Adult Day Treatment Eating Disorder Program


Eating Disorder Treatment Includes:

  • Treatment setting that provides a warm nurturing environment and more closely mimics a home setting.
  • Dedicated Clinical Milieu.
  • Eating Disorder-specific Psychiatry, Individual, Group and Family Therapy.
  • Experiential activities including food planning, grocery shopping and meal preparation.
Eating Disorder Treatment Phases

An assessment in critical areas including: medical, psychological, psychiatric, motivational/spiritual, and nutritional.

Clinical therapies in a monitored community-based setting designed to enhance awareness, challenge thinking processes and behaviors that contribute to the maintenance of the disorders, and develop skills to manage emotions more effectively.

Participation with family members in solidifying the aftercare plan and preparing for the challenges of returning to home and school/work.

Family systems therapy draws on systems thinking to view the family as an emotional unit. When applied to families, systems thinking—evaluating the parts of a system in relation to the whole—suggests that an individual’s behavior is informed by and inseparable from the functioning of his or her family of origin.

Therapy sessions include:

  • Family Therapy Sessions
  • Couples Therapy

Cognitive-behavioral therapy, or CBT, is the leading evidence-based treatment for people with eating disorders. It is based on the theory that a person’s thoughts, emotions, and behaviors are interconnected and can be restructured to support new, healthier thoughts and actions. Cognitive behavior therapy provides the foundation for individual and group therapies throughout all levels of care at Madrone Mental Health.

The cognitive-behavioral model emphasizes the important role that both thoughts (cognitive) and actions (behavioral) can play in maintaining negative behavior patterns. CBT stresses education and skills training and consists of structured treatment that focuses on the present and the future. Three phases of CBT may unfold over the course of treatment:

  • Behavioral Phase
  • Cognitive Phase
  • Maintenance & Relapse Prevention Phase

The primary goal of Dialectical Behavior Therapy (DBT) is to help individuals build a life that has meaning and worth, with a freedom from suffering. DBT was originally developed by Marsha Linehan, Ph.D., to treat individuals who engage in self-harm behavior, many of whom meet the diagnostic criteria for borderline personality disorder.   In DBT eastern approaches and western therapies are combined to build skills and address emotional dysregulation.

DBT is composed of four modules, each with its own goals and skill sets:

  1.  Mindfulness
  2.  Distress Tolerance
  3.  Emotion Regulation
  4.  Interpersonal Effectiveness

MMH facilitates group therapy focusing on DBT skills every day of the week in the Day Treatment Program.  Individual therapy is also utilized to address DBT skill development and practice.

Acceptance and Commitment Therapy (known as “ACT”) utilizes a mixture of metaphor, paradox, a wide range of experiential exercises and values-guided behavioral interventions to help people work toward cognitive flexibility.

The Goal of ACT

The goal of ACT is to create a rich and meaningful life, while accepting the pain that inevitably goes with it. “ACT” is a good abbreviation, because this therapy is about taking effective action guided by our deepest values and in which we are fully present and engaged. It is only through mindful action that we can create a meaningful life. As we attempt to create such a life, we will encounter barriers (in the form of unpleasant and unwanted thoughts, images, feelings, sensations, urges, and memories). ACT reaches to mindfulness skills as an effective way to handle these.

What is Unique to Act?

In stark contrast to most Western psychotherapy, ACT does not have symptom reduction as a goal. This is based on the view that the ongoing attempt to get rid of “symptoms” actually creates a clinical disorder. As soon as a private experience is labeled a “symptom,” a struggle with the “symptom” is created. A “symptom” is by definition something “pathological” and something we should try to get rid of. In ACT, the aim is to transform our relationship with our difficult thoughts and feelings, so that we no longer perceive them as “symptoms.” Instead, we learn to perceive them as harmless, even if uncomfortable, transient psychological events.

Ambivalence and resistance towards recovery are common among those with eating disorders even when faced with the negative, and sometimes dangerous, consequences of their illness. Because of this, a key ingredient in the initial phase of treatment at Madrone Mental Health is developing motivation for change.

The Stages of Change:

  • Pre-contemplation (no intention to change)
  • Contemplation (thinking about change, but not committed)
  • Preparation (intending to take action, but, have not done so)
  • Action (modifying behavior)
  • Maintenance (relapse prevention)

At Madrone Mental Health, therapists work to identify each patient’s readiness for change. Unless medical risks dictate otherwise, therapy begins with support, education, and other efforts to increase motivation. The overall goal is to move each patient toward acceptance and readiness for change.

Overcoming an eating disorder involves, among other things, learning to focus (and maintain that focus); control emotional impulses; and to redirect thoughts from negative to positive.
 
Meditation teaches us to observe and control our bodies and minds – sitting for extended periods without moving, and resisting the urge to fidget or give up is difficult. It is the process of learning mental control; first we gradually learn to observe thoughts and feelings, or shut them out entirely, and then to choose positive rather than negative thoughts or emotions.
 
Meditation/Mindfulness groups are facilitated two times per week in the Day Treatment Program at MMH.

Madrone Mental Health offers quality, innovative, and compassionate care for mental health recovery and treatment of psychiatric disorders. We understand that untreated mental illnesses can result in poor performance at school, work or home as well as significantly diminish quality of life. Our evidence-based treatment modalities are administered by a medical expert in a safe and secure environment so that the patient is able to concentrate on recovery. Our licensed psychiatrist and psychiatric mental health nurse practitioner use the best practices in mental health treatment to offer a compassionate, customized treatment program that embodies the latest techniques in the field of psychiatric care.

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Trauma Specialty Track

The Trauma Specialty Track is available for patients in our Day Treatment Program as well as our outpatient treatment care. Often times, patients will continue trauma-focused therapy as they progress through treatment and step down into outpatient care with an individual therapist. It is important to continue this work after hospitalization to promote continued healing from the trauma and the eating disorder.

Trauma

It is not uncommon for individuals with PTSD to engage in dangerous eating disorder behaviors in an attempt to cope with painful memories. Our Trauma Specialty Track is a unique therapeutic opportunity to simultaneously address the eating disorder and the effects of trauma.  At Madrone Mental Health, specialized Trauma treatment is based on methods with empirical support and following expert consensus guidelines. That is, similar to the treatment of eating disorders in general, trauma treatment is based on an approach that highlights the importance of biological, psychological, and social factors.

In addition to receiving individualized eating disorder interventions, MMH’s trauma specialty track offers the following therapeutic components:

  • Specific CBT-based trauma work during individual psychotherapy
  • Weekly participation in trauma group therapies including psycho-education, skills training and art therapy
  • Individualized nutritional counseling around trauma-related fear foods
  • Psychiatric assessment and treatment of trauma symptomatology
  • Individualized trauma work during art therapy and other expressive therapies
  • All individual and group trauma work is specially tailored to address the individual’s developmental needs

Similar to all patients in our program, the therapy focus will be determined based on individual needs but within the context of the trauma.  Additionally, it should be noted that for all patients, regardless of therapy track, the goal of individual therapy is to cultivate an understanding of the development, maintenance, and purpose of their eating disorder while reducing and eliminating eating disordered behaviors. Thus, the individual conceptualization of the eating disorder will therefore need to include an understanding of the personal meaning of the trauma. And, eating disorder symptom management occurs concurrently with trauma symptom management.