Most people interested in services at ACE want to know if our program is successful. We measure success in two ways. Upon discharge, data is collected to determine the amount of improvement the individual has achieved. ACE’s outcome data is amazing! The outcomes are based on anyone who was in the program for at least one week. In 2012, even though the program was extremely full with larger than ever groups and a patient to staff ratio that decreased slightly, the discharge data was stronger than ever! 87% of all patients were at least somewhat improved, with 64% of patients being significantly improved. Of the remaining 13% who achieved no improvement, 10% were referred inpatient. Many of those returned to do well after spending time in inpatient or residential treatment.
Our most recent analysis included 151 participants (74 with AN and 77 with BN) who went through either the partial hospitalization program (PHP) or intensive outpatient program (IOP) at ACE between 2001 and 2010. The number of weeks the participants were in the program ranged from 2 to 57 weeks for people with AN and 1 to 45 weeks for people with BN, with an average length of stay of 13 weeks for both. The participants’ average age was 21 years old and ranged from 13–57 years old. Of the participants in the study, 12% of people with AN and 5% of people with BN participated in the partial hospitalization program (PHP) only, while 63% of people with AN and 73% of people with BN participated in the intensive outpatient program (IOP) only. Another 23% of people with AN and 18% of people with BN participated in a combination of PHP and IOP treatment.
We give several questionnaires to participants at their initial assessment appointments and again at discharge from the program. The questionnaires are used to assess participants’ eating disorder symptoms, depressive symptoms and anxiety symptoms. The instruments used include the Eating Disorder Inventory — Second Edition (EDI-2; Garner, 1991), the Eating Disorder Inventory — Symptom Checklist (EDI-SC; Garner, 1991), the Beck Depression Inventory — Second Edition (BDI-II; Beck, Steer, & Brown, 1996), and the Sheehan Patient Rated Anxiety Scale (SPRAS; Sheehan, 1990). The participants’ weight and use of eating disorder behaviors are also obtained weekly throughout treatment by the therapist or nutritionist.
Remarkably, the comparison of scores in the analysis yielded significant reductions on every variable measured! These outcomes are far above those found in published studies in eating disorder journals (see International Journal of Eating Disorders and Eating Disorders: Prevention, Treatment and Research).
Specifically, participants reported a significantly lower number of eating disordered symptoms, attitudes, personality features such as body dissatisfaction, drive for thinness and perfectionism. Additionally, the analysis revealed a significant reduction in depressive and anxiety symptoms.
Table 1 shows the means (average scores) and sample size for each of these comparisons.
Mean Differences in Eating Disorder, Depressive & Anxiety Symptoms
EDI-2 = Eating Disorder Inventory — Second Edition
BDI-II = Beck Depression Inventory — Second Edition
SPRAS = Sheehan Patient Rated Anxiety Scale
Participants experienced a significant reduction in eating disorder symptoms. Thirty-one of the women in the study reported experiencing binge eating episodes in the initial assessment. Among these women, there was a significant decrease in the average number of binges per week at the post-treatment assessment. In the initial assessment, thirty-one women in the sample reported using purging. Among these women, there was a significant decrease in the average number of purges per week at the post-treatment assessment. The analysis revealed a significant change in weight among the participants who were anorexic. Among the participants who reported their weight at pre-treatment and post-treatment, there was a statistically significant increase in weight at post-treatment.
These results suggest that ACE’s treatment program is highly effective in decreasing eating disorder symptoms, depressive symptoms and anxiety symptoms in an average of three months of treatment. The program effectively integrates evidence-based treatments (e.g., cognitive-behavioral therapy) with clinical experience and additional interventions designed to address individual differences. This study demonstrates hope and expectation that symptoms, complications and struggles of an eating disorder may be alleviated or significantly reduced with effective treatment in an outpatient setting.
Most recent publication: Schaffner, A.D., & Buchanan, L.P. (2011) IJBCT, 6(1).