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Adult Day Treatment for Eating Disorders
Eating disorders do not exist in a vacuum. As life and the world continues to move around you, receiving the proper treatment can be difficult, and that is if you can even receive treatment at all. Perhaps this is why research shows that eating disorder treatment for children and adolescents is most effective when done in the least restrictive environment, such as a day treatment program like outpatient treatment [1].
Evidence on most effective adult interventions, however, are not as well-established, with many clinicians and professionals employing various combinations of diverse interventions. What we can surmise is that, with the relapse rate of adults struggling with eating disorders at approximately 52%, this may not be the most effective solution [1].
One possible solution is the implementation of Day Treatment Programs (DTP’s), “posited both as a means to forestall or preclude the need for admission to hospital and enabling sustainable recovery from EDs following acute treatment [1].”
A 2019 study aimed to look at the development and implementation of DTPs in Queensland, Australia, to learn more about the patient’s experience in these treatment interventions.
In this study, both patient and service provider interviews were conducted and assembled as well as focus-group feedback and service documents and records being analyzed.
Structure of a Day Treatment Program
The day treatment program examined was a closed group and consisted of 3 phases. Phase 1 occurred during weeks 1 and 2 and involved assessment and treatment planning, Phase 2 occurred weeks 3 to 10 and was focused on supportive meal therapy and group program. Finally, Phase 3 occurred weeks 11 to 12 and explored discharge planning [1].
The Service Providers that structured this treatment chose for it to run as a 12-week program, acknowledging that individuals participating would need to put their lives on hold. Their intention was to allow for maximum beneficial treatment in a limited timeframe that would allow individuals an opportunity to avoid “checking out” of their lives for too long a period [1].
Providers also gave one day off in the middle of each week as well as one week off in the middle of Phase 2, reasoning that this was beneficial for both staff and patients to “have a rest” in the middle of the intensive and challenging program.
Feedback
The study received interesting feedback from patients that can be helpful in adjusting or developing future day treatment programs.
For example, despite the intention to provide patients with a break, most felt that the break in the middle of the week and middle of Phase 2 were unhelpful. “Time away was commonly described as disruptive of process and negatively influencing progress and engagement [1].”
Many also felt that the treatment intervention duration of 12 weeks was too short, with one individual sharing that “it was long enough to learn the tools but wasn’t long enough to put them into practice [1].”
Most participants found the group setting to be supportive and shared feeling connected by other group members.
Group members also noted issues that can be typical of eating disorder treatment and groups such as the challenge of not compensating or restricting when returning home, which many people in Intensive Outpatient Treatment also report. Additionally, members noted that there was occasional competitiveness to be “the sickest,” which is, sadly, not uncommon in eating disorder treatment settings.
Upon discharge, many patients “reported difficulty adjusting when the program concluded, with a loss of routine and structured plans for their ongoing treatment [1].”
Overall, end results suggest that “with tight timeframes to achieve multiple tasks, service providers experienced implementation as a difficult and stressful undertaking,” however, the end result has the potential to be beneficial for both service providers and patients.
Resources:
[1] Matthews, K. et al. (2019). A day treatment program for adults with eating disorders: staff and patient experiences in implementation. Journal of Eating Disorders, 7:21.About the Author:
Margot Rittenhouse, MS, PLPC, NCC is a therapist who is passionate about providing mental health support to all in need and has worked with clients with substance abuse issues, eating disorders, domestic violence victims, and offenders, and severely mentally ill youth.
As a freelance writer for Eating Disorder Hope and Addiction Hope and a mentor with MentorConnect, Margot is a passionate eating disorder advocate, committed to de-stigmatizing these illnesses while showing support for those struggling through mentoring, writing, and volunteering. Margot has a Master’s of Science in Clinical Mental Health Counseling from Johns Hopkins University.
The opinions and views of our guest contributors are shared to provide a broad perspective on eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.
We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.
Published November 14, 2019, on EatingDisorderHope.com
Reviewed & Approved on November 14, 2019, by Jacquelyn Ekern MS, LPC
The EatingDisorderHope.com editorial team comprises experienced writers, editors, and medical reviewers specializing in eating disorders, treatment, and mental and behavioral health.
