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Modern Eating Disorder Treatment Might Not Be What You Expect

When first facing the prospect of entering an eating disorder treatment center, many people are unsure what to expect. They may even be nervous or resistant. It’s natural to have some cold feet when it comes to entering an eating disorder treatment center, but a quality facility will have some characteristics that make the time spent pursuing eating disorder recovery much less intimidating. In general, residential psychiatric care is much less cold and impersonal than the popular image might suggest. Even day treatment (sometimes known as outpatient) programs still face a negative stereotype among first-time clients.

In recent years, specialized treatment for a variety of mental health illnesses, from eating disorders to substance abuse has begun to challenge those perceptions.Here, we will outline some of the eating disorder counseling programs and techniques commonly found in both day treatment and residential programs for eating disorder treatment and help to set aside some of the fears you or a loved one may be having about getting treatment.

A Setting That Promotes Feelings of Safety and Acceptance

Eating disorders, including anorexia nervosa, bulimia nervosa, and binge eating disorder, are classified and recognized as mental health disorders. Most are listed as standalone disorders in the manual for diagnostic criteria, the DSM-V, and those that aren’t are usually mentioned.Many more people attend specialized mental health treatment than ever before; it’s hardly a rare occurrence.

Unfortunately, a realistic portrayal of what eating disorder treatment at a mental health facility is like is still hard to find. Movies and TV have sometimes put forward an image of impersonal, hospital-like hallways with fluorescent lighting, people being held under lock and key, and so on.Even depictions of mental health treatment that aren’t so dystopian still portray treatment as grim.

A quality eating disorder treatment center couldn’t be more different.

The best facilities will be luxurious and well-appointed, often with a cozy and home-like feel to them. Bedrooms will be well-appointed and comfortable, and the facility itself should include a community cooking and eating space which can normalize the rituals of cooking and eating together. A stay at one of these centers won’t be nearly as intimidating as those portrayed in the media.

That being said, individuals going into eating disorder treatment for the first time shouldn’t expect a vacation. Eating disorder treatment is highly focused and regimented. Clients in treatment should expect to feel safe and acknowledged. However, their time in treatment is centered around understanding the causes of their disorder and working to address them. It’s hard work, but the benefits of beginning recovery are worth it.

Modern, Evidence-Based Therapy and Experiences

Mental health treatment in general and eating disorder treatment, in particular, has grown in leaps and bounds recently, with the embrace of modern, evidence-based therapeutic techniques. This means two things: first, empirical evidence guides the use of these techniques – using the scientific method to design treatment for each client based on what has been proved to work time and time again. Secondly, every effort is made to match the treatment program to the client’s specific needs.

Rather than a cookie-cutter methodology that applies identical techniques to every case, a quality eating disorder treatment center will tailor the program to each client’s unique needs. As an example, exposure therapy is often useful for treating eating disorders. However, an exposure therapy designed fr orthorexia nervosa, where a person is gradually exposed to their “fear food” will not work effectively in a case of binge eating disorder. Instead, the person with binge eating disorder will be asked to respond to a stressor by meditating or otherwise replacing their urges to binge eat with a healthier alternative.

These evidence-based therapies are often geared towards specifically addressing disordered behaviors like the repeating purging associated with bulimia nervosa. One such therapeutic technique is known as Dialectical Behavioral Therapy (DBT). This technique consists of mindfulness training and emotional distress tolerance – which means, through training and discussion with the eating disorder counselor, the individual getting treatment learns to process the negative emotions which help to cause eating disorders. These emotions can be processed in a way that doesn’t involve harmful behavior or self-harm, providing a grounded path to long-term eating disorder recovery.

There are other commonly used modern therapeutic methods such as Cognitive Processing Therapy (CPT), which is focused specifically on addressing past trauma, PTSD, and the emotions that come with them. Each method may not be used on each client, but having the options available is a must for successful eating disorder recovery.

Experiential and Alternative Therapies

What is experiential therapy? They are still an unknown to many people, but they are proving effective at many of the best eating disorder treatment programs. An experiential therapy goes outside the bounds of traditional talk therapy and even techniques like DBT. They do not necessarily need to be directly associated with food, eating, or body image, but instead put the mindfulness techniques being taught to a real-world application.

A common form of experiential therapy is art therapy, in which the client draws, paints, or sculpts under the guidance of a therapist. It’s extremely useful in taking steps towards acknowledging and processing the previously mentioned negative emotions. Art therapy is also known for surprising individuals. Often, feelings and thoughts, when put down in a drawing or painting, are more easily expressed than through talking in a typical talk therapy setting.

Music also helps with self-expression and releasing emotions. The good news? Clients don’t need formal training in art or music to take part in experiential therapy. Simple instruments like percussion or basic keyboards can be used with a music therapist leading the way, and the point of art therapy isn’t to become the next Rembrandt; it’s to give a new perspective on a person’s emotions.

Other experiential therapies that are more food-centric should also be part of a good eating disorder recovery program. A great example of this would be excursions to a grocery store to go shopping for a balanced diet. This is so effective because it simultaneously teaches a valuable life skill (picking nutritious food in balanced amounts) and helps address fears or anxieties around food and eating, which are common in most eating disorders, especially anorexia nervosa. Experiential therapies like this and other, similar methods are the hallmark of a forward-thinking eating disorder treatment center.

Aftercare and Alumni Programs

Recovering from an eating disorder isn’t like taking your car in for repairs – it’s not realistic to expect that everything will be “fixed” after either residential or day treatment. There is always a chance for relapse, lingering psychological effects, and continued need for therapy after specialized treatment is finished. There is usually a need for continued care after eating disorder treatment, and modern treatment centers must take that into account.

The most common and intensive option is what’s known as “step-down” care. After a stint in an intensive residential treatment center or focused outpatient treatment, regular sessions with a psychologist or psychiatric team can help the client manage to get back to their daily routine while incorporating life changes taught at the facility. Step-down care can be performed in individual or group settings. The care team can also continue to provide meal planning and nutritional advice as well as maintain prescriptions for any medications.

The treatment center may also organize alumni associations for past graduates of their treatment programs. These promote peer support and capitalize on clients’ desire to bond with each other. Many strong friendships are formed during residential care; having people who know exactly what you are going through (and sharing those experiences) makes it easier to overcome an eating disorder.

Expect More from Your Eating Disorder Treatment

When you or a loved one has reached the point where you’re ready to seek out eating disorder counseling, remember that some anxiety about getting started is normal. The portrayal of mental health treatment in the media has caused some confusion about what it’s really like. You should expect the best from your eating disorder recovery program – including a safe, comfortable setting, evidence-based talk therapy, and a variety of different experiential methods to ensure the best chance at a long-term, recovered life.

Melissa Orshan Spann, PhD, LMHC, RTY 200, is Chief Clinical Officer at Monte Nido & Affiliates, overseeing the clinical operations and programming for over 50 programs across the U.S. Dr. Spann is a Certified Eating Disorder Specialist and clinical supervisor as well as an accomplished presenter and passionate clinician who has spent her career working in the eating disorder field in higher levels of care. She is a member of the Academy for Eating Disorders and the International Association of Eating Disorder Professionals where she serves on the national certification committee, supervision faculty, and is on the board of her local chapter. She received her doctoral degree from Drexel University, master’s degree from the University of Miami, and bachelor’s degree from the University of Florida.