Eating Disorder Partial Hospitalization Program

February 14, 2019 | Alcohol Addiction , Drug addiction

Eating disorders can be challenging to treat. Traditional outpatient therapy may not be effective because of the deep emotional issues that often contribute to eating disorder behaviors. Many patients require more intensive care, such as eating disorder partial hospitalization programs (PHPs).

What is Partial Hospitalization?

Partial hospitalization allows you to participate in individual and group therapy while still living at home. If necessary, you will typically also participate in family therapy and nutritional counseling.

The length of PHP treatment varies based on the patient’s needs. Some patients may only need a few weeks of PHP care before returning to traditional outpatient psychiatry therapy. Other patients require PHP care for several months or years after completing inpatient treatment.

Partial hospitalization is necessary for the most severe anorexia, bulimia, or binge eating disorder. When patients cannot care for themselves due to low weight or other medical complications, this type of intensive therapy may be required.

Types of Eating Disorder Programs

There are two different types of eating disorder partial hospitalization programs.

Intensive Outpatient Program (IOP)

An intensive outpatient program is often the first step in treatment for many patients with less severe eating disorders. This type of PHP care usually requires between 3 and 6 hours per day of therapy, typically spread out over five days each week. Patients must attend all sessions, but they can go home between them.

Outpatient Care

Patients with less severe eating disorders may only need outpatient care after completing an intensive program. This type of PHP care typically requires 3-4 hours each week that the patient participates in group and individual therapy sessions at the facility. The rest of the week, patients are free to go about their daily activities as they usually would.

In general, those hospitalized before will typically benefit from outpatient treatment after leaving a hospital setting. This gives them a safe environment to continue their recovery without worrying about being discharged too early or going back home before they are ready.

While it is essential to have enough support before inpatient to outpatient, it is equally important to remember that some people need more time in treatment. This means hospitalization may be necessary for some; however, partial hospitalization can give them the essential skills before transitioning back into their routine while still staying safe.

The Benefits of Partial Hospitalization

With proper nutrition and counseling, the body can recover from an eating disorder. But even when you’ve recovered physically, emotional issues may still need to be addressed by a mental health professional. Eating disorder partial hospitalization programs (PHPs) can help you learn better-coping skills and communicate more effectively with others. This type of care gives patients the support they need without taking up all their time or interfering with their daily lives.

What are Partial Hospitalization Program Services?

A Partial Hospitalization Program can vary from the treatment facility to treatment facility. Some of the most common components in an eating disorder partial hospitalization program include:

Individual Therapy

Partial hospitalization is considered individual therapy, not group therapy. Patients will meet with an eating disorders specialist for approximately three to five hours per day. Some of the topics covered include:

Nutritional Counseling

Patients learn about healthy eating and how to manage their diet to get on the road to recovery. Since nutrition is crucial for malnourished patients, this component is critical.

Psychiatric Evaluation

During an eating disorders partial hospitalization program, patients are evaluated by a psychiatrist to determine the best medication plan.

Family Therapy

Since family plays such an integral part in recovery, family therapy is often included in an eating disorder partial hospitalization program. This allows families to take part in the patient’s treatment. Patients are encouraged to have their family members in therapy as much as possible.

Group Therapy

Eating disorders partial hospitalization programs will often include group therapy, but it won’t be the only type of therapy offered. This is a less intense form of treatment and can help boost confidence and allow patients to feel more comfortable opening up about their eating disorder struggles.

Outpatient Visits

Patients might also have outpatient visits as part of their eating disorder partial hospitalization program. Outpatient visits can be doctor’s appointments or therapy sessions with a different therapist from the one treating them during the partial hospitalization portion of their plan.

What Causes Eating Disorders?

Many different factors can cause eating disorders. They might be related to body image, or they might be a way to escape from stress or pain. Sometimes, they’re caused by genetics or even side effects of another condition, such as depression.

Body Image

Strict rules about body image can be damaging, especially when they involve not eating or undereating to lose weight.

Social Influences

Personal problems don’t always cause eating disorders; they can also be caused by outside influences, such as social pressure.

Psychology and Genetics

An eating disorder may be hereditary or psychological factors that can lead to an eating disorder.

Physical Conditions

Sometimes, a physical condition might cause an eating disorder. For example, someone with diabetes may not eat certain foods or carbohydrates because of their illness. This can lead to feelings of stress and depression that trigger the development of an eating disorder.

Common Eating Disorders

Anorexia

Anorexia is an eating disorder in which the patient severely limits their food intake and might even avoid eating altogether. This causes them to become extremely thin and malnourished. It’s a severe condition that can cause multiple health problems if left untreated, including organ failure, bone density issues, and malnutrition.

