Parents’ FAQs
In this section, we will try to answer some of the questions most frequently asked by parents at the beginning of treatment. Please understand, however, that some of these answers are very general in nature, and specific questions may be best answered in a family therapy session. Being involved in family therapy is the biggest contribution you can make to your child's recovery.
1. What does intensive treatment for an eating disorder involve?
2. Why don’t all ACE participants have the same schedule?
3. How do we determine which level of treatment and which groups our child should attend?
4. When would an ACE participant be referred for inpatient treatment?
5. How involved should we be in our child’s treatment?
6. What causes an eating disorder; is it the parents’ fault?
7. How do we find out how our child is progressing?
8. What is the difference between a case manager and an individual therapist?
9. Are people actually “cured” of an eating disorder?
1. What does intensive treatment for an eating disorder involve?
There are two levels of intensive treatment and an aftercare level:
Partial Hospitalization or Day Hospital (PHP): These terms are used interchangeably and refer to our most intensive level of care. In this program, participants are at the center for six to eight hours during the day from 12:30–8:15 p.m. (we offer no overnight treatment at ACE). This level of care is recommended for people whose symptoms are such that they need structure throughout the day to enable them to manage food. Most participants are only in this program for two to three weeks, after which they taper down to three to four hours a day.
Participants in the day hospital will have Relaxation Therapy, lunch with a therapist and Recovery Skills Group. This group is designed primarily to educate participants on various topics regarding their eating disorder. There is evidence from research that education about eating disorders is an important component of the treatment process. This group includes the use of live and videotaped lectures, as well as practical application activities. At 4:00 p.m., the group will join together with participants of the intensive program for evening groups.
Intensive Outpatient Program (IOP): A participant is considered to be in the IOP program if they are in two or more groups. IOP groups are held Monday through Thursday between 4:00 p.m. and 8:15 p.m. There are many different groups offered, and each group meets once a week at the same time each week. Some participants may come only one day a week and others may come every day depending on the severity of symptoms, their resources, their schedule and their level of commitment.
Aftercare Program (AP): The Aftercare Program consists of one group per week with individual and/or family therapy. When a person reaches discharge criteria (healthy weight, etc.) they are no longer in need of intensive treatment. However, most people benefit from continuing in therapy to maintain their progress, reduce the likelihood of a “slip,” and to continue working on the underlying issues (e.g., perfectionism). On occasion a person will be admitted to the aftercare program right after their initial evaluation if their symptoms are very mild and/or have just begun.
2. Why don't all ACE participants have the same schedule?
Most intensive programs require that all participants attend the whole program. Our ability to individualize people’s treatment schedules is a very unique aspect of the ACE program and one that we are most proud of. Our mission is to provide intensive treatment while encouraging people to maintain their normal lives as much as possible. Additionally, as people are progressing in their recovery, they can taper groups at their own pace. The groups are designed to address eating problems from many different angles, and not all participants need all groups. Once a participant has been in the program for several weeks, she may recognize that some groups are more helpful than others for her particular needs (note, they may not be the ones she likes the best). Therefore, by consulting with her case manager, you and your child may revise her schedule over time.
It should be noted, however, that providing individualized treatment schedules is much more difficult from an administrative perspective. It is the most challenging administrative task at ACE to keep up with each person’s schedule and keep up with the changes that are made over time. You can help by doing the following:
3. How do we determine which level of treatment and which groups our child should attend?
Initial Evaluation. People who are interested in the ACE program are asked to go through an initial evaluation, which involves approximately three hours. You as the parent will be asked to fill out a questionnaire and sign several consent forms while your child is also doing paperwork. This involves several questionnaires which screen for eating problems as well as other problems which tend to accompany eating disorders such as depression, anxiety, self-esteem, perfectionism, etc. One of our psychologists then reviews the paperwork and spends about an hour with the potential patient. We make it a point to go over the questionnaires and give feedback that helps you and your child understand the relative severity of various problems and symptoms. Our goal when reviewing the paperwork and meeting with you is to make a recommendation which is highly individualized regarding which parts of our program would be helpful in starting treatment (that is, if intensive treatment is indicated). This assessment helps us determine which groups are going to be the most helpful and is necessary if we are going to individualize schedules.
