NEDA TOOLKIT for Parents
Selecting a Treatment Center for Your Loved One
If your loved one is struggling with outpatient
treatment or needs a higher level of care, you will need
to consider several different options. Finding a program
or physician that has expertise in treating all aspects of
eating disorders is crucial.
Determining level of care
Several types of treatment centers and levels of care
are available for treating eating disorders. Knowing
the terms used to describe these is important because
insurance benefits (and the duration of benefits) are
tied not only to a patient’s diagnosis, but also to the
type of treatment setting and level of care.
Treatment is delivered in hospitals, residential
treatment facilities, and private office settings. Levels
of care consist of acute short-term inpatient care,
partial inpatient care, intensive outpatient care (by
day or evening), and outpatient care. Acute inpatient
hospitalization is necessary when a patient is medically
or psychiatrically unstable. Once a patient is medically
stable, he/she is discharged from a hospital, and
ongoing care is typically delivered on an outpatient
basis or at a subacute residential treatment facility,
where the individual lives in a home or dormitory
setting. The level of care in such a facility can be full-
time inpatient, partial inpatient, intensive outpatient by
day or evening, and outpatient. There are also facilities
that operate only as outpatient facilities. Outpatient
psychotherapy and medical follow-up may also be
delivered in a private office setting.
The level of care your loved one needs will depend
on a variety of factors. The most important factor
is medical and psychiatric safety, which may require
hospitalization before selecting a more specialized
program. Hospitalization may be required for
complications of the disorder, such as electrolyte
imbalances, irregular heart rhythm, dehydration,
severe underweight, or acute life-threatening mental
breakdown. Partial hospitalization may be required
when the patient is medically stable, and not a threat
to him/ herself or others, but still needs structure to
continue the healing process. Partial hospitalization
programs last between 3 and 12 hours per day,
depending on the patient’s needs. As the patient
improves, they will typically move to less intensive and
less structured programs.
Other factors influencing level of care are the goals of
treatment. Generally, the following issues are typically
treated in this order:
• medical and psychiatric stabilization
• stopping destructive behaviors (i.e., restricting
foods, binge eating, purging/nonpurging)
• addressing and resolving any coexisting mental
health problems that may be triggering the
behavior Be aware that normalization of eating patterns can take
months to establish themselves in the patient’s day-
to-day life. It is important to remember that seeking
intensive eating disorder treatment is only the first step
towards recovery. Recovery from an eating disorder
is an active, ongoing process, and they will continue
to need lots of support at mealtimes and elsewhere
long after discharge. This is why family involvement
in treatment is so important: you need to learn how
to help manage your loved one’s eating disorder after
they are discharged. High levels of support, whether
through a step-down program, family involvement, or
both, can help stop a revolving door of admissions and
discharges. Selecting an appropriate eating disorder treatment
program First, you will need to find a treatment program
that meets your loved one’s needs. Consulting with
your family member’s treatment providers and
recommendations should give you a good idea of what
level of care is most appropriate and what aspects of
the eating disorder most need addressing.
Second, determine whether a particular level of care
and specific treatment center is covered by your
insurance carrier, and whether the treatment facility
accepts insurance. If the treatment center is not part
of the health insurer’s system (out-of-network), the
insurer may pay a percentage of the treatment costs,
with the patient responsible for the remainder. It is
best to negotiate this percentage with the insurer
before starting treatment. If your insurance does
not provide any coverage, you need to determine
whether you and/or your loved one will be able to
pay for treatment without insurance. A small number
of treatment centers offer financial assistance; but
most do not. However, inquiring whether a facility is
able to work with your current financial situation may
Page | 37