At CCED, we are truly committed to providing clinically proven treatment and care for individuals of all ages suffering from Eating Disorders such as Anorexia and Bulimia. We encourage you to Speak with our Trusted Specialist.
Please take the time to browse our Website and further educate yourself using these links: Anorexia Nervosa, Bulimia Nervosa, EDNOS, Binge Eating Disorder, Treatment Options and Resources, and to answer your questions, such as Why does an eating disorder happen? Where can I find information for parents of Children and Adolescents with an ED? Where can I find Information for parents of Adults with an ED? Did I Cause my Child’s Eating Disorder?
What do I do if I think I have (or my loved one has) an eating disorder?
The realization that you or a loved one may have an Eating Disorder can be scary and bewildering. An Eating Disorder may first be recognized by sustained and substantial weight loss with noticeable changes in eating habits, which is the case of anorexia nervosa . Bulimia nervosa does not always result in a drop in weight, but instead is recognized when the purging or other compensatory behaviors (vomiting, use of laxatives, extreme exercise) feels out of control, or when binges become uncomfortable physically, economically or socially. It is useful to remember, however, that many Eating Disorders do not fit neatly into these general descriptions of either anorexia nervosa or bulimia nervosa.
If you are worried about yourself or a loved one, the first step is to ask for help. For many people, this will mean calling a local Eating Disorders clinic, such as Cleveland Center for Eating Disorders (216-765-0500), where you will be able to arrange an assessment with a qualified clinician who will then guide you in the process of identifying an appropriate treatment plan.
If you are under the age of 18, or otherwise dependent on your parents/guardians you will probably need to ask them for help first. It will also be very important to seek medical guidance. If possible, find a medical professional in your area who has specialized training in Eating Disorders. If you are in the Northeast Ohio area, CCED will be able to provide you with appropriate referrals.
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Did I cause my child’s Eating Disorder?
The short answer to this question is: NO. There are many theories, which seek to explain why, and how an Eating Disorder develops. The Cleveland Center for Eating Disorders treatment philosophy is based on a biosocial theory of development. Generally speaking, this theory suggests that multiple factors may play a role in the development of an Eating Disorder.
Biologically, research evidence suggests that Eating Disorders are genetically based, and thus ‘pre-wired’. Psychologically, some individuals may have a temperament, which makes them more susceptible to development of an Eating Disorder. Finally, if genetics are the predisposing factor, the social environment can be viewed as the ‘trigger’ in the development of an Eating Disorder. This means that while an individual may have genetics and perhaps temperament that predisposes them to an Eating Disorder, there is generally some trigger within the social environment, which causes the Eating Disorder to manifest. This trigger may be, for example, an ill-placed comment from peers or family members, an increased amount of stress, media-based exposure, or well intentioned education about ‘health’. Often the trigger is never known. Thus, generally speaking, there is no single cause, which may be held responsible for an Eating Disorder.
Some theories do unfortunately place blame with parents. At the Cleveland Center for Eating Disorders, we do not ascribe to those theories. Instead we believe that family is central to the recovery process. Our Maudsley Approach to treatment for adolescents relies on the involvement of parents as treatment team leaders, and individuals in our adult program are encouraged to include family members in their treatment process.
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Why does an Eating Disorder happen?
There are many theories, which seek to explain why and how an Eating Disorder develops. The Cleveland Center for Eating Disorders treatment philosophy is based on a biosocial theory of development. Generally speaking, this theory suggests that multiple factors may play a role in the development of an Eating Disorder.
Biologically, research evidence suggests that Eating Disorders are genetically based, and thus "pre-wired". Individuals with Eating Disorders often have a family history of an Eating Disorder, Depression, Anxiety, or Obsessive Compulsive Disorder. When considering this possibility in your family, keep in mind that the medical/psychological diagnosis of Eating Disorders was not commonly known or used until the 1970s.
Psychologically, some individuals may have a temperament which makes them more susceptible to development of an Eating Disorder. For example, individuals may often be able to identify as perfectionists and may also have a difficult time understanding or experiencing their emotions.
