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NEDA TOOLKIT for Parents be worth investigating if the patient does not have financial resources or insurance. If you are having trouble obtaining insurance coverage for your loved one’s eating disorder treatment, see page 45 for more information. Thirdly, determine the philosophy of the treatment facility and the type of care they provide. Is the center’s view of eating disorders supported by up-to-date research? Does it support ideas of eating disorder causes and recovery that are congruent with your family’s situation? Does it encourage or require a high level of family involvement? In addition, “evidence-based treatment” is increasingly emphasized, meaning that many eating disorder programs advertise that they use these types of treatments. It’s important to check how frequently these therapies are used, and the qualifications of the therapists providing them. Many facilities have also begun advertising their efficacy via outcome studies. However, residential treatment hasn’t been studied for efficacy in randomized control trials, and long-term outcomes have not been followed. Some treatment centers will only evaluate people who were not discharged prematurely, or they may only assess individuals who returned surveys, which could be biased towards individuals who are doing well. The eating disorder community also does not have a standard definition of what recovery looks like, which can make interpreting these studies even harder. Don’t ignore these data, but interpret them with caution. Lastly, think about what will happen after discharge. Does the program have a step-down program or is there another one that you intend to use? Discharge plans can be complicated and require much coordination of care among different healthcare providers. That takes time. Effective discharge planning needs to start much earlier than a day or two before the patient is expected to be discharged from a facility. Other factors to consider when selecting a treatment center include religious affiliation (if any), multidisciplinary approach to care, distance from home, staff/patient ratio, professional qualifications of staff, their experience in treating eating disorders, and adjunct therapies offered. Some treatment centers provide therapies in addition to psychiatric counseling and pharmacotherapy, like equine therapy, massage, dance, or art therapy. These therapies may be appealing, although there is no evidence for these being essential to treatment response, and they may not be covered by your health insurance. Determining Quality of Care Determining the quality of care offered by a center is difficult at this time. No organization yet exists to specifically accredit treatment centers for the quality and standard of eating disorder-specific care. Leaders within the national eating disorders community organized in mid-2006 to develop care standards and a process for accrediting eating disorder centers. That effort is ongoing. One national organization, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), provides generic accreditation for healthcare facilities, and some eating disorder centers advertise “JCAHO accreditation.” JCAHO accreditation does not link directly to quality of care for treatment of eating disorders; it assesses safety and credentials of staff. Another issue regarding quality of care is that much care is delivered on an outpatient basis. For individual psychotherapists in private practice, no special credentialing or specialty certification exists regarding treatment of eating disorders. Thus, any mental healthcare professional can offer to treat an eating disorder whether or not he/she has experience or training in this specific area. Therefore, it is important to ask a prospective therapist about his/her knowledge about eating disorders and years of experience treating them. Professionals in a Multi-disciplinary Care Team • Primary care physician (i.e., family doctor, internal medicine doctor, pediatrician, gynecologist) • Psychiatrist • Nutritionist • Clinical psychologist • Social worker • Claims advocate for reimbursement • Other professionals who administer supplemental services such as massage, yoga, exercise programs, and art therapy Page  | 38