Treatment
The treatment recommended is based upon the level of care the client requires according to the American Psychiatric Association (APA) Guidelines for Treating Eating Disorders.
Level 1 care is introductory and educational.
Level 2 offers more advanced and specialized outpatient treatment.
Level 3 and 4, which involve day hospital and inpatient admission is recommended only for clients with very severe eating disorders. Levels 3 and 4 are not currently available in northeast Ontario. Clients requiring these levels of service are referred to specialized centres in southern and eastern Ontario.
The REDP also offers Level 1 & 2 outpatient programming for families.
When a client is admitted or identified during an admission to an inpatient unit in the northeast, the REDP will consult to the inpatient team for the duration of the stay. There is no specialized programming available on the units. Individual treatment plans may be