Finally, if genetics are the predisposing factor, the social environment can be viewed as the "trigger" in the development of an Eating Disorder. This means that while an individual may have genetics and perhaps temperament which predisposes them to an Eating Disorder, there is generally some trigger within the social environment which causes the Eating Disorder to manifest. This trigger may be, for example, an ill-placed comment from peers or family members, an increased amount of stress, media-based exposure, or well intentioned education about "health". Some triggers may be cumulative, that is occurring over a period of time, and other triggers may be discrete events.
There is no hard and fast rule about what qualifies as a trigger for an individual. Contrary to commonly held theories, an Eating Disorder is not a "diet gone bad" and is not typically linked with overly-controlling parents, or a history of sexual abuse.
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How do I get treatment?
The first step in getting treatment is contacting an Eating Disorder treatment center in your area. You may contact the Cleveland Center for Eating Disorders at 216-765-0500 or at info@edcleveland.com, and request information. Individuals seeking help at the Cleveland Center for Eating Disorders will be required to attend an assessment with a qualified clinician who will provide you with an accurate diagnosis if one applies, and who will guide you in building an appropriate treatment plan.
If you are not in the Northeast Ohio area, you may call for information on recommended eating disorder treatment centers in your area, or use the following websites: http://www.joyproject.orgor http://www.behavioraltech.org/.
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What Will My First Assessment/Visit Be Like?
At the Cleveland Center for Eating Disorders, you will be assessed by a qualified clinician at your first appointment. Generally speaking, during this assessment, you will be asked to describe the history of behaviors which you are concerned about. This may include: weight loss or gain; a drastic change in eating habits, quantities, or types of food; increasing focus or obsession with exercise, frequency of purging (voluntarily throwing-up food), use of laxatives, social isolation or withdrawal, and changes in work/school habits or ability to concentrate. Other important information to include might be a family history of mental disabilities, prior mental health treatment history, important medical history, and recent stressors or changes to the social environment.
If you are a minor attending with your parents, you (the minor) will speak with the clinician alone, followed by your parents. At the close of the assessment, the clinician will discuss the most appropriate treatment options for you. Based on your treatment needs and questions, you may be introduced at this time to other CCED staff. Also, you will be given a sheet for your medical doctor with instructions about lab tests and records we require for admission to our treatment program.
Finally, if you agree to engage in treatment at CCED, you will be asked to sign documents, including treatment fee agreements and “releases of information” in which you specify to whom we are legally allowed to release your treatment information.
The assessment usually lasts about 90 minutes. We at CCED understand that this is a scary and vulnerable time, and that you may have many questions and uncertainties. Our clinicians will work to conduct the assessment in a supportive and caring manner, and will work with you to help you understand the assessment, diagnostic, and treatment processes.
Finding the right treatment center for you can seem incredibly difficult. The Cleveland Center for Eating Disorders prides itself on being the only Northeast Ohio eating disorder treatment center to offer only evidence-based treatment programs. This means that all our treatment programs are designed around what scientific research shows us works.
At the core of our program are three treatment methods: Dialectical Behavioral Therapy (DBT), Cognitive Behavioral Therapy (CBT) and the Maudsley Approach. We believe that our use of these methods in particular sets us apart as treatment providers. Further, we provide eating disorder group therapy, family therapy, and individual therapy services, which all occur under the guidance of a treatment team. This allows all clinicians to be supervised and supported in a team-based environment on a twice-weekly basis, which means that all treatment decisions are guided by the team and not the individual clinician.
Our adolescent and adult teams are comprised of the medical and clinical directors of CCED, the therapists and dietitians who work with the clients. However, we understand that our services may not meet the needs of everyone in the Northeast Ohio area. If this is the case, we will gladly provide you with an appropriate referral. If you do not live in the Northeast Ohio Area, we recommend that you use the following websites to find treatment programs in your area: http://www.behavioraltech.org/, http://www.joyproject.org/, http://www.maudsleyparents.org/. We have also worked with those from outside Northeast Ohio who have chosen to stay here to obtain treatment.
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How Do I Know I Am Asking for the Correct Level of Care?