Some of the Signs and Symptoms of Anorexia included:

  • Refusing to eat because you fear gaining weight.
  • Restricting your diet to an extreme degree.
  • Obsessively counting calories or fat grams to make sure you stick to a specific dietary plan.
  • Focusing on food all the time, including constantly thinking about what you will eat next and making excuses to avoid eating.
  • Wearing loose clothing or refusing to eat around other people hides the physical effects of what you’re doing and how little you’re eating.
  • Feeling guilty about food and hating your body.
  • Use laxatives, diuretics, excessive exercise, vomiting, or fasting as a means of controlling your weight.
  • Frequently dieting even after you have reached a healthy weight.

Bulimia

Bulimia is a disorder in which patients eat large amounts of food, usually junk food, and then purge it from their system. This can involve making themselves vomit or taking excessive laxatives. It’s also a severe illness with many adverse side effects on the body, including damage to the esophagus and stomach lining.

Some of the signs and symptoms of bulimia include:

  • Eating in private to purge
  • Hangry moods in between binges where a patient feels irritable
  • Inappropriate use of laxatives or diet pills
  • Going to the bathroom right after eating or when they get home from being out.

Binge Eating Disorder

Binge eating disorder is when a patient has an uncontrollable craving to eat large quantities of food until they feel sick. Feelings of guilt or shame often accompany this.

Some early signs of binge eating disorder might be:

  • Eating much more than other people during a meal or snack time.
  • Consuming vast amounts of junk food, even when they’re already feeling full.
  • Emptying the contents of a bag of snacks in one sitting
  • Lying about how much they’ve eaten or made excuses for eating so much

Who is Affected by Eating Disorders?

Anyone can suffer from an eating disorder. It’s most common in women, but men are also susceptible to the illness. Eating disorders usually begin during adolescence or early adulthood and affect all social classes, cultures, and ethnicities.

What Are the Risk Factors for Eating Disorders?

As with other mental health conditions, the risk of relapse is present. However, this can be lowered by participating in aftercare programs that provide continuing support. Support groups and therapy sessions are often available after leaving treatment to help you deal with triggers that may cause you to return to using unhealthy behaviors.

Other risk factors include:

  • Having anxiety issues or a history of depression.
  • Disturbed body image.
  • Being exposed to bullying, teasing, or criticism about your weight during childhood.
  • Low self-esteem and poor self-image.
  • Dealing with abuse, trauma, divorce, stress, or other traumatic experiences that cause you to feel anxious or depressed.

When someone succumbs to an eating disorder, it’s often because they have extremely low self-esteem and feel hopeless about ever being able to recover. Some people with eating disorders have difficulty coping with their problems, so they find comfort in controlling what they eat. Others might suffer from anxiety, stress, or depression that’s caused them to turn to food for solace.

Does Partial Hospitalization Program Take Place at a Hospital?

A partial hospitalization program only occurs at a hospital if the individual needs emergency medical treatment or decides to enter a particular inpatient rehabilitation center for their eating disorder. These programs can treat anorexia, bulimia, and binge eating disorders if needed.

How Long is an Eating Disorder Program?

Most patients can complete their partial hospitalization program in six to eight weeks. Those less severely affected by their disorder might only need outpatient care. In contrast, others will stay longer if they are recovering from a more severe case of anorexia or bulimia.

During this time, patients will typically meet with their therapist for three hours during the day. These sessions are held in the morning, in the afternoon, and the evening so that patients can attend classes or their job during the day. The time between sessions allows patients to spend time with family members and do things they enjoy besides treatment. At night, however, patients will sleep in a supervised environment to ensure safety when they are vulnerable at the end of the day.

What to Expect During an Eating Disorder Hospitalization

During the program, patients will learn to manage their eating disorders through talk therapy and nutritional counseling. Family members are also encouraged to attend family therapy sessions to learn more about what their loved one is going through and how they can offer support throughout their recovery.

Is a Partial Hospitalization Program Right for Me?

An eating disorder program might be the perfect option for you if you need more than outpatient therapy can offer but aren’t ready to check into a residential treatment facility (inpatient rehab center) yet. Since patients only spend six to eight hours per day at the facility, it doesn’t take as much time out of their schedule as outpatient therapy does. It also allows them to continue attending school or work outside the facility. Patients who begin their recovery in an inpatient rehab center (residential care) and then transition into partial hospitalization usually do very well with this type of plan because they already know how to manage meals and snacks. They can then use= the outpatient visits to focus on more of the mental aspects of their eating disorder.

Medications for Treating Eating Disorders

The most common medications used to treat anorexia include:

  • fluoxetine,
  • sertraline,
  • and the atypical antipsychotics risperidone
  • Or olanzapine.

Patients who suffer from both anorexia and bulimia may be prescribed:

  • fluvoxamine,
  • fluoxetine,
  • paroxetine
  • or sertraline.

