- Are bathroom visits supervised?
- Are the bathrooms locked?
- Do I have to eat all the food on my plate?
- Do you take insurance?
- How do you deal with vegetarians, individual food preferences and other food issues?
- How do you deal with weight gain?
- How do you determine who will share rooms?
- How do you figure out how much a person needs to eat?
- How do you treat athletes and exercise disorders?
- How individualized is the program?
- How long do people usually stay?
- How many and what kind of staff members do you have?
- How many people in a room?
- How much will I need to pay?
- How soon can I go on a pass?
- How will my treatment prepare me for real life?
- What is a typical day like?
- What is the average age of the clients?
- What is your success rate?
- What kinds of recreational activities or outings do you provide?
- What percentage of your clients have anorexia nervosa verses bulimia nervosa?
- What transitional or aftercare programs do you offer?
- When are visiting hours?
- Will I be meeting with a psychiatrist?
- Would it be possible to speak with former graduates of Monte Nido?
In the beginning, and as deemed necessary, clients are on an observation period after meals and snacks, as this is usually the hardest time for clients.
Our bedrooms each have a bathroom that can be locked or unlocked depending on the need of the client and/or the level they have achieved in the program.
The percentage of your meal you need to complete is worked out between you and our dietitian. Our goal is that prior to leaving our program, clients will have the opportunity to eat according to their own hunger and fullness.
Yes, we are contracted with many insurance companies such as Blue Cross, Blue Shield, Aetna, United Behavioral Health (UBH) PacifiCare, Cigna and Magellan. RainRock accepts all of these contracts and, in addition, are contracted with Providence and ODS. If your insurance company is not contracted with us, we may be able to make a single case agreement on your behalf.
Clients are individual in terms of food fears, likes and dislikes. We are sensitive to each individual's food issues and provide flexibility in our menus. We offer vegetarian choices and take into account any diagnosed food allergies, blood sugar problems or other dietary needs. We work slowly and empathetically with all food issues. Clients are not forced to eat any particular food, however, we are careful to help each client understand the differences between food preference and eating disorder driven choices. Eventually clients are allowed to shop and cook for themselves.
Not all of our clients need to gain weight, but for those that who do we work out an individualized program. Most treatment programs follow the American Psychiatric Association guidelines of 2-3 lbs. per week. Some clients can succeed with these guidelines, however we have found that not all of our clients can tolerate the APA rate of weight gain and do better when we proceed more slowly.
When you first arrive you usually go into the room that has just been vacated by the client who discharged. However, there are times when it seems more appropriate to change rooms. There are also times where roommates will not get along and may come to staff to seek a room change. Usually we work on the relationship in order to work things out, but if necessary a room change might be made.
Meal plan and calorie levels are determined on an individual basis taking into account a variety of factors including both psychological and physical concerns.
We specialize in the treatment of female athletes. Since each athlete’s needs are unique and different we take particular care in treating each person on an individual basis. When lack of nutrition is combined with hours of exercise, the body gets broken down at a rapid pace and residential or inpatient treatment may be required as a way to relieve the vicious cycle of nutrition deprivation combined with excessive exercise. In situations with athletes it is often difficult for those involved (athletes, parents, coaches) to determine where the “appropriate” amount of training and attention to diet ends and the eating disorder begins. We work hard to help individuals distinguish between healthy and excessive behaviors.
At Monte Nido we are sensitive to the factors that may have played a part in the development of an athlete’s eating disorder. Ideas about perfection, pushing through pain, being in top physical form, focus on a low body weight and high muscle mass, demanding coaching and the prioritization of training and performance above all else can all factor into the development and maintenance of an eating disorder. All of this is to say nothing about the other areas in an athlete’s life such as school, family and social life that may also have an influence on the thoughts and behavior that make an eating disorder possible.