4. When would an ACE participant be referred for inpatient treatment?
5. How involved should we be in our child’s treatment?
Research has shown that the more the parents are involved in treatment, the faster and more fully their child will recover. The younger the child, the more vital your involvement is. However, we recommend that any ACE participant who is living at home with their parents be involved in family therapy and the Multifamily Group. Some insurance companies even require family treatment as a condition for receiving benefits for an eating disorder.
6. What causes an eating disorder; is it the parent's fault?
There is no single known cause for eating disorders, so we never place blame on the parents. However, you are very significant people in your child’s life and your involvement and openness to explore your own issues can greatly enhance your child’s recovery. See the article Raising Resilient Children in an Eating Disordered Culture for more information, and our page on Causes, Prevention and Treatment.
7. How do we find out how our child is progressing?
The very best source of information is through family therapy. In these sessions, you are encouraged to talk about anything which concerns you about your daughter and all family relationships. A second source is your child's case manager. You may be in contact with the case manager, but, whenever possible, do so in the presence of your child so that trust is facilitated.
8. What is the difference between a case manager and an individual therapist?
If your child is seeing an ACE staff member for individual therapy, this person will also act as her case manager. If the individual therapist is outside ACE, a case manager will be assigned at ACE. The case manager will meet with your child for approximately 15 minutes a week to monitor progress and set goals and will act as a liaison with you and with her outside therapist. There is no charge for this service.
9. Are people actually “cured” of an eating disorder?
It is our opinion and experience that people can and do fully recover from eating disorder symptoms, although they may go on to struggle with the underlying issues (such as perfectionism) for years. Our outcome statistics show that the average length of stay at ACE is three months and that not only do patients’ eating disorder symptoms improve greatly in that short period of time, but so do the underlying problems. It should be noted, however, that no two people are alike and that some people meet discharge criteria within a month, while others take up to two years. Additionally, some people leave and return to treatment several times during the course of their recovery, which is understood as movement toward the end goal. Finally, some studies suggest that relapse prevention is enhanced the longer a person is in treatment.
1. What does intensive treatment for an eating disorder involve?
2. Why don’t all ACE participants have the same schedule?
3. How do we determine which level of treatment and which groups our child should attend?
4. When would an ACE participant be referred for inpatient treatment?
5. How involved should we be in our child’s treatment?
6. What causes an eating disorder; is it the parents’ fault?
7. How do we find out how our child is progressing?
8. What is the difference between a case manager and an individual therapist?
9. Are people actually “cured” of an eating disorder?
1. What does intensive treatment for an eating disorder involve?
There are two levels of intensive treatment and an aftercare level:
Partial Hospitalization or Day Hospital (PHP): These terms are used interchangeably and refer to our most intensive level of care. In this program, participants are at the center for six to eight hours during the day from 12:30–8:15 p.m. (we offer no overnight treatment at ACE). This level of care is recommended for people whose symptoms are such that they need structure throughout the day to enable them to manage food. Most participants are only in this program for two to three weeks, after which they taper down to three to four hours a day.
Participants in the day hospital will have Relaxation Therapy, lunch with a therapist and Recovery Skills Group. This group is designed primarily to educate participants on various topics regarding their eating disorder. There is evidence from research that education about eating disorders is an important component of the treatment process. This group includes the use of live and videotaped lectures, as well as practical application activities. At 4:00 p.m., the group will join together with participants of the intensive program for evening groups.
Intensive Outpatient Program (IOP): A participant is considered to be in the IOP program if they are in two or more groups. IOP groups are held Monday through Thursday between 4:00 p.m. and 8:15 p.m. There are many different groups offered, and each group meets once a week at the same time each week. Some participants may come only one day a week and others may come every day depending on the severity of symptoms, their resources, their schedule and their level of commitment.
Aftercare Program (AP): The Aftercare Program consists of one group per week with individual and/or family therapy. When a person reaches discharge criteria (healthy weight, etc.) they are no longer in need of intensive treatment. However, most people benefit from continuing in therapy to maintain their progress, reduce the likelihood of a “slip,” and to continue working on the underlying issues (e.g., perfectionism). On occasion a person will be admitted to the aftercare program right after their initial evaluation if their symptoms are very mild and/or have just begun.
