Determining Levels of Care for Individuals with Eating Disorders
At The Emily Program, we are committed to providing exceptional care across a continuum of levels, ensuring every client receives treatment that addresses their unique needs. This personalized approach takes into account the psychological, nutritional, and medical aspects of eating disorders to help clients lay a solid foundation for long-lasting recovery.
Understanding the Levels of Eating Disorder Care
The Emily Program offers a continuum of eating disorder care levels in order to ensure our clients have the support they need throughout their entire treatment experience. We conceptualize these levels of care as a ladder, with each rung representing a different degree of support. The top rung of the ladder is residential treatment, which includes around-the-clock supervised care, and the bottom rung is outpatient, or non-intensive eating disorder treatment. Progressing step-by-step down the ladder is crucial for optimal treatment success, as skipping down levels can weaken treatment outcomes. However, individuals can always go up a level for additional support if needed.
Outpatient care is the lowest level of care at The Emily Program. Outpatient treatment is typically recommended as a starting point for individuals who require non-intensive support or for those transitioning down from a higher level of care. Outpatient treatment takes place in-person or virtually. Treatment may include individual therapy, nutrition counseling, medical or psychiatric interventions, and group or family-based therapy (FBT).
During individual outpatient sessions, clients engage in personalized meetings with a therapist, dietitian, psychiatrist, and/or physician. The specific type and frequency of these individual sessions are determined by the client’s unique treatment plan, with the goal of moving forward in the recovery process. Clients may also join therapeutic and skill-building groups, such as cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT) skills training, eating disorders and substance use disorder recovery, or families supporting families, as part of outpatient care.
Intensive Outpatient Program (IOP)
The Emily Program offers intensive outpatient treatment (IOP) for individuals who need more intensive support and intervention than traditional outpatient care affords. IOP is offered both virtually and in-person, a minimum of 12 hours per week. These sessions incorporate similar components as outpatient care but at a greater frequency and intensity. A benefit of IOP is that clients can practice the recovery-supporting skills they learn with their loved ones in their real-life settings.
Additionally, staff-supervised and shared therapeutic meals are included in the program, which address clients’ relationships with food and provide support during the actual eating experience.
Partial Hospitalization/Intensive Day Program (PHP/IDP)
Our partial hospitalization/intensive day program (PHP/IDP) is for clients stepping up or down from a different level of care, as well as individuals entering treatment who do not need 24/7 support, but do require a higher level of care than outpatient or IOP provide. Both in-person and virtual PHPs/IDPs require a minimum of 30 hours per week and include two therapeutic meals and snacks each day.
PHP/IDP provides intensive interventions such as skills-based group therapy, individual therapy sessions, expressive arts, individual nutrition sessions, psychiatry and medical services, and more. As with IOP, an important aspect of PHP/IDP is that it enables clients to practice recovery skills in their everyday environment with their personal support systems.
The Emily Program offers residential care for individuals who need 24/7 support, supervision, and medical, nutritional, and therapeutic intervention. Clients at this level are medically stable but require continual structure to manage their disordered behaviors. Residential clients develop skills and coping methods to use as they transition into lower care levels, all with the support of their multidisciplinary care team. Interventions such as individual, group, and family therapy, nutrition education, psychiatry and medical services, culinary and mindfulness training, and more are used to address the full range of eating disorders and related health issues.
Determining the Appropriate Level of Care
Once an individual, caregiver, or provider has reached out, our admissions team schedules a comprehensive eating disorder assessment with the individual in need of care. This assessment allows us to gather important information about the individual’s needs and offer an informed recommendation for the level of care. Our recommendation is tailored to the client and incorporates clinical expertise, best-practice evidence, and client preferences and access to treatment. Determining the appropriate level of support for each client is key to a successful treatment experience.
Our care recommendations are informed by years of evidence-based research and extensive clinical work in the field. We incorporate recommendations from the American Psychiatric Association (APA) and the REDC Consortium (REDC), considering factors such as:
- Medical instability
- Frequency of symptoms and the client’s ability to decrease or stop eating disorder and weight control behaviors without meal support or monitoring
- Nutritional intake
- Co-occurring conditions that may require a higher level of care
- Level of motivation to recover, including insight, cooperation with treatment, and willingness to engage in behavior change
- Percentage of natural body weight or degree of weight change
- Indicators suggesting the need for inpatient psychiatric treatment and stabilization, such as significant suicide risk
- Lack of response or deterioration in the client’s condition while receiving outpatient treatment
- The recovery environment and the extent and accessibility of support systems
- Logistical factors such as geographical and insurance considerations, transportation barriers, and school, work, and childcare needs
Successful eating disorder treatment is not one size fits all. At The Emily Program, our comprehensive range of treatment levels and our passionate multidisciplinary team of experts allow us to meet clients where they are, and support them every step of the way forward.