Hospitalization and residential treatment programs are often viewed as a last resort and in extreme or crisis situations, a period of medical stabilization can be life-saving. But residential treatment can offer substantial benefits early in the disease progression, benefits hard to replicate in an outpatient counseling environment.
Available Residential Options for Eating Disorder Treatment
The ideal treatment facility will vary depending on the severity of the situation and only through an individual needs assessment, preferably consulting with all members of a clinical team, can a best choice be made.
The most intensive and expensive level of care is found within a hospital inpatient program. Hospitals offer 24 hour nursing and doctor care, and have the expertise and equipment necessary for life saving interventions. Ideally, any hospital under consideration will run an eating disorder specific program and thus offer informed and compassionate care.
For crisis situations involving suicidal thoughts or attempts, a psychiatric facility is likely the best choice. These hospitals will offer continual supervision and safety to all patients in crisis. In most cases, psychiatric hospitals will offer needed medical care in conjunction with a local health facility. Although most psychiatric hospitals will have experience with suicidal patients, ideally, the hospital should run a specific eating disorders track.
Hospital inpatient tops the continuum of care in intensity and usually, in expense. In most situations, patients are able to transition into a less structured and supervised facility following a period of medical and psychiatric stabilization.
Hospital inpatient should be considered if:
- The patient has an immediate medical need. Patients with serious low blood pressure, cardiac dysfunction, electrolyte imbalances or pulse rates of less than 45 beats per minute need immediate medical stabilization.
- The patient is not responding to outpatient therapies. If weight loss continues unabated in spite of counseling, or if purging and binging occur multiple times daily – and is showing no signs of improving.
- The disease has progressed to the point where the patient cannot function independently, or cannot participate actively and effectively in outpatient therapies.
- There are any signs of suicidal ideation.
- The patient's home environment is contributing to a worsening of the disease.
Eating Disorder Rehabs and Residential Facilities
Residential facilities offer a step down in intensity from a hospital inpatient program. Most will not have round the clock medical care, and most will be considerably less expensive than a hospital.
Many patients, whose needs do not require medical stabilization and are in no immediate risk of suicide, are best placed in a residential facility.
Although a residential facility will not offer "medical" around the clock, patients will benefit from continual supervision and support – supervision and support that may be needed for patients to break free from compulsions to binge, purge or fast.
These facilities tend to be located in pleasant and serene environments and feel more homelike than clinical. Places of healing and recovery, where patients are given the opportunity to focus inwards, free from distraction and stress, and guided along a journey of healing.
The intensity of therapy as offered can vary considerably, but most will make use of group and individual counseling sessions, nutritional education and counseling, and cognitive behavioral therapies. Many will offer additional seminars on topics such as body image, self esteem and life skills training.
Many eating disorder rehabs will also encourage clients to take part in the shopping for and cooking of meals – practicing healthy eating skills for an eventual return to the home.
Residential facilities will vary greatly in intensity of therapy, and in cost, but these recovery centers will meet the needs of most patients, and need not be considered a last resort – and because of home-like and comfortable environments, those with eating disorders may be more easily persuaded to attend.
Eating Disorder Halfway Houses
The most affordable and least intensive form of residential care occurs within a halfway house, also sometimes called a transitional living house, or a recovery home.
Based on a peer support model, most halfway homes will offer some limited therapy and supervision, but mostly offer eating disorder patients a safer place to continue on a journey of healing. "Rents" can be as low as a few hundred dollars per month, but most patients will not benefit from such minimal supervision and therapeutic structure until they have already made some considerable progress towards recovery. For most, halfway houses are only a valid option as a transition after some period of more intensive residential living.
Not a Last Resort
Residential care is a valid option. You never have to wait until things reach a crisis point before considering a healing break. For families, it can be far easier to convince a somewhat reluctant patient of the need for a brief stay in a comfortable residential facility than to convince later in the disease, of the need for a hospital stay.
In all but the most extreme of cases, gaining patient acceptance is critical. Eating disorders are in many ways about control, and patients do far better when they retain some control over their own recovery.
If outpatient isn’t working, consider a residential facility. They can be expensive, and are not well covered by most insurance plans, but they can sometimes do what outpatient cannot, and give eating disorder sufferers the foundation they need for a lasting recovery.
Page last updated Aug 05, 2010