful movement techniques, especially yoga, allow for exercise to continue in a non-impactful way. They also promote mediation and general mindfulness, tying into the first concept we’ve discussed.
As the individual gets further away from their time at the center, the coping skills that help most may change. By altering their coping activities over time, clients can determine what will work best as they head home to remain recovered on their own. At this point, the individual’s personal support system becomes much more important – after all, no one is an island.
Family and Friends’ Roles in Providing Support
No one is more important to our mental health than the people closest to us – our family and close friends. These folks can make the difference between a relapse and continued success in recovery. Most eating disorder treatment centers get the family involved early in the recovery process via family therapy sessions, both with the client present and separately.
After discharge, the people in the clients’ lives can also watch for the warning signs of eating disorders and help their loved ones seek help as needed. They can simply be there as a sounding board or a shoulder to cry on, or with permission, take a more active role. Facing a difficult post-treatment challenge like visiting a restaurant and eating in public becomes much easier with encouragement from a parent or spouse.
Throughout recovery, treatment centers help foster these relationships through family programming, group therapy sessions, and outings with friends and family. This training before the individual leaves the treatment center gives the family and friends a base of knowledge and understanding of eating disorders and how they affect people. Most people want to see their loved ones happy and healthy. Family training gives them a leg up to make this happen.
Outpatient Care and Eating Disorder Therapists as Part of Aftercare
After an intensive residential eating disorder treatment program, the staff might recommend a step-down to outpatient care or recommend an individual therapist.This provides a necessary lifeline of professional help, which can check up on the recovery and wellbeing of the client in the months and years following treatment. They can also provide treatment for co-occurring medical conditions such as substance abuse, depression, anxiety, or PTSD that often accompany eating disorders.
It’s important to remember that eating disorders are ever a “quick fix.” Treatment is ongoing.
Eating disorder treatment centers normally have lists of therapists and outpatient centers they trust and have worked with before, maintaining continuity in treatment methodology and best practices. These approaches align with those used at the treatment centers, helping ease the client’s transition from one care team to another.
The providers utilize their knowledge and experience to develop and follow relapse prevention strategies for all their clients. People who are remaining recovered can come to these providers anytime they feel extra support is warranted, such as when disordered thought patterns arise.
Alumni Groups and Services
After family support and ongoing therapeutic checkups from professionals, another great resource for graduates of an eating disorder treatment program is the center’s alumni groups and resources.Normally the individual will register and begin to participate in these groups before or directly after discharge from the residential program.
Recovering clients can stay connected to their treatment center staff and, importantly,the peers they bonded with through groups and webinars. Webinars can provide continuing education about EDs and recovery, and chat groups and web meetings on Zoom can help people maintain friendships and support systems. They also offer insightful information and new perspectives that help people stay on track in using their healthy coping skills. The treatment center’s online offerings might include:
- Educational newsletters
- Community updates
- Supportive online community groups
In keeping with the importance of loved ones’ support,family members often can also access the online portal as needed to view information in the resource library and speak to staff for advice on how to provide support.
Getting the Most Out of an Aftercare Program
Oliver-Pyatt Centers’ eating disorder treatment programs are always available to help their graduates navigate life and further their recovery. After promoting the importance of communication and self-sufficiency during residential programs, clients are encouraged to continue pursuing those lessons. The eating disorder treatment center staff will use their knowledge to assist clients in times of crisis and help celebrate milestones of success.
If you or a loved one is struggling with an eating disorder, it’s important to take action, even if that means simply talking about it. That sets the basis for accepting help and entering a residential or day treatment program. When that time comes, choose one that is prepared for the day when treatment ends and recovery truly begins.