Many of our therapists have struggled with an eating disorder or exercise addiction in their past, and have special insight into the experience of the person suffering. Our therapists maintain a calm, caring stance with the goal of helping the individual discover what he or she needs to be healthy and recovered. We believe that clients need to develop a sense of faith and trust in their body and that self-care is an important component of any training program. With the help of nutritionists, exercise trainers, psychiatrists and therapists we assist the client in developing a unique, healthy, balanced approach to exercise and nutrition.
Clients vary in their ability to overcome their eating disorder, tolerate weight gain, stop intrusive thoughts or alleviate depression. Our program is based on providing individualized care. With a small number of clients and a relatively large staff (e.g., at Monte Nido Malibu, we have 6 clients and 30 staff), we have the ability to address each client's unique individual needs. Our primary therapists are usually assigned no more than 2 or 3 clients at a time. Each client meets with her therapist 3 times per week as well as individual sessions with the dietitian, medical director, psychiatrist and the clinical director. Each client has an individualized contract with her own personal goals for each week. Clients work out their contract goals in conjunction with the primary therapist and in the weekly contract group. We work with each client's special needs or interests. For example, we have arranged for clients to take classes, have massage or sports rehabilitation treatments, do volunteer work and finish academic courses.
We have a minimum stay of 30 days, but most clients stay somewhere between 2-4 months. A few clients have stayed 6 months or more. When a client is ready to leave 24 hour care, but not ready to go home, we can work out an aftercare program which is less structured and more affordable than full 24-hour care. At our Malibu location, we offer both a day treatment program and a transitional living house.
All our facilities have a large and varied staff. Carolyn Costin, the executive director of all our programs and clinical director of Monte Nido Malibu, sets the tone for clinical treatment. Each administrator collaborates with Carolyn and the clinical director to provide treatment for all clients. Our primary therapists provide individual, group and family therapy. Our psychiatrists oversee all psychiatric issues and provide each client with appropriate medications or naturopathic alternatives. Our medical doctors attend to the overall physical health of each client and help resolve any medical issues that arise. We have dietitians who collaborate with each client to develop lifelong eating habits. Our fitness trainers and yoga teachers help establish healthy exercise goals and provide a variety of physical activities. Our chefs provide wholesome, beautifully presented fresh food for meals, and where possible, e.g., in Malibu, use the Monte Nido garden for some ingredients. When appropriate, our chefs work individually with clients in the kitchen and make everyone feel at home. There are several other staff members including nurses, group therapists, eating disorder counselors, program coordinators, and specialty practitioners who personally invest their time and energy in helping Monte Nido clients recover from their eating disorder. Please refer to the section titled "Team Members" for a detailed description of the main core staff you will be interacting with at Monte Nido programs.
The cost to you depends on insurance coverage. We are contracted with several insurance companies and will assist you in determining your coverage and other options.The staff at our intake department is available to help you with all of your questions . Call us at 310-457-9958 - we are here M-F from 9:15 – 5:30 p.m. to assist you. Our residential rate includes room and board and all programming including all group and individual therapy, weekly sessions with the RD, psychiatrist and our physician who provides routine medical care. Individualized medical needs, such as lab work, prescription medications, outside consultations and medical emergencies are the responsibility of each client.
All passes are decided on an individual basis but each of our levels allows for different kinds of passes. For example on level 1 clients can only go family passes, while on level III, clients can go out on pass independently. Details about passes are explained in the client handbook given to clients upon admission.
We know all too well that clients can be successful in a treatment setting and then relapse after returning to normal living. Prior to opening Monte Nido Malibu, our executive director, Carolyn Costin, ran several hospital programs and saw that the relapse rate was high. Our entire program and level system is based on this concern. Progressing through the level system at a Monte Nido program gives each client increasing freedom over her food and exercise so that, upon graduation, she is better prepared to handle real life situations. Clients will be shopping, ordering food in restaurants, and making their own meals while on level III and IV. When appropriate, clients go on passes. Clients may go on passes with friends and family members and eventually alone to test recovery skills. If feasible, we encourage clients to go home for a period of time to test their ability to abstain from dysfunctional behaviors in their own environment. Our system has been well thought out. We fully understand that what the client does at a Monte Nido program is important but not nearly as important as what she continues to do when she returns home. Experience has shown us that if clients can remain in treatment through the entire program we provide, they will have less chance of relapse and a far greater chance of full recovery.
