How Much Support Do You Need? Looking at Levels of Care in Eating Disorders
Eating disorders are complex conditions that impact not only mental health, but also physical health. Imagine a ten-year-old child who becomes anorexic and quickly becomes medically destabilized — this patient may need to be hospitalized before beginning the road to recovery. Now imagine a teenager who has recently started restricting or purging; this person may be able to recover at home with the support of a therapist and their family.
Because eating disorders are complex, individuals with these conditions often benefit from a multidisciplinary approach involving therapists, dietitians, psychiatrists, and other medical professionals. This care exists on a broad continuum that balances varying levels of support and autonomy based on the person’s needs.
Let’s walk through the various levels of care, starting with the most acute:
Hospitalization.
Hospitalization is warranted when medical conditions or other safety concerns require care in a hospital setting with around-the-clock medical resources. This includes careful refeeding protocols, medical management, and often IVs or feeding tubes. Hospitalization may take place in a traditional hospital or within a program embedded in a residential treatment facility. Hospitalization costs are typically covered, at least in part, by medical insurance.
Residential (or “Res”).
Residential treatment is a step down from hospitalization. Residential treatment centers are usually dedicated to eating disorder treatment, although some include multiple programs. In a residential setting, clients live full-time at the facility, sleeping and eating all meals there. Residential clients are more medically stabilized but are often still working on weight restoration, struggling to complete meals and snacks, and needing to focus full-time on their recovery in a structured environment. These programs generally provide medical support, dietitian support, and group and individual therapy. Some allow family to join the patient for certain meals, therapy sessions, or events, and many also offer family support programs.
Partial Hospitalization Program (PHP).
Partial Hospitalization Programs may be a step down from residential care or a step up for someone who realizes they need more support than they have in daily life. These programs provide medical support, dietitian support, and psychotherapy. They vary in structure but typically run five to six days per week for about half the day, with patients usually eating one or two meals in the program setting each day. Patients do not sleep at the facility during PHP.
Intensive Outpatient Program (IOP).
Like PHPs, Intensive Outpatient Programs may be a step down or step up. IOPs vary widely and are often customized to meet the needs of specific populations (for example, virtual attendance or evening programs to enable clients to continue working). IOPs typically run for a few hours each day and may include eating a meal together as well as group and individual therapy.
Outpatient.
In outpatient care, a client has a therapist or a team of therapists and other multidisciplinary specialists who meet regularly with them. The client may schedule appointments with an individual therapist, a family therapist, a dietitian, a psychiatrist, and a medical doctor — all providing support through their own clinics. These professionals often collaborate to provide coordinated care. Clients receiving outpatient services are typically trying to maintain as normal a life and routine as possible — living at home, continuing to work or go to school, etc. Many clients in eating disorder treatment try Family-Based Therapy, in which the person recovers at home with the support of their family (usually parents or a partner) and the guidance of an outpatient team.
Individuals with eating disorders can move up and down the levels of care — some start at the top and work their way down, while others begin at a lower level and decide they need more support in order to recover well. Some move in and out of higher levels of care multiple times before achieving full recovery. Many people find that different levels of care are necessary or helpful as they work through various stages of recovery.
These levels of care exist to support you and your loved ones — and there are many options. If we can help you begin treatment or determine what level of care you or a loved one may need, please reach out.
Here at Atlanta Wellness Collective, we want to help. For support, contact us or schedule an appointment online.
This blog post was written by Jennifer Oswald.
This blog is not intended to substitute professional therapeutic advice. Talk with your healthcare provider about your health concerns and before starting or stopping therapies. No content on this site, regardless of date, should ever be used as a substitute for direct professional advice from your doctor or other qualified clinician.
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