NEDA TOOLKIT for Parents
How to find a suitable treatment setting
Several considerations enter into finding a suitable
treatment setting for the patient. The patient’s options
may be limited by his/her available insurance
coverage, by whether or not a particular center or
therapist accepts insurance, and the ability of the
patient to pay in the absence of insurance. Primary
care physicians (i.e., family doctor, gynecologist,
pediatrician, internal medicine doctor) may be able to
play a valuable advisory role in referring patients for
treatment if they have had previous experience with
referring to eating disorder facilities, participating as a
member of a care team for a patient with an eating
disorder, or outpatient therapists. Some primary care
physicians, however, don’t have much or any
experience in this area. Therefore, it’s important to ask
about their experience before asking for a referral.
In 2005 and again in 2007, ECRI Institute (a nonprofit
health services research organization) sought to
identify all healthcare facilities that stated that they
offered treatment for eating disorders. This included
hospitals, psychiatric hospitals, residential centers,
and outpatient-care facilities. We surveyed treatment
facilities nationwide to obtain information about their
treatment philosophies, treatment approach, years of
experience, and the clinical and support services they
offer. The information is available in a searchable
database, www.bulimiaguide.org. This database
focuses on facilities offering any or all levels of care
(see the tool explaining Treatment setting and levels
of care). It does not include a listing of individual
therapist outpatient practices. For information on
outpatient-only therapists, go to the “treatment
referral” source at www.nationaleatingdisorders.org;
www.something-fishy.org/treatmentfinder; or
www.edreferral.com. 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. 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. Factors Affecting Choice of Treatment Center
For insured patients, the choice of a treatment center
may be dictated by the beneficiary’s health insurance
plan. Health insurers should provide a list of in-
network (covered) treatment centers. If the treatment
center is outside of the health insurer’s system (out-of-
network), the insurer might pay a percentage of the
treatment costs leaving the patient responsible for the
remainder. It is best to negotiate this percentage with
the insurer before starting treatment. A small number
of treatment centers offer financial assistance; but
most do not. However, inquiring about treatment
scholarships, as they are termed, may be worth
investigating if the patient does not have financial
resources or insurance.
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