Q: What is the philosophy of the ED-180 programs?
A: As the name implies, ED-180’s purpose is to “turn around” an eating disorder. ED-180 programs are not only designed to treat eating disorders, stabilize a patient, and promote a path to recovery, but to give hope, strengthen character and self-esteem and help patients find personal reasons for wanting and demanding recovery for themselves.
Q: What is unique about an ED-180 program?
A: The ED-180 programs combines traditional approaches that have been proven over time with cutting-edge therapeutic groups and classes that either have evidence-base support and/or a specific neuroscience basis for their use. Nearly every group, course and activity can and is explained in our program from a neuroscience perspective. And yet, while based in science, is made “user-friendly” and enjoyable for the patients. One of the most unique features of the program are the therapeutic courses which support the recovery process by helping patients find a reason for their recovery and start to find sources of passion in their lives. Other unique features include our Mosaic Meal Rehabilitation (MMR) program approach and our mindfulness training approaches.
Q: What types of patients are appropriate for the ED-180 programs?
A:The ED-180 programs provide services for women who have an eating disorder such as anorexia nervosa or bulimia nervosa and require a “higher level of care” than simple outpatient treatment. A higher level of care is indicated when eating disorder symptoms are worsening or have failed to respond to traditional outpatient treatment. Using the American Psychiatric Association (APA) guidelines, the ED-180 provides treatment for clients who require level 2 (IOP) or level 3 (full-day) treatment. Patients meeting criteria for level 2 or 3 care generally are medically stable without extensive medical monitoring, have no active suicidal thoughts, are at 80% of expected body weight, have at least partial motivation for treatment, do not have any dangerous mood or substance use issues, require supervision for meals and weight restoration with the ability to adhere to a treatment plan when not in a program, has some control to resist urges to purge or compulsively exercise, are capable of reducing and maintaining a reduction in purging behaviors without constant supervision, and has at least some limited support when not in a supervised environment.
Q: What is a “step-up” or a “step-down” treatment program?
A: A program such as ED-180 is often considered a “step-up” or “step-down” program. A “step-up” program is a treatment program that provides a higher level of treatment care than is currently provided (i.e. a patient who goes from once a week outpatient therapy to a full or partial day treatment program.) Step-up programs are designed to intensify the treatment process while trying to utilize the least restrictive environment required for safe and effective care. A “step-down” program refers to when a patient is discharged to a lower, or less restrictive, type of treatment program (i.e. a patient transferred from a hospital unit to a residential center, or a patient discharged fro a residential treatment center to full or partial day treatment program.) Step-down treatment programs play a vital role in the monitoring of a smooth transition to a less restrictive environment and to minimize the risk of relapse.
Q: What is special about the ED-180 program staff?
A: The programs utilize a true medical/biological and psychosocial approach that is supervised by on-site physicians who play a very active role in all aspects of treatment including therapy and nutrition. Dr. DeSarbo, the program creator, is not just the programs psychopharmacologist, be he also runs many of the therapy groups, therapeutic classes, and individual therapy. The entire ED-180 supervisory team is comprised of the most experience treatment professionals who each have a minimum of 10 years of practice (most over 20 years) in both private and institutional settings and are members of national and international eating disorder associations.
Q: What is required for a patient evaluation?
A: Whether a patient calls on their own or is referred by their clinician, the ED-180 program begins with an initial intake evaluation. On-line forms are to be completed and brought to the initial evaluation that is conducted by a senior therapist or physician. Candidates are assessed for appropriateness for level 2 or 3 care, degree of motivation for treatment, and specifics of their case and special needs that may be required. While any medical history or recent laboratory information should be brought to the evaluation, all patients who are suited for an ED-180 program must be cleared as medically stable for the program by their treating physician before starting the program. A list of required lab work will be given to patients and their doctor. The time from initial contact to ED-180 and the start of the program can be 4 days or longer depending on program openings and the patient/doctors ability to complete acceptance requirements.
Q: What ages are appropriate for an ED-180 program and do you treat men/boys?
A: As a private program, ED-180 will respond to the needs of the local community and demand for services. The primary treatment programs include one treatment for adults 18 and over and one for adolescents 15 to 18 years old. Individual assessment and current group dynamics will determine the suitability for patients entering a program that is outside of these parameters. The creation of programs for men and adolescent boys will be based of the needs of the community.
Q: How often do patients come for treatment in an ED-180 program?
A: The ED-180 offices will be offering morning, evening, and full-day programs. Morning and evening programs are usually 3-5 hours a day, 3-4 days a week, while the full-day program is usually 9 hours daily, 5 days a week. As a private program, ED-180 program availability and enrollment can be flexible to meet the needs of the local community. Interested patients should call for information about availability.
Q: What can a patient expect from treatment?
A: A patient who completes an ED-180 program should expect a significant reduction in their eating disorder symptoms, an improvement in their mood and self-esteem, and hope for their future. A balance of eating disorder, mood and health stabilization should allow a patient to return to their private outpatient treatment team to further work on their overall mental and physical wellbeing.
Q: What type of rules and supervisions are there in a program?
A: Patients are continuously evaluated for their need for supervision and receive color levels during their stay. For instance, all patients entering the program are level RED denoting close observation, escorted bathroom visits, monitoring of all meals and snacks, etc. As the color levels progress during treatment from RED to YELLOW to GREEN to BLUE, the amount of supervision lessens and program independence increases. Cell phones are only allowed during scheduled break periods.
Q: Are there separate programs for different types of eating disorders or are patients integrated into one program?