A typical day begins with breakfast and morning exercise. After taking time to get ready for the day, there is a Primary Therapy Group, followed by lunch. After lunch we have a specialized group, such as Food & Feelings or Cognitive Behavioral. Following afternoon group, clients will have individual therapy sessions, meetings with the clinical director, physician or dietitian. If no sessions are scheduled, clients will work on individual assignments or have free time for reading, art projects, visiting, etc. In the evening, dinner is followed by another specialized group such as Body & Soul or Creativity. Clients are busy with therapy at our facilities; however, free time, organized activities and outings are also important parts of our program and are interspersed throughout the week.
Monte Nido is licensed to accept adolescents and adults. Monte Nido now accepts 16 and 17 year olds on an individual case basis. The age of clients in treatment at any given time varies.
RainRock is licensed to accept 18 year olds and older.
We are committed to following our clients progress and improving our program, therefore we are conducting ongoing outcome research. Data from our program at Monte Nido Malibu continues to show an overwhelming degree of success for clients from admit to discharge. However, we are most concerned with how our graduates do over time and continue to follow their progress.
We just completed an outcome report of our Monte Nido graduates ranging from 1 to 10 years post treatment. 75% of our graduates participated [a very high percentage] and the results are nothing but extraordinary. We are very proud to see that our work with clients has produced long term post graduate success rates in the 88% range for full and partial recovery. We recommend that you go to the Outcome Study Results page and read this report summary as it should be valuable in your decision making on where to seek treatment as well as your perception of "can you be recovered"!
One goal is to provide a variety of activities that nourish both body and soul. We believe that providing activities for a fuller more soulful life is part of what helps clients diminish their 'need' for an eating or exercise disorder. We have scheduled outings 2-3 times per week and special events periodically. Our recreational outings can involve going to an art studio, to the beach, to a museum, to a miniature golf course, or anywhere that seems appropriate. Occasionally we attend special events, like dance performances, concerts and plays.
We also utilize a variety of recreational activities that have a direct therapeutic value such as ropes courses and basketball.
This varies at any given time.
We are conscientious regarding the issue of continuity of treatment and step down levels of care, e.g., day treatment or outpatient treatment. Transitional living and independent living situations can be arranged. All Monte Nido clients are encouraged to participate in some kind of transition program prior to resuming outpatient therapy alone, if only for a minimal time period. We have found this to be enormously beneficial in helping clients practice their recovery skills.
All facilities differ in terms of specific aftercare offered in the vicinity. For example, at Monte Nido Malibu we have a day treatment program, transitional living house and out-patient services.
At no cost, we offer our ongoing Family/Significant Other Group to all former clients and their significant others. This group serves as an ongoing alumni group for clients in the area or as a 'recharge' when needed for those who want to come back to attend.
When clients are ready to return home, we assist in the transition back to the referring therapist and treatment team or, if need be, we draw from our extensive referral list both in and outside the United States. Our therapists provide transition sessions to all clients returning home in order to facilitate a smooth return to the outside treatment team.
You may have visitors during any free time when you are not scheduled to be in a meal or activity. However, we do have times which we suggest are best for visiting and we encourage you to stick to these times if possible.
Upon admission, each client will have an initial meeting and evaluation with our psychiatrist. After the initial meeting, each client will meet with our psychiatrist with more or less frequent sessions according to need.
We would be happy to provide phone numbers of graduates as well as family members or significant others who have agreed to discuss their experience at Monte Nido. Anyone requesting phone numbers should call our office manager and intake coordinator at 310-457-9958.