Unfortunately, not all eating disorders can be treated solely on an outpatient basis. Many people need the additional treatment and support that a higher level of care such as a residential treatment center or inpatient hospitalization can provide.
What does residential treatment entail?
Residential treatment centers provide a long-term treatment option for people in need of intensive therapies, support, and supervision. People typically enter residential treatment centers for a minimum of 30 days and up to 90 days or more. As you might imagine, residential treatment centers are typically quite expensive. Depending on your insurance plan, some portion may be covered. Occasionally, treatment centers will offer scholarships for treatment as well.
Like other levels of care, residential treatment centers provide clients with intensive individual therapy as a cornerstone of treatment. Because, clients are actually living at the treatment center, individual therapy may take place several times per week or even daily, depending on the client’s needs and the treatment program. A therapist may even be available on an ‘on-call’ basis should someone need additional support outside of regularly scheduled appointments.
Nutrition counseling by a dietitian is also provided. The dietician is able to be directly involved in meal planning and accountability, in addition to regularly scheduled appointments.
Group therapy, supported meals, and treatment from a staff psychiatrist are also typical components of the treatment plan. One of the positive things about being at a treatment center is that all of the treatment team members typically meet and talk on a daily basis with each other and are all on the same page, working towards the same treatment goals.
Unfortunately, most people have to travel a lengthy distance to residential treatment centers, often out-of-state. This makes regular family therapy somewhat challenging. Thankfully, most treatment centers address this issue in a number of ways. Some centers offer family therapy intensives, in which family members arrive and participate in family therapy over the course of several days. Other centers, host ‘family weeks’ or ‘family weekends’ in which multiple families arrive at the same time to participate in family therapy and in multiple-family groups as well as education about eating disorders and supporting someone with an eating disorder. If families are unable to travel to the treatment center, they may be able to use video chat programs or telephone calls to supplement therapy.
Unlike most inpatient hospitalization programs, residential treatment centers are often located on acreage, making them feel more like a ranch or campus rather than a hospital. This additional space may also allow them to offer unique programs such as ropes courses, equine therapy (therapy with horses), and other types of outdoor activities as well as space for meditation and personal reflection. Some treatment centers also have on-location schools which allow students to continue their studies while working on recovery.
Who is residential treatment appropriate for?
If a person is unable to make progress in treatment and recovery on an outpatient basis, then residential treatment may be an appropriate option for them. It is also a good option for people who have made some progress on an outpatient basis but seem to have reached a plateau in their treatment. Some treatment centers specialize in treating people with comorbidities (co-occurring diagnoses), such as eating disorders and substance abuse. If you, or a loved one, is struggling with multiple issues this type of center may be a good choice.
If a person is experiencing medical complications from their eating disorder, a residential treatment center may or may not be an option. Each treatment center maintains its own standards as to what a person’s physical state (weight, blood pressure, etc.) must be in order for them to accept the person as a patient. For example, some residential centers provide medical re-feeding and some do not. If a person wants to pursue treatment at a residential center but first needs to be stabilized at an inpatient program, that may be an option as well.
If you or your loved one is interested in residential treatment centers, talk with your therapist about whether or not it is the right fit for you. Your treatment team likely has recommendations and referral information for various treatment centers as well.
American Psychiatric Association. (2006). Practice guidelines for the treatment of patients with eating disorders. (3rd ed.). Washington, DC: Author.