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Transitioning from Eating Disorder Treatment to Everyday Life

For many patients and their families who seek eating disorder treatment, just getting started with treatment requires complete focus. It takes courage to seek treatment in the first place, and it often requires full engagement to enter the program and participate. But every treatment program ends, so there will come a point when the patient and their family need to consider eating disorder aftercare as well. Life after treatment can present its challenges, so it can be helpful to understand the transitionary process that happens once treatment ends, and everyday life begins again.

Eating Disorder Aftercare – Considerations for Patients and Family

1. Remember that the treatment center staff are there to help.

One major benefit of getting treatment at an eating disorder treatment center is that patients and families can get guidance from caring treatment professionals. These professionals can help both with the actual treatment program and with things like life after treatment. Both patients and their family members can consult with members of the treatment staff before treatment begins and throughout the treatment process. That means that they can ask questions and get help with what the patient should do after the main program is over to maintain the progress that the patient made.

2. Strive to fully engage in treatment during the program.

No matter how successful a treatment program for a patient, there will always be hurdles to overcome once the program is over. Going back to regular life always involves adjustments, whether it’s going back from vacation or going back from a program of self-discovery and healing like an eating disorder treatment program. But the transition can be made somewhat easier by developing as much momentum as possible by striving to fully engage with the program while in it.

Full engagement in an eating disorder treatment program is the best way to develop the skills and coping strategies necessary to carry positive developments into life after treatment. The more fully a patient can incorporate the lessons from the treatment program, the less effort they will need to maintain positive behaviors once out of the program.

To get the most out of a treatment program, patients can:

  • Check in with treatment staff. When a patient has questions or concerns during a treatment program, talking them over with a staff member of the treatment center is a great way to feel heard and get answers and insights from the people best qualified to give them. It is helpful to talk about such things sooner rather than later so that issues can be addressed, and patients can feel better about their treatment experience.
  • Open up in therapy sessions (once it feels safe to do so). It is extremely common for people who enter therapy to hold back on expressing what they are thinking or feeling, especially early on. Wanting to protect oneself is understandable and a natural reaction to being asked difficult or personal questions by someone one barely knows. However, it is important to understand that progress in therapy tends to be related to the level of trust established between the therapist and the patient. Once the patient trusts the therapist enough to open up and say how they feel, the therapist can then help guide the patient to the goal they are both seeking. As long as the patient feels relatively safe with the therapist – like they can trust the therapist to have their best interests at heart – opening up more fully to the therapist can accelerate the benefits that come from therapy sessions. 
  • Learn about nutrition and how it applies to oneself. Some patients find nutrition lessons boring, while others think they are the most interesting thing in the world. While no one can force themselves to love a particular subject, those diagnosed with eating disorders can gain more of a feeling of control over their nutrition by learning as much as they can about the subject as it applies to them. The facts and concepts taught in eating disorder treatment programs are tailored to the needs of eating disorder patients – and to the unique perspectives of those patients, such as lessons tailored to younger patients who need more actionable information, not just cold, plain facts and data. The more patients can absorb information about how to eat a balanced diet and enjoy foods that are good for them, the easier it is for those patients to use that information when they are living their normal lives.
  • Take advantage of multiple types of therapy. All good therapists will tell their patients that there is no one-size-fits-all approach to therapy. Some types of therapy seem to work great for one patient while not working as great for another patient. It can take several different therapeutic approaches to achieve the outcomes that therapists and patients are looking for – which is completely fine and to be expected. After all, every patient is a unique individual with their history, thoughts, feelings, and expectations. That is why eating disorder treatment programs will usually have patients participate in at least a few different types of therapy. One may work better than another, and there is not always a way to tell which will be most effective until they have been tried out by the patient. Patients can get the most out of their treatment center program by taking advantage of several different types of therapy. 

3. Try a gradual progression from treatment to no treatment.

Those that are diagnosed with eating disorders can go on to live a fully recovered life – but achieving that goal can take time and may require going through several stages of the treatment process. While some patients may be able to enter a treatment program, complete the program, and then go on without treatment successfully, it is usually a better idea to gradually taper off the treatment for the eating disorder over a longer period. How that taper will look depends on where the patient begins the process.

