Steps in Choosing the Right Treatment Facility
By Angela Picot, PhD
Reprinted from Eating Disorders Recovery Today
Fall 2008 Volume 6, Number 4
©2008 Gürze Books
If you have made the critical decision to pursue a higher level of care to treat an eating disorder, it is important to carefully consider your options. Every individual has different needs and not all treatment centers are the same. There is a wide range of orientations, interventions, services, and specialties unique to each center.
Step One - Determine Level of Care
The first step is for you and the treatment team (any therapist, psychiatrist, nutritionist, or internist with whom you currently receive services) to determine the most appropriate level of care. If you do not currently have a treatment team, schedule a thorough clinical assessment with a therapist who specializes in the treatment of eating disorders for recommendations.
If you need more support than individual outpatient therapy can provide, consider an intensive outpatient or partial hospitalization program, which typically offer daily 4-8 hours of psychotherapy and meal support with periodic medical monitoring. If you are in need of medical intervention or require stabilization in a safe, contained environment prior to beginning more intensive therapy, a 2-3 week inpatient stay may be the best choice. If symptoms have persisted despite other interventions, consider a residential treatment center, where the typical length of stay is 1-3 months.
Step Two - Specific Issues
The next step is to think about other issues, in addition to the eating disorder, that might need to be addressed in treatment. For instance, do you suffer from depression or anxiety? Do you have a history of trauma? Are you battling substance abuse problems? Many centers have special groups, treatment interventions, and trained therapists to help address these and other co-occurring conditions. This will help narrow down your choices. A general Internet search is often sufficient for research, although there are other resources, such as Gürze Books (www.gurze.com) and the Eating Disorder Referral and Information Center (www.edreferral.com) that offer a list of treatment programs by state.
Step Three - Ask Questions
Once you have a list of possible choices, it is time to more deeply explore each specific program. Here are some questions to consider:
✔ What is the orientation of the program? (i.e., Is it a 12-step model? Is there a spiritual component? Is there behavioral and nutrition therapy?)
✔ How much time is spent in group and individual therapy? What is the staff to participant ratio?
✔ What types of experiential therapies are offered? (i.e., art, movement, equine)
✔ Is there a physician on staff? What happens if I need immediate medical attention or medical monitoring?
✔ Are psychiatric services available and what is the treatment perspective?
✔ Is there a family or marital therapy component?
✔ What are the possibilities for discharge planning? (i.e., Does the program have options for step-down level of care or transfer back to the referring providers?)
✔ Will the program communicate with my existing team to ensure continuity of care?
✔ Can they provide statistics regarding number of patients treated in the past year, their ages and clinical characteristics, and short-term and long-term outcomes?
Step Four - Insurance and Availability
Call each center and ask about availability and insurance. Some have a wait-list, so anticipate that it might be several weeks before admission is possible. Most centers will take your insurance information and check benefits to determine if reimbursement is possible. The billing departments will typically work in advance to determine a payment plan. Some programs offer discounted rates or scholarships based on need. Some require payment up front for a certain length of stay, while others use a pay-as-you-go model. Even if you don't think that your insurance will cover a certain program, call to see what type of plan can be arranged. Look for the article, "Securing Eating Disorder Treatment: Ammunition for Arguments with Third Parties" by Margo Maine, PhD, on the NEDA website (www.nationaleatingdisorders.org) for help navigating the insurance reimbursement process.
Step Five - Make a Decision
A number of treatment centers around the country provide high-quality services. It is worth the time and effort to select the one that will be the best fit for you. Be sure to talk to your treatment team and support system when making this decision. Keep in mind that any intensive treatment should be followed up by an appropriate aftercare plan. Congratulations on taking this important step in your recovery.