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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