Often patients and their families realize that the individual is struggling with eating disorder symptoms before ever seeking any kind of treatment. Once they realize that there is an issue that needs to be addressed, they may seek out a therapist, a doctor, or go directly to an eating disorder treatment center. The treatment professionals, whether an individual therapist, medical doctor or eating disorder treatment center staff, will then give some feedback on what type of treatment the patient will need.

The patient may need inpatient – also known as residential treatment – or they may get a recommendation for outpatient treatment. How a patient gradually moves from one treatment to another will depend on where they start.

Progression after Inpatient Treatment

A patient that enters an inpatient program may be in treatment for an extended period. They will go to live at the treatment center for anywhere from 30 days to several months or longer. They can and should try all of the things listed above to get the most out of the inpatient eating disorder treatment program they are in, but at some point, they will need to leave the program. Once that happens, they need a plan for how they will transition to their normal lives.

Many times, an inpatient treatment program will recommend that patients who finish their time at an inpatient center enroll in an outpatient program for once they get out of the inpatient center. They recommend an outpatient program because such a program serves as a gentle progression from the residential treatment environment to the environment of everyday life. Coming out of a residential program can be a bit of a shock. One day the patient is in a program where they live at a treatment center day in and day out and participate in treatment multiple times a day. The next day they have to go back home and try to integrate back into their old lives and make changes to facilitate their recovery – all of which can be challenging no matter how excellent the residential program happens to be.

The significant benefit of an outpatient program after an inpatient program is that it can provide a bridge of familiarity and support into the regular life of the patient. Many of the treatments that the patient gets at the inpatient program are available as part of an outpatient program, like individual therapy and group therapy. The patient can continue participating in these treatments while getting back to school, work, family life, and the other demands of their lives. Two or three times a week, they can come back to a treatment center to find the refuge and support they may need to maintain their fully recovered life.

Progression after Outpatient Treatment

A patient in an outpatient treatment program may have come from an inpatient program first or may have only been in an outpatient program. Some people diagnosed with eating disorders do not require inpatient treatment, and others choose outpatient instead of inpatient because it allows them to maintain many of their obligations like school and work. Whatever the reason someone is in an outpatient program, there may come a time where they feel like it is time to transition out of the program.

Often, those leaving an outpatient program will get advice and guidance from one or more of the treatment professionals they see for their eating disorder symptoms concerning the transition. They may be advised to still maintain an ongoing relationship with a therapist, for example, so that they have someone to discuss their circumstances with regularly so that they are less likely to fall back into eating disorder symptoms. Or, if the treatment professional believes that the patient has reached a point where they do not require regular therapy, they may tell the patient that they can take what they have learned and use it to live a fully recovered life without regular therapy.

It is worth noting that many people, even those who were never diagnosed with an eating disorder, will from time to time find themselves in a situation where therapy could be beneficial. So, even if the former patient is not seeing a therapist regularly for eating disorder issues, they can and should still seek out a therapist if they feel that they could benefit from one. Mental illness is just one of many types of illnesses – and everyone gets ill from time to time. When someone gets sick, they go see the doctor for help. When someone is suffering from symptoms of mental illness, it is only reasonable to go get help from a mental health professional.

4. Work as a team to maintain recovery.

Most young eating disorder patients have one or more people that they rely on for support, whether emotional, financial, or both, after treatment is complete. They may be parents, siblings, significant others, or friends, but there is usually someone that patients are connected to. These individuals can help make the process of recovery easier for the patient by becoming engaged in the recovery process during recovery and after.

One of the main types of therapy used in eating disorder treatment, particularly for younger patients, is family-based therapy or FBT. FBT involves both patients and their families in treatment so that stronger connections can form between patients and their loved ones. FBT also helps families come to understand the patient better, including their needs as someone who has been diagnosed with an eating disorder. Families can learn to provide the best possible support for patients through FBT – support that should ideally be maintained long after the treatment program is over.

5. Don’t hesitate to ask for help again.

There is no shame in seeking help for eating disorder symptoms again after the completion of a treatment program. One of the best ways to maintain recovery is to recognize when doing so is becoming too difficult for the patient to do alone. When patients notice that they need help, the best time to seek it is now.

 

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.