Teamwork in therapy is the key to creating a therapeutic dream team. However, there is one key component to teamwork that can make or break the treatment. You have to know your role and stay in your own lane.
residential treatment Centers
When the agency/treatment center takes on the role of parenting and mandating eating, and the parents try to be supportive and empathic, which may involve agreeing with their child that the treatment team is being mean, guess what happens? The patient drops out of treatment, goes back home, and immediately stops eating again. As a result, the recidivism rate for residential and daycare centers is very high. Even more importantly their “success” rates are usually around 50% or less.
One of the reasons may be how the treatment centers mandate compliance. They are under the gun. They need to get results in a month, as most insurance runs out at that point. Too often they resort to using shame, isolation, and punishment (or bad parenting strategies) that are nothing short of damaging and in some instances, frankly disturbing.
I have had patients who were basically put in isolation because they refused to eat. One teenager was in her room by herself for 30 days ingesting only boost and when representatives of the “treatment” team entered her room they were instructed that they should not make eye contact with or speak to her. You don’t get that kind of isolation in a prison.
But don’t get me started on the problems with most of the treatments for these disorders. It’s abysmal. With only a 30-40% success rate, these institutions still have the nerve to charge $1500/day for their “treatment”.
A few other important things to consider if you are the parent. The longer your child has an ED without receiving treatment, the more deeply ingrained the belief is that they cannot live without it. Indeed, they will fight to keep it, irrespective of what they must give up in order to do so. Please try not to blame yourself, as blaming yourself can and often does delay treatment.
Wrap up
In closing, people come to their ED for many different reasons. The triggers can be very complicated having to do with family dynamics, social pressure, and/or a society that just values thinness. Or it can be something else altogether. Recently, COVID has been a major trigger as we have seen an uptick in EDs since it began. I believe the isolation caused by COVID created higher levels of anxiety in a society that was already fairly anxious. As I mentioned earlier in this serieries of articles, the ED gives the anxiety focus, and in so doing, a way to cope. Just not an effective way to cope. We are also seeing this dynamic play out with those who gained weight during COVID.
Irrespective of how they end up here, this group of patients is unique in that they are highly intelligent, hard workers, organized and determined. Ordinarily, these traits would be a benefit. However, when applied to being a good anorexic or bulimarexic they can be deadly. I have a 94% success rate with this population. My patients have gone on to be exceptional parents, doctors, lawyers, artists, and humanitarians. My family systems-based approach works.
If you or a loved one is struggling with disordered eating please reach out to me. I am the Eating Disorder Pro and I can help.
