Levels of Care in Eating Disorder Treatment

Once you, your loved one or your client has been diagnosed with an eating disorder things can get overwhelming quickly. Contributing to this overwhelm is ensuring you are getting the "right care" and doing everything you can to ensure a safe and swift recovery. Unfortunately, for many, the recovery trajectory may have significant ups and downs and understanding the options and indications for levels of care at different points in the

process is an important component to alleviating some of the stress. This post will describe in brief detail the various levels of care and when each may be utilized. The diagnosing therapist, physician, or dietician will collaborate together and with the family and/or client to create a safe and appropriate treatment plan. While it may start at one "level" this is closely monitored for progress and stepping up and down is common in the recovery journey depending on their current medical and psychological status. Eating disorder treatment typically involves a range of levels of care, depending on the severity of the disorder and the needs of the individual.

The levels of care typically include:

• Outpatient Care

  This level of care generally involves regular therapy sessions with an eating disorder professional, such as a therapist, counselor, or psychologist, and is typically recommended for individuals with mild to moderate symptoms of an eating disorder. Outpatient care is appropriate for individuals who are able to maintain their physical health and safety while living at home and participating in their daily activities. Treatment sessions are often held on a weekly basis and can include different therapies such as cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), or family-based therapy (FBT). Nutritional support with a registered dietician skilled in eating disorder treatment is often included as well as regular visits with the individual's physician to monitor medical status and progress toward recovery.

• Intensive Outpatient Program (IOP)

  IOP is a level of care that falls between traditional outpatient therapy and more intensive programs such as partial hospitalization or residential treatment. IOP programs are typically more structured and focused on addressing the specific needs of individuals with eating disorders and typically include individual therapy sessions, structured group therapy and groups meals with subsequent emotional processing. They may also include medical monitoring, nutrition education, and additional meal support. IOP may be an appropriate level of care for individuals who are medically stable, but still require a higher level of support than traditional outpatient therapy. It may also be appropriate for individuals who have completed a higher level of care, such as inpatient or residential treatment, and need additional support as they transition back to their daily lives.

• Partial Hospitalization Program (PHP)

  This level of care involves a more intensive treatment program that typically lasts for several hours each day, usually five to seven days a week. It is typically recommended for individuals with moderate to severe symptoms of an eating disorder who require more intensive treatment than what can be provided on an outpatient basis, but are able to return home after each treatment session. The program usually includes group therapy, individual therapy, and meal support and monitoring. There is often a physician available 24/7 or on-site as closer medical monitoring may be indicated. It can be difficult to continue going to work or school with many PHP programs.

• Residential Treatment Center (RTC)

  This level of care involves living in a treatment facility for an extended period of time, typically several weeks to several months. Residential treatment is typically recommended for individuals with severe symptoms of an eating disorder who require a highly structured and intensive treatment program in order to stabilize their physical and emotional health. They may be suffering from co-occuring mental or physical illness that require more medical interventions and monitoring. The program includes round the clock medical care, nutrition education and support, individual, group and family therapy, and daily activities such as grocery shopping, meal preparation, experiential groups and movement.

• Inpatient Treatment

  This level of care involves being hospitalized and getting around the clock medical care and is recommended for individuals with severe and life-threatening symptoms of an eating disorder such as severe malnourishment, electrolyte imbalances, or cardiac complications. It is used for for both medical and psychiatric stabilization and choice of where to hospitalize can be difficult as specialized medical facilities may be hard to find or have waiting lists. Inpatient treatment is the most intensive level of care for eating disorders and can help stabilize individuals who are in immediate danger.

• Aftercare

  This level of care is designed to provide ongoing support and follow-up after the completion of a more intensive treatment program, such as residential or inpatient treatment. Aftercare can include regular therapy sessions, support groups, and check-ins with a treatment team to ensure that the individual is maintaining progress and preventing relapse. It is similar to outpatient care and is not necessarily a specific "level" but placed here to highlight the importance of continued monitoring and care.

• Telehealth

  With the recent advancements in technology, telehealth has become an increasingly popular option for eating disorder treatment. It is outpatient care at various levels that can be done remotely, through video conferencing, phone or messaging. Utilization of remote patient monitoring and blind weights is an ideal component. While it may not be optimal for everyone, it increases access to specilialized care which can ultimately improve outcomes for patients.

When selecting the appropriate level of care for eating disorder treatment, it is important to consider several factors such as the individual's symptoms, physical health, and support system. A treatment team, most often composed of a physician, therapist, and dietitian, can help determine the most appropriate level of care based on the individual's specific needs. The team will also consider the individual's history of treatment, the type and duration of the eating disorder, as well as the individual's readiness for treatment or recovery. It is also important to note that individuals may move between levels of care as their symptoms and needs change over time. It is essential to have a continuous and comprehensive care plan that is tailored to the individual's needs and goals and that there is clear and consistent communication between team members and the client.

For additional information on levels of care please see:

https://www.psychiatry.org/Psychiatrists/Practice/Clinical-Practice-Guidelines#section_0

Academy of Eating Disorders:https://www.aedweb.org/resources/about-eating-disorders/treatment-options

To find a professional in your area please see:

https://www.aedweb.org/expert-directory

https://www.edreferral.com/home

To learn more about eating disorders consider tuning in to my upcoming free lecture or reach out to me directly.

https://doctorsonsocialmedia.com/eating-disorder-recognition-and-mismanagement-for-physicians/