PSYCHIATRY

Renee Hoste, Ph.D., provides intensive treatment for eating disorders in a partial hospitalization setting.

Family Focus

Intensive partial hospitalization for eating disorders

issue 2 | Fall 2012

In the past 20 years, previous theories about the demographics related to eating disorders have been invalidated. Eating disorders are equal opportunity problems that can affect people of any gender, race, age or socioeconomic background, not just high-achieving adolescent girls.

As the understanding of eating disorders has changed, so have treatments. Experts now know that eating disorders are highly treatable illnesses with several contributing causes. However, left untreated, eating disorders may result in significant psychosocial disability, serious medical complications or even death.

The University of Michigan Comprehensive Eating Disorders Program at C.S. Mott Children's Hospital takes a comprehensive, family-based approach to treatment. "This program is a collaboration between our pediatrics and psychiatry departments," says David Rosen, M.D., adolescent medicine specialist. "We can provide our patients and their families with integrated counseling, medical care and nutritional restoration, all in a family-friendly environment."

BETTER SOLUTIONS TO DIFFICULT PROBLEMS

"The typical treatment for eating disorders in our state has been outpatient care that is often highly disjointed," says Daniel Gih, M.D., child and adolescent psychiatrist. "Patients may have multiple therapists and doctors who don't communicate with each other regularly, and patients only see those specialists once a week or so."

If patients required medical intervention, they were treated as inpatients, which also wasn't ideal. "Medical hospitalization diminishes the psychotherapeutic focus of treatments," explains Gih. "The only other alternatives have been out-of-state programs that require three months away from family."

A better solution is a partial hospitalization program. "Partial hospitalization combines outpatient and inpatient care," says Rosen. "Instead of a few hours of treatment a week, patients have several hours a day. Patients eat two meals a day here, so we can more actively support nutritional rehabilitation. However, patients go home every day and sleep in their own beds, which is less intrusive and less costly than inpatient hospitalization."

SUPPORT FOR FAMILY

Additionally, this program integrates the concept of family-based treatment. "We concentrate on the family, because they are the best people to help a young person with an eating disorder," explains Rosen. "They know the child the best, and they are best suited to support and encourage positive changes in behavior."

"Family-focused programs are the most effective form of treatment for anorexia and bulimia, particularly in adolescents," says Gih. "For example, patients get therapeutic meals with their families that are supervised by trained staff, so parents can learn to promote success and recovery from an eating disorder."

"By the time we meet many families, they are very frustrated, and they believe nothing works," acknowledges Rosen. "So, our goal is to empower them to help their son or daughter get better."

Eating disorders are dangerous illnesses that can spin out of control very fast. "These kids don't get better by themselves," says Rosen. "Children and young adults with suspected eating disorders need timely and focused evaluation. We're here to give primary care physicians a team to partner with to get their patients access to comprehensive evidence-based treatment as quickly and easily as possible."