What is Inpatient Treatment?
Experiencing Inpatient Treatment
Contributed By Staff of New Dawn Treatment Centers
Eating disorder prevalence rates continue to increase among men and women. According to the National Association of Anorexia Nervosa and Associated Disorders (ANAD), the mortality rate for individuals suffering from Anorexia Nervosa is 12 times higher than the death rate of all causes of death for females between the ages of 15 and 24 years old. The South Carolina Department of Mental Health estimates that 8 million Americans (seven million women and one million men) have an eating disorder and 80% of individuals who have accessed care for their disorder do not receive adequate treatment needed to maintain recovery. Whether an individual pursues an inpatient or outpatient treatment program depends, in part, on the severity of one’s eating disorder. Severity may be assessed according to weight status, cardiac status, metabolic status, vital signs, and lab values. According to the Agency for Healthcare Research and Quality, between 1996 and 2009 inpatient hospitalizations for eating disorders drastically increased 119 percent for children 12 years of age and younger and increased 48 percent for individuals between the ages of 45 and 64 years old. When examining whether an individual is suitable to receive inpatient treatment, it is also necessary to evaluate previous treatment attempts. A history of inadequate response to treatment in a less intensive setting typically provides enough support to warrant admissions into an inpatient treatment facility. Inpatient treatment providers typically serve to stabilize acute individuals prior to transitioning into a long-term, less restrictive treatment program. Criteria for admission may include severe malnutrition in which the affected individual falls below 75% of his or her ideal body weight, electrolyte disturbance, cardiac dysrhythmia, etc. However, factors such as medical coverage often limit the time available for individuals to remain in an inpatient program, and thus result in patients incurring the remaining costs for additional treatment subsequent to medical stabilization.
Inpatient care provides clients with a structured and well-defined atmosphere in the effort to allow clients the space to focus on their physical and psychological healing process. Although inpatient treatment is often necessary for individuals struggling with disordered eating, it is not uncommon for one to avoid committing to an inpatient facility because of such rigidity.
“Being in an inpatient treatment program is really difficult in the sense that there is no way out,” said a current client at New Dawn Treatment Center. “On the other hand being in that type of program keeps you from returning to your old, unhealthy behaviors, which I think is ultimately an important part of the recovery process. Before I entered inpatient treatment I had a lot of issues with respecting boundaries and many of the boundaries I pushed up against were because I wanted to use ED behaviors. It was definitely hard to accept certain rules but that’s what helped me get to where I am today.”
Entering an inpatient treatment program is often accompanied with feelings of anxiety and fears surrounding living a life independent from one’s eating disorder. However, the structure of an inpatient treatment program is designed to support clients in eliminating such stressors. Inpatient treatment programs provide clients with a holistic treatment experience, which includes individual and family psychotherapy, nutritional counseling and education, medical monitoring, psychiatric medication management, and supervised meals and snacks. Additionally, many programs provide supervised outings, enabling clients to experience a snapshot of life outside of a treatment program. A cohesive treatment team that consists of a psychiatrist, internist, psychologist, dietician, social worker, and nurse works individually to provide the utmost care for each inpatient client.
From the moment the clients wake up they are guided through their day. A typical day begins as early as 7:30 am in the effort to assist the clients in being active rather than ruminating on their thoughts while remaining sedentary. The day begins with a vitals check, followed by a supervised shower. Vitals typically involve a nursing staff member who assesses the client’s heart rate, blood pressure, body temperature, and weight. After monitoring vitals clients are ushered into a community room to eat breakfast with the other inpatient residents. Although specific time schedules vary according to the program, breakfast generally occurs somewhere between 8am and 9am. Following breakfast clients participate in groups, which differ according to the particular day. Such groups often include therapeutic meal process groups, forms of expressive art, stress reduction and meditation as well as dialectical behavioral therapy. Following these various groups clients eat a snack before returning to another group activity. Lunch generally occurs between 1pm and 1:45pm, followed by individual therapy appointments. Around 4pm clients eat another snack before beginning dinner at 5:45pm. Because clients in an inpatient program reside within the facility 24 hours per day, program support continues on into the evening. After dinner clients engage in a community support group, which often involves discussing the challenges of the day while incorporating a light and social activity. Before bed clients eat a third snack. Clients are expected to be in bed, with the lights out, no later than 10pm.
Because the overall structure of an inpatient program is designed to prevent clients from retreating to previous eating disorder behaviors, some individuals view inpatient treatment as rigid and militaristic. Due to this perception, health professionals make an added effort to approach clients in a caring, nurturing, and compassionate manner. Many clinicians who work within an inpatient facility choose to do so because of the opportunity to work with affected clients in an environment that fosters relationships between the clients and the clinicians.
“Inpatient care allows for more focused attention on more dimensions of the disorder,” said Alan Dearborn, Psy.D., licensed clinical psychologist at New Dawn Treatment Center in Sausalito, California. “It allows for opportunities to engage with clients during their struggles and to notice successes that might otherwise go unnoticed in care models with less concentrated hours of contact time.”
Although clinicians work with clients to ensure a positive, supportive inpatient treatment experience, the challenges evoked during the recovery process often contribute to a client’s negative views with regard to seeking such structured treatment. As witnessed with treatment program graduates, the pain felt during the recovery process often does not compare to the relief felt when a client experiences life without the black and white lens of the disorder.
When asked if inpatient treatment was worth the pain involved a former client at New Dawn Treatment center responded. “In retrospect, yes, totally worth it. I was miserable for over a decade, and even though I still struggle and have moments where I hate myself, I am also able to see that a life exists beyond obsessing about my next binge. It’s scary, but also pretty cool to feel my body working again.”
Eating Disorders Statistics « « National Association of Anorexia Nervosa and Associated Disorders. (n.d.). National Association of Anorexia Nervosa and Associated Disorders. Retrieved from http://www.anad.org/get-information/about-eating-disorders/eating-disorders-statistics/
Eating Disorder Statistics. (n.d.). 2003 Retraining Grant Program. Retrieved from http://www.state.sc.us/dmh/anorexia/statistics.htm
Mental Health: Research Findings. (n.d.). Agency for Healthcare Research and Quality (AHRQ) Home. Retrieved from http://www.ahrq.gov/research/mentalhth3.htm
Published Date: November 7, 2012
Last reviewed: By Jacquelyn Ekern, MS, LPC on November 7, 2012
Page last updated: November 7, 2012
Article Contributed by New Dawn Treatment Centers
Published on EatingDisorderHope.com, Eating Disorders Help