2. Why don't all ACE participants have the same schedule?
Most intensive programs require that all participants attend the whole program. Our ability to individualize people’s treatment schedules is a very unique aspect of the ACE program and one that we are most proud of. Our mission is to provide intensive treatment while encouraging people to maintain their normal lives as much as possible. Additionally, as people are progressing in their recovery, they can taper groups at their own pace. The groups are designed to address eating problems from many different angles, and not all participants need all groups. Once a participant has been in the program for several weeks, she may recognize that some groups are more helpful than others for her particular needs (note, they may not be the ones she likes the best). Therefore, by consulting with her case manager, you and your child may revise her schedule over time.
It should be noted, however, that providing individualized treatment schedules is much more difficult from an administrative perspective. It is the most challenging administrative task at ACE to keep up with each person’s schedule and keep up with the changes that are made over time. You can help by doing the following:
- When a participant joins any particular group, she is asked to make at least a one-month commitment to the group (four meetings). Many times, people feel worse at first due to being in a new situation and don't realize the benefits that they will get from the group until after a couple of weeks.
- Bring your child to all scheduled groups and make every effort to be on time.
- If you need to cancel, give 24 hours notice so that you will not be charged.
- Whenever possible, write down any dates that you need to cancel and give to our office manager. If you are not at ACE, you may call in your cancellation.
- Always discuss any desire to change the schedule with your child’s case manager.
3. How do we determine which level of treatment and which groups our child should attend?
Initial Evaluation. People who are interested in the ACE program are asked to go through an initial evaluation, which involves approximately three hours. You as the parent will be asked to fill out a questionnaire and sign several consent forms while your child is also doing paperwork. This involves several questionnaires which screen for eating problems as well as other problems which tend to accompany eating disorders such as depression, anxiety, self-esteem, perfectionism, etc. One of our psychologists then reviews the paperwork and spends about an hour with the potential patient. We make it a point to go over the questionnaires and give feedback that helps you and your child understand the relative severity of various problems and symptoms. Our goal when reviewing the paperwork and meeting with you is to make a recommendation which is highly individualized regarding which parts of our program would be helpful in starting treatment (that is, if intensive treatment is indicated). This assessment helps us determine which groups are going to be the most helpful and is necessary if we are going to individualize schedules.
4. When would an ACE participant be referred for inpatient treatment?
- As a result of the initial assessment, if the symptoms are considered too severe for outpatient treatment.
- Whenever a medical doctor determines that the child may be in medical danger. (Note that we need to have bloodwork and physicals conducted by your physician at the start of treatment).
- If symptoms are worsening after two weeks of intensive treatment.
- Purging multiple times per day and below 70% of expected weight are often considered criteria for inpatient treatment.
5. How involved should we be in our child’s treatment?
Research has shown that the more the parents are involved in treatment, the faster and more fully their child will recover. The younger the child, the more vital your involvement is. However, we recommend that any ACE participant who is living at home with their parents be involved in family therapy and the Multifamily Group. Some insurance companies even require family treatment as a condition for receiving benefits for an eating disorder.
6. What causes an eating disorder; is it the parent's fault?
There is no single known cause for eating disorders, so we never place blame on the parents. However, you are very significant people in your child’s life and your involvement and openness to explore your own issues can greatly enhance your child’s recovery. See the article Raising Resilient Children in an Eating Disordered Culture for more information, and our page on Causes, Prevention and Treatment.
7. How do we find out how our child is progressing?
The very best source of information is through family therapy. In these sessions, you are encouraged to talk about anything which concerns you about your daughter and all family relationships. A second source is your child's case manager. You may be in contact with the case manager, but, whenever possible, do so in the presence of your child so that trust is facilitated.
8. What is the difference between a case manager and an individual therapist?
If your child is seeing an ACE staff member for individual therapy, this person will also act as her case manager. If the individual therapist is outside ACE, a case manager will be assigned at ACE. The case manager will meet with your child for approximately 15 minutes a week to monitor progress and set goals and will act as a liaison with you and with her outside therapist. There is no charge for this service.
9. Are people actually “cured” of an eating disorder?
It is our opinion and experience that people can and do fully recover from eating disorder symptoms, although they may go on to struggle with the underlying issues (such as perfectionism) for years. Our outcome statistics show that the average length of stay at ACE is three months and that not only do patients’ eating disorder symptoms improve greatly in that short period of time, but so do the underlying problems. It should be noted, however, that no two people are alike and that some people meet discharge criteria within a month, while others take up to two years. Additionally, some people leave and return to treatment several times during the course of their recovery, which is understood as movement toward the end goal. Finally, some studies suggest that relapse prevention is enhanced the longer a person is in treatment.