A: Eating disorders are often considered a “spectrum” disorder meaning that disordered eating patterns can change over the course of time and treatment. Some anorexic patient could become bulimic at some point, and vise versa. Disordered eating patterns such as Binge-Eating Disorder (BED), Night Eating Syndrome (NES), and PICA can also occur along the eating disorder spectrum. While symptoms with each disorder may be unique, the underlying types of psychopathology for eating disorders often have common themes such as the concept of control. ED-180 integrates patients with different eating disorders into their programs for this reason unless there is good cause to not do so during the initial evaluation process. A great amount of therapeutic education is embedded into the ED-180 programs to build understanding and acceptance amongst the patient population.
Q: How many people are in the program?
A: The maximum size of a program group is 8 people to allow for more individualized attention and customization of the program schedule. This group size also allows for a safe environment for the therapeutic intimacy that takes place in the recovery process.
Q: What is a typical day like?
A: A typical day depends upon if a patient is enrolled in a full-day or partial day or evening program. The core components of a program day include supervised meals in our Mosaic Meal Rehabilitation (MMR) program, primary support and process group therapy, one or two therapeutic courses, and one or two therapeutic activities (a list of therapy groups, courses and activities is available online as well as sample schedules). There are periodic breaks and snack-times scheduled throughout the day as well as bathroom breaks. Occasionally, planned “excursions” are a part of the program such as going to the “campus deli,” to the food court at the mall or at a nearby restaurant as a part of the MMR program, or to go clothes shopping across the street to the mall as a therapeutic exposure activity. Patients are also often given “homework” to be completed outside of program hours.
Q: How do you deal with vegetarians and patients who have special diets due to their spiritual beliefs?
A: ED-180 does its best to accommodate dietary restrictions based on religion and cultural customs. Since there is a disproportionate amount of eating disorder patients who are vegetarians, the ED-180 team must approach each patient as an individual to assess whether or not their vegetarianism was a trigger or enables their eating disorder. This exploration process continues throughout the program and dietary adjustments are made accordingly.
Q: Do you treat patients with “duel diagnosis” and what is Addiction-180?
A: The ED-180 program does treat patients with a duel diagnosis (i.e. an eating disorder and a substance use disorder). Dr. Igal Rahmani, an addiction psychiatrist and Director of the Addiction-180 program, has his office on-site with our program and is active with the duel-diagnosed patients and treatment team. Some of our therapist also have extensive experience in the addiction field and play an integral role in the treatment of patients. The Addiction-180 program is currently a supporting program of ED-180 and offers its own supplementary groups and treatment plans.
Q: Do you work in conjunction with a patient’s outside treatment team?
A: When a patient schedules an ED-180 initial intake, we often depend on collateral information provided from a patient’s outside treatment providers such as medical history and therapeutic documentation of a patient’s treatment history. When a patient enters an ED-180 program, treatment providers may request, with the patient’s permission, to be provided with weekly updates of treatment progress. Approval to continue treatment as an outside provider while in an ED-180 program is usually not required but may be allowed on a case-to-case basis.
Q: What type of after care is offered to patients?
A: To protect the integrity of our referral sources, all patients who complete an ED-180 program are required to return to their original treatment providers for a minimum of 60 days unless otherwise agreed upon by their referring provider and discharged from their care. Patients who do not have providers required for their discharge plan may request referrals for outside treatment clinicians who have experience with eating disorder care. Every attempt will be made to find clinicians who are conveniently located and cost effective for proper care. Some patients may also want to supplement their aftercare plan by continuing in a non-ED-180 program therapy or eating group offered at our offices or through Health Team Members (HTMs).
Q: Will you have any family based groups where parents/spouses can participate?
A: Family “week” will occur monthly for parents, siblings and spouses. During this week there will be special groups for families and individual family sessions and attendance and participation is vital. Dates for these weeks will be given upon acceptance to the program.
Q: Are their parent support groups and other groups offered that do not require someone to be in an ED-180 or Addiction-180 program?
A: ED-180 will be offering a changing list of various support groups and programs throughout each year. Most groups consist of 10 weekly sessions, are paid for in advance and may be covered by out-of-network insurance. The cost of each group varies based on services provided and the staff running the group. In addition to general eating disorder groups, other groups will include a parent support group, a meal and yoga group, a mindfulness group, an addiction support group and others. These groups are not a part of an ED-180 program, are open to non-ED-180 clients and may be useful for patients who seek to compliment their current outpatient care. To receive updates about new groups forming please ask to be added to our email list and also visit the announcement section on the ED-180.com homepage.
Q: Do you accept insurance and/or offer a sliding scale or treatment scholarships?
A: Currently, the ED-180 programs are not on insurance panels but we do provide all the necessary documentation to receive reimbursement for patients who are entitled to “out-of-network” benefits. Furthermore, ED-180 will often negotiate for a “single case agreement” with an insurance provider for patients who require level 2 or 3 care. We are also in the process of working out agreements with a few of the major insurance companies to be an accepted out-of-network provider for patients with those companies. Our sliding scale policy is based on a demonstration of financial need based on 2 years tax returns and banking statements. When financial need is demonstrated and documented, scholarships may be awarded through Project HEAL (www.TheProjectHEAL.org).
Q: Are there special considerations for military veterans?
A: Any person, or their spouse or children, who has served overseas in the Middle East is likely entitled to full-scholarship treatment in an ED-180 program. It is our small way to say “thank you” and give back to you for all you have given to us. Please call the office manager for details.