Understanding the various levels of care available for Eating Disorders treatment can be confusing. To start, the term “Level of Care” is a clinical term, which essentially means “the most appropriate plan of treatment in the least restrictive setting possible”. This term will be important not only for yourself, but also for helping your insurance company to determine your benefits. There are many levels of care available clinically for treatment of an Eating Disorder: meal support, support groups, individual counseling, family counseling, group counseling, intensive outpatient treatment (IOP), day treatment/partial hospitalization (DTP/PHP), residential treatment, and inpatient treatment.
At this time, CCED offers care at the meal support, individual, family, DTP therapy and IOP levels of care. If you require a different level of care, we will make an appropriate referral following your assessment appointment. The clinician conducting your assessment will make a Level of Care recommendation based on your individual needs and treatment history, taking into account our clinical experience in treating Eating Disorders.
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What if I Have Not Successfully Treated My Eating Disorder in the Past?
Like anxiety or depression, an Eating Disorder is a mental disorder, which most people will be at risk for a lifetime. Our treatment at CCED is designed to support individuals in the process of regaining mental, emotional, and physical strength so that they may learn and use skills to control their Eating Disorder that will be of use for a lifetime. These skills are taught in the format of Dialectical Behavioral Therapy (DBT) and Cognitive Behavioral Therapy. In particular, DBT therapy was developed to treat the most difficult clients who had experienced minimal success in other mental health treatment formats.
Many of our clients have a history of working on recovery from their Eating Disorder, and thus, as clinicians we are experienced with this population. We believe that treatment of this disorder is a process, as is recovery, and that individuals may need varying levels of support throughout their recovery.
We welcome all individuals, from those newly diagnosed to those who have been working towards recovery for many years. We will work to build a treatment program, which will adapt to your individual needs. And, even if you feel you have been unsuccessful in the past, we will not give up on you now.
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How Long Does Treatment Take?
Typically speaking, treatment can be seen to occur in two main stages: acute and on-going. At the Cleveland Center for Eating Disorders, the acute stage will comprise the periods of weight restoration and re-gaining control of behaviors. This often occurs in the setting of the adolescent/adult Day Treatment Program and the Intensive Outpatient Program (programming).
For both adolescents and adults, clients who enter these programs will be in group for a minimum of two weeks; four to six weeks in DTP therapy and another two to four weeks in IOP would be typical. However, the eating disorder treatment team will make clinical recommendations for duration of DTP therapy and IOP based on individual treatment progress and needs.
Clients who do not require a DTP/IOP level of care, or are in an on-going treatment stage will require varying lengths of treatment, ranging from a "booster" to refocus the continuing recovery process to on-going long-term individual counseling. All decisions regarding treatment length are made by the client and their therapist, in conjunction with the recommendations of the treatment team.
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How Will I Pay for Treatment?
The Cleveland Center for Eating Disorders attempts to work with all insurance payers. During the assessment process, CCED will contact your insurance company to identify your plan benefits. In most cases, we are able to form a "Single Case Agreement" with insurance companies with whom we do not have a standing contract. This essentially is an agreement by an insurance company to cover a portion of service cost (usually in the range of 80-90%), which will be reimbursed to you the client. We are able to develop a single case agreement with many managed care programs sponsored by Medicaid.
At CCED we have endeavored to provide the highest quality of care at the lowest reasonable cost.
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What if I Do Not Live in Northeast Ohio?
Many of our clients travel 1-2 hours each way to attend treatment services at CCED. However, if you are not within a daily travel range, Ronald McDonald House might be an option. Adolescents and their parents are able to stay at the Ronald McDonald House located adjacent to the Cleveland Clinic Foundation Main Campus, while they are in our treatment program. Unfortunately, the Ronald McDonald House is not an option for adults seeking treatment.
There are several inexpensive hotel options in the immediate vicinity. If you require services outside of the NE Ohio area, please do not hesitate to contact us at either 216-765-0500 or info@edcleveland.com for some referral ideas. Alternatively, the following sites may offer help: http://www.behavioraltech.org/, http://www.joyproject.org/, http://www.maudsleyparents.org/.
We believe that a strong eating disorder treatment program will incorporate the Maudsley Approach for adolescents, and will use Dialectical Behavioral Therapy in a team setting. We encourage you to work to identify a treatment setting that would include these formats.
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