Exploring  Intensive  Outpatient  Treatment  Options  

For  patients  struggling  with  an  eating  disorder,  realizing  that  they  no  longer  have  control  over  their  thoughts,  behaviors  and  general  health  can  be  difficult.  Perhaps  more  difficult  yet,  however,  can  be  the  exploration  of  eating  disorder  treatment  at  an  intensive  level  of  care,  as  it  requires    some  degree  of  disruption  in  one's  daily  life  and  routine.    

Karen  Trevithick,  PsyD,  Eating  Recovery  Center’s  Clinical  Director  of  Outpatient  Services,  often  observes  this  conflict  among  individuals  considering  a  higher  level  of  care,  and  she  acknowledges  the  difficult  task  of  the  professional  working  with  this  eating  disordered  patient.    

“Professionals  must  manage  the  competing  tensions  between  their  patient’s  awareness  that  his  or  her  illness  interferes  with  daily  life  and  their  fear  that  treatment  might  disrupt  their  personal,  professional  and  social  lives,”  explains  Dr.  Trevithick.  “Understanding  the  function  of  outpatient  treatment  for  eating  disorders  and  for  whom  it  is  appropriate  can  help  healthcare  professionals  ease  patients  into  this  higher  level  of  care,  which  often  represents  an  integral  step  toward  lasting  recovery.”  

Outpatient  programs  offer  comprehensive  eating  disorders  treatment  options  with  the  goal  of  teaching  the  skills  necessary  for  sustainable  recovery.  Administered  in  a  flexible  setting  by  a  team  of  psychiatrists,  registered  dieticians,  family  therapists  and  individual  therapists,  an  increasingly  common  delivery  of  outpatient  treatment  is  the  Evening  Intensive  Outpatient  Program  (EIOP).  EIOP  involves  a  few  hours  of  intensive  outpatient  programming  three  evenings  per  week  and  allows  patients  to  work,  go  to  schoolor  care  for  children  during  the  day  and  sleep  at  home  at  night,  and  can  be  a  meaningful  next  step  in  a  patient’s  treatment  continuum  or  a  valuable  adjunct  to  individual  therapy.  

While  all  patient  cases  are  unique  and  require  individual  consideration  within  the  context  of  general  evaluative  criteria,  candidates  for  EIOP  treatment  are  generally  characterized  as:  

• Having  healthy  systems  of  support,  including  supportive  friends,  family  and/or  colleagues;  • Not  being  medically  compromised  by  their  eating  disorder;  and  • Not  exhibiting  overwhelming  symptoms  of  depression  or  anxiety.    

 Furthermore,  EIOP  is  particularly  effective  in  helping  patients  confront  common  “triggers”  for  harmful  thoughts  or  behaviors  related  to  their  eating  disorder,  including:    

• Challenging  and  confronting  daily  patterns—EIOP  provides  a  safe,  supportive  environment  for  patients  to  address  behaviors  and  feelings  relating  to  destructive  daily  patterns—including  struggles  with  disordered  eating  patterns,  complete  weight  restoration  or  fully  connecting  with  relationships  and  experience—which  is  critical  to  lasting  recovery.    

• Addressing  stressors  or  crises  when  they  arise—Stressors  or  crises  in  a  patient’s  life  have  the  potential  to  derail  recovery.  EIOP  can  provide  the  structure  and  support  necessary  to  help  patients  confront  and  manage  these  unanticipated  challenges  that  emerge  on  the  path  to  lasting  recovery.  

• Stepping  down  from  a  higher  level  of  care—EIOP  can  help  to  foster  a  positive  transition  into  activities  of  daily  living  for  adults  returning  from  facilities  providing  a  higher  level  of  care,  including  intensive  inpatient  and  partial  hospitalization  programs.    

“Because  EIOP  is  a  group-­‐  and  skills-­‐based  program,  it  offers  an  excellent  treatment  option  for  men  and  women  who  would  benefit  from  intensive  recovery  services  while  remaining  engaged  in  their  daily  lives,”  says  Dr.  Trevithick,  who  encourages  professionals  exploring  treatment  options  with  patients  to  start  a  dialogue  about  the  role  the  eating  disorder  has  played  in  his  or  her  life.  “By  identifying  data  that  shows  how  disruptive  an  eating  disorder  has  become  and  taking  a  firm  yet  compassionate  stance,  you  can  help  ease  an  individual  into  the  recovery  process,  enabling  patients  to  truly  feel  successful  in  their  lives  again  –  or  to  honestly  feel  success  for  the  first  time.”