Inpatient Treatment Results for Adolescents

Group of people ready for the NEDA Come As You Are: Marginalized People

Inpatient hospitalization for any person, especially adolescents, is a unique and challenging experience. Very rarely does anyone spend a period of their life restricted to living each moment in a hospital with limited access to activities, food, social support, and the outside world.

This is precisely the reason that inpatient hospitalization can be successful in treating severe eating disorders. The normal noise and chaos of everyday work responsibilities, social encounters, and cultural messages are quieted enough for individuals to hear their recovery voice and learn how to amplify it.

Even so, the intense nature of this treatment impacts each individual differently and can be especially impactful on adolescents, as removing them from their daily school and family life is often jarring and frightening. Are the possible consequences of inpatient treatment for adolescents worth the benefits?

Consequences for Adolescents

It is never ideal to remove a child or teen from their familiar environment, particularly when that child struggles with stability, lack of control, and concerns with their mental health. As such, outpatient family-based treatment is the recommended first-line treatment for children and adolescents (1).

Even so, the severity of some adolescent’s disordered eating behaviors will require medical attention or an inpatient hospital stay, as their symptoms may be life-threatening. The challenge here becomes the potential harm these inpatient stays may cause for teens.

One study points out that the average length-of-stay (LOS) at these facilities can be long compared to other medical and psychiatric disorders, with the average being greater than seven weeks (1). These prolonged LOS’ “can disrupt adolescent development and engagement in school, family, and social life (1).”

These inpatient stays are long and costly, which teens are often aware of, and can increase feelings of shame or guilt. Another possible consequence of inpatient hospitalization involves the challenge of reintegration.

Group therapy session with AdolescentsAn adolescent in inpatient treatment is removed completely from a life and world that continues functioning without them. Returning can be difficult as the teen feels they have missed out on so much. A lot of things have changed, and the things that haven’t maybe dangerous or triggering to their disorder.

Benefits

A recent study considered whether inpatient hospitalization was actually beneficial for adolescents and reviewed much of the current literature to learn what the research consensus is. Surprisingly, the study found that the only stand-out benefit from inpatient hospitalization across numerous studies was “success in helping underweight patients with restrictive eating disorders gain weight (1).”

It may be because of this primary benefit that inpatient hospitalization has become “acute care,” that is, it “used primarily for symptom stabilization” as opposed to full treatment of a disorder (2). This may be beneficial for adolescents, as they are not intended to stay hospitalized until their disordered eating behaviors disappear, only until they become medically and physically stable.

At this point in time, adolescents would receive a reduced level of care that still addresses their severe disordered eating beliefs and behaviors. Treatments such as Intensive Outpatient would allow the adolescent to live at home but attend treatment for much like they would school. This would allow for some semblance of stability as the teen improves their mental health.

As their symptoms and thought processes improved, they would continue to reduce their level of care and increase the daily activities they have time to engage in safely while maintaining recovery. The important message here is that inpatient hospitalization has its benefits but cannot be seen as a cure-all.

An adolescent going into inpatient hospitalization may be discharged with improved symptoms, but this is not where the work ends. Much needs to be done to support the adolescent continuing to improve mentally and physically and reintegrating into daily life.


Resources:

1. Isserlin, L. et al. (2020). Outcomes of inpatient psychological treatments for children and adolescents with eating disorders at time of discharge: a systematic review. Journal of Eating Disorders, 8:32.

2. Tharayil, P. R., et al. (2013). Examining outcomes of acute psychiatric hospitalization aiming children. Social Work in Mental Health.


About the Author:

Image of Margot Rittenhouse.Margot Rittenhouse, MS, PLPC, NCC is a therapist who is passionate about providing mental health support to all in need and has worked with clients with substance abuse issues, eating disorders, domestic violence victims, and offenders, and severely mentally ill youth.

As a freelance writer for Eating Disorder Hope and Addiction Hope and a mentor with MentorConnect, Margot is a passionate eating disorder advocate, committed to de-stigmatizing these illnesses while showing support for those struggling through mentoring, writing, and volunteering. Margot has a Master’s of Science in Clinical Mental Health Counseling from Johns Hopkins University.


The opinions and views of our guest contributors are shared to provide a broad perspective on eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published August 25, 2020, on EatingDisorderHope.com
Reviewed & Approved on August 25, 2020, by Jacquelyn Ekern MS, LPC