When deciding on a client’s level of treatment for an eating disorder many factors come into play. Following are the five levels of care and a break down of how a person may qualify for each.
Inpatient is the highest level of care available, and it is reserved for those who are deemed medically or psychologically unstable.
A medically unstable person has:
- Volatile vital signs
- Lab results that put the patient at possible acute health risk
- Complications from a separate medical condition that is occurring at the same time
Psychological instability is identified as:
- Suicide risk without a safety agreement
- Symptoms which are becoming increasingly worse
In inpatient hospitalization, the focus is solely on getting the patient stable enough to go to a residential treatment facility. Therapy is not provided at this level. Typically, people at this level are too neurologically compromised to process therapy, so it is deemed ineffective.
To qualify for residential treatment, typically you would
- Require supervision for all meals
- Have eating disorder behaviors that are out of control (ie. restriction, purging, binging, exercising, etc.)
- Need 24 hour care, but medically stable
- Depending on the type of eating disorder, require weight restoration
Residential treatment takes place in various settings, from a facility that looks like a home to a modified hospital setting.
Partial Hospitalization Program
Partial hospitalization program (PHP) is also known as Day Treatment. It is exactly what it sounds like; you would spend your days at the treatment facility, but sleep at home. At this level of care, you may still have a
- Preoccupation with intrusive thoughts
- Need for structure, but not 24-hour care
PHP programs are 5-7 days/week, 8-11 hours/day, depending on the treatment facility. During the day, you will spend your time in individual and group therapy settings with counselors, dietitians and family therapists. You will also eat supervised meals and snacks.
Intensive Outpatient Program
An Intensive Outpatient Program (IOP) is for those who have
- Higher levels of motivation
- Need some meal support
- Require some structure to work on eating disorder behaviors
IOP is usually 2-3 days/week for 3 or more hours/day. Most clients can continue with some level of work or schooling while at this level and will sometimes work with their outpatient therapist and dietitian while doing group and family therapy at the treatment center.
In an outpatient setting, you are living at home and working with a treatment team made up of a counselor, dietitian and physician. Together they will coordinate care. You can typically expect to see your therapist 1-2 days/week for an hour at a time, the dietitian for weekly sessions, and occasional doctor visits.
To qualify for outpatient therapy, you will probably
- Be medically stable
- Not be suicidal
- Have a fair amount of motivation
Everybody is different
Every person is different, and the break down above may not work in every case. It is a guideline that is used by eating disorder professionals to assess for appropriate care, but exceptions might be made for varying reasons.
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