--Adolescent program parent
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By, Dr. Mark Warren
The word “community” is used in many of our blog posts and can have various meanings for different people. An obvious community that exists is a community of eating disorder providers. At CCED, we work very hard to stay in good contact and good relationships with other eating disorder providers, the local community, and across the United States to ensure that we know what our colleagues are thinking, doing, studying, and experiencing.
The history of therapy has historically been one in which providers worked only from one specific perspective and were often unaware of advances happening in other parts of the field. By being part of a community of providers, we strive to make sure that wherever good work and good care is happening we learn about it so our clients can benefit from it. Our community continually develops through direct communication with other individual providers, hospitals, residential centers, and with patients who have participated in these programs. It also happens through regular attendance to conferences in the United States and around the world. CCED is also an organizational member of numerous eating disorder organizations so that we can stay current in the field.For patients and clients, the eating disorder community shares some things in common with the professional community. The relationship with the treatment center, program, or provider will help you obtain the information you need to make educated and important choices about your care. An issue that patients and their families unfortunately must confront is differences in treatment modalities among various providers. When these kinds of disagreements of philosophy occur, being able to trust a larger community of providers, patients, and families becomes critical. Most providers are giving you the best information they can based on the education they have. However, this does not necessarily mean they are as up to date or informed as they need to be. By reaching out to the larger community of other professionals, national organizations, and patients who have been through treatment, someone looking for care should hopefully be able to navigate conflicting information. The true community we would like for all of our patients is one in which they feel trusted, respected, understood, and are provided with the most excellent care, follow up, and support that they need to go on to lead the life they want to have.
Should you have any questions or comments regarding this post please email blog@eatingdisorderscleveland.org.
Contributions by Sarah Emerman
Join us Saturday, February 5, 2011, at the Dolan Center at John Carroll University for Nourishing the Artist Within, a fundraiser to benefit The Eating Disorder Network and The Fairmount Center for the Arts.
The benefit features our special guest speaker, Harriet Brown, author of Brave Girl Eating, and will honor Drs Laura Gillespie and Ellen Rome for their contributions to the treatment of eating disorders.
The benefit will also include a silent auction, remarks by Harriet Brown, an art gallery of works by clients from CCED, as well as other entertainment from The Fairmount Center for the Arts.
For questions regarding the event, or to purchase tickets please call (440) 338-3171 or email semerman@eatingdisorderscleveland.org.
Hope to see you there!
This letter was written by an adolescent who has gone through our day treatment program. It is published with her permission in hope that it will inspire others to move into recovery.
Dear Ed,
Let me just start off by saying I don't hate you, I actually sometimes still love you. I felt like you made me strong, confident, likable, and overall a better person. I thought you were my best friend, Ed. I thought you loved me, I thought you would take care of me. If you loved me, why did you try to kill me? Ed, why did you take a hold of me like a leach sucking the life out of me. How come you took everything away, leaving a disrespectful malnourished zombie? You have brought me into treatment far too many times, you have hurt me for the last time. In fact, Ed, I want to thank you, because you made me stronger. I know you thought that you would control me, take over me over and over again after treatment. I promise you that I am learning more and more each day, learning that there are better things than starving myself. I will live my life and prosper like a stronger individual.
Should you have any questions or comments regarding this post, please email blog@eatingdisorderscleveland.org.
Sadly, we want to return this week to a topic we have blogged on before, the lethality of eating disorders, in particular anorexia. We know the outset that current data suggests that all eating disorders are lethal and that none should be seen as less serious than any other. The statistics are staggering, as many as 20% of those suffering from anorexia will die from the illness or suicide. The death last week of Isabelle Caro, who featured prominently in an anorexia awareness campaign, comes as a stark reminder of the seriousness of eating disorders and of the absolute necessity to get the best possible care. It also equally highlights that even with progressive care these illnesses may prove fatal. As we think about the sadness of Ms. Caro's life and the illness that consumed her we also want to reflect on what this means for all of us as professionals, individuals who suffer from eating disorders, family members, and friends.
For individuals, families, and friends, it has to underscore how very hard these illnesses can make one’s life and how important the struggle is to keep trying to get better. Our notions of what is healthy, what is okay, what we can do to help ourselves and to help others, must be constantly open and moving forward. We must always look to see if there is something more we can do, even if we are trying as hard as we possible can.
For professionals, we see that even at the best of our knowledge, at the best of our awareness, at the best of our understanding and practice, we still do not have anything close to all the answers. Even when a treatment is 50%, 60%, or even 80% effective it means there will be a large number of people who suffer and who are not moving into recovery. We are challenged to continually ask ourselves if our assumptions are right, if our treatments are enough, and if there is more we could be doing. Anyone who suffers from an eating disorder deserves the absolute best care that exists and all of us in the field need to work harder to come up with better and more effective treatment, so that there will be less suffering and fewer deaths.
For more information about anorexia nervosa, click here.
At CCED, our focus is to provide care to clients both in our local community and those who may benefit from Dialectical Behavioral Therapy and Maudsley Family Therapy. In both cases patients live at home or with family while they are receiving care with us. It is our experience for the large majority of patients with eating disorders that care can be provided in the outpatient setting with a high degree of effectiveness. However, in some situations higher levels of care including residential and inpatient treatment are necessary.
For patients that require this care, choosing which facility to use becomes extremely important and may be quite complex. To make this decision there are several factors that may be considered. For almost everyone, insurance will be an issue. Residential care is usually quite costly and access to insurance coverage to help off set the cost is one of the single greatest factors in choosing which facility you will use. In addition to cost, questions of which type of care is going to be the most effective is also a core issue. For adolescents, given CCED’s orientation to Family Based Treatment, our tendency is to favor those programs that have as much family involvement as possible during the residential or inpatient stay of your child. We also give preference to programs that stress weight gain when necessary, extinguishing behaviors, and development of balanced eating patterns that can be continued after discharge. For adults, CCED will refer to programs that fully incorporate evidence based care, including CBT and DBT. We recommend facilities where the primary emphasis is on the need to gain appropriate weight if needed, and stop life threatening behaviors. We have had experience with referrals to multiple residential centers, and if it seems that residential care is needed, specific recommendations can be made.
For some patients, inpatient care followed by partial hospitalization may be preferred to residential care. Usually the factors that drive inpatient rather than residential are medical complications, and/or the need to be medically monitored during stages of refeeding.
For all patients, our belief is that the establishment of balanced eating patterns, gaining weight appropriately, and extinguishing eating disordered behaviors are the core of achieving long term success and recovery from an eating disorder. Good residential and inpatient care is sometimes an important step in this recovery process.
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