Bulimia is often treated with:

  • naltrexone,
  • topiramate,
  • zonisamide
  • or bupropion while BED

It is commonly treated with antidepressants or naltrexone. Depression and anxiety medications, such as fluoxetine, sertraline, and venlafaxine may also be helpful.

What to Expect During Eating Disorder Treatment?

It’s important to realize that eating disorders treatment isn’t a quick fix but a long-term process. It generally takes about one year for a patient to fully recover from their eating disorder. They will make significant progress in managing their illness and learning new coping skills during this time.

During the beginning stages of eating disorder treatment, you can expect to begin learning how to balance your mood, emotions, thoughts, and physical health to become more self-confident.  

During the middle stages of eating disorder treatment, you may be introduced to new coping skills that help you manage symptoms early on, so they don’t spiral into a full-blown relapse. You may also be encouraged to express your feelings by journaling or participating in an art therapy session with your therapist.

Finally, during the later stages of eating disorder treatment, you will focus more on prevention. Your therapist may work with you to develop a relapse prevention plan like setting personal goals and practicing healthy coping skills.

Patients who complete an eating disorder partial hospitalization program are healthier, happier, and more productive than before the treatment began. They know how to manage their illness and can do so without relying on other people for help.

How Do I Find an Eating Disorder Program?

Start by asking friends or family members for recommendations on treatment centers in your area. Some facilities may accept private health insurance while others require payment upfront, so it’s essential to call ahead and ask about the costs of different programs before you decide which one is right for you or your loved one.

What Are the Dangers of Skipping Outpatient Treatment?

The most significant danger of skipping outpatient treatment is that it can allow your eating disorder to worsen. If you don’t follow a meal plan or get healthy coping mechanisms in place, your symptoms may escalate and become more dangerous. It would help if you were ready to deal with the issues that led to your eating disorder to recover.

A partial hospitalization program for eating disorders, such as bulimia or binge eating disorder and anorexia, teaches patients about healthy habits and helps them manage their mental health. Inpatient care is typically preferable for those hospitalized previously, but partial hospitalization can be beneficial for individuals who require more outpatient help after completing treatment.

Assessment for the procedure for PHP

Assessing the Severity of Nutritional Degradation-

A physician will perform a physical exam on the patient to determine their nutritional status, which is then used to assess the severity of the disease.

If treatment in PHP is warranted, patients are typically seen Monday through Friday for 3-5 hours per day. During this time, they receive individual therapy and group education on topics such as meal plans and how to prepare them, exploring triggers for unhealthy behaviors, and finding healthy coping mechanisms. In addition, family sessions may be offered as part of group therapy to work on issues that may have contributed to the development of this illness.

Examine your medical condition

Patients may be admitted to PHP if they eat solid food, have an average body mass index (BMI), and meet specific medical criteria. One requirement is usually the inability to care for oneself adequately. This includes not having the ability to prepare their meals or do their laundry.

Once admitted into the program, patients will work with the team to develop an appropriate treatment plan for their eating disorder. This typically begins with learning how to eat normally and adjusting their meal plans as needed. It may also include recommendations for medications or other supplements to help them recover if they cannot eat enough on their own.

What Are Long-Term Effects of Eating Disorders?

Eating disorders are deadly for various reasons, including suicide and malnourishment, resulting in organ failure, bone loss, and other serious health effects. An eating problem that is not treated promptly may be fatal.

Male and female patients benefit from inpatient programs because they offer round-the-clock care and 24/7 monitoring. This means that patients are safe from harming themselves or others due to their symptoms during treatment.

Which Long-Term Effects of Eating Disorders Can Be Prevented?

Most long-term effects can be prevented if you get help early enough, so it’s imperative to reach out for help when you realize that you have an eating disorder. Common long-term effects include malnutrition, organ failure, bone density loss, infertility, and osteoporosis.

What Are After Care Programs?

The goal of aftercare programs is to help patients maintain their progress and continue to make healthy changes long-term. Personalized therapy sessions will be made available for continued support in individual and group settings. If applicable, this may also include recommendations for community resources or employment services.

Eating disorder treatment typically starts with learning how to eat normally again, incorporating healthy behaviors into their daily lives, and adjusting to a healthier body image. This is usually done in an inpatient setting to ensure that their eating disorder does not compromise individuals’ safety. However, some individuals may require more time for this phase of treatment before transitioning back into outpatient care.

There is Help Available for Eating Disorders.

Eating disorders can be life-threatening, but with the help of a partial hospitalization program (PHP), individuals struggling with these conditions can get the treatment they need to recover. If you or someone you love is suffering from an eating disorder, it’s essential to seek out professional help right away. PHP programs offer round-the-clock care and support, so you can focus on getting better. We hope this blog post has been helpful and that you will consider seeking treatment for your loved one.