Study Evaluates Residential Treatment Programs

According to new research,the number of residential treatment programs for persons with eating disorders has tripled in the past 10 years, but such centers vary widely and are still highly unregulated. The study gathered information from 18 programs across the United States to evaluate methods, licenses, outcome studies, and types of staff. These residential treatment programs offer an alternative to inpatient care, particularly when insurance companies limit coverage and individuals become responsible for their own care.

Length of Stay & Costs

Researchers found that on average, the length of stay in residential treatment is 83 days, more than three times the length of stay for inpatient care. The cost per day ranged from $550 to $1,500, with an average of $956. Therefore, according to the study, an average stay costs approximately $79,348. Even though this is a high number, compared to the average $2,000 a day for hospitalization, residential treatment may be a cost-effective option for long and short-term care.

Treatment

Most residential treatment centers used a diverse approach and various therapy techniques. Eighty-nine percent of programs reported cognitive-behavioral therapy (CBT) as a primary method. Only 16% used interpersonal therapy, and 33% reported using dialectical behavioral therapy.

The kinds of therapy used were categorized as traditional group, nontraditional group, and individual therapy. Clients received an average of 5.9 hours of nontraditional therapy for every 10 hours of group therapy. Clients also received an average of 1.8 hours of individual therapy for every 10 hours of traditional group therapies. The most common nontraditional therapies were art-based (334 minutes per patient, per week), recreational-experiential (175 minutes per patient, per week), and yoga/meditation (122 minutes per patient, per week).

Surprising Results

Many programs operate with licenses for group homes, foster care, or no license at all. While most programs hold a general state license, few if any states require licenses specific to eating disorders treatment. This inconsistency shows that regulations are badly needed, especially with so many new facilities being started. Another surprising find was that no program offered services exclusively for males. While all programs accept females for treatment, only 22% of those surveyed accepted men.

Outcome Studies

Slightly more than half of all programs were conducting treatment outcome studies. More than one third reported having at least one doctoral-level staff member specifically engaged in research. Interestingly, the researchers found no published data about effectiveness or quality, aside from the varying accounts of success found in promotional brochures. One-third of all programs evaluating treatment methods relied only on client-initiated post-treatment phone calls.

Recommendations are that facilities conduct more in-depth studies to measure the effectiveness of their approaches. Given the length and cost of care, further information is crucial. (Source: Eating Disorders Review, 2006, Vol. 17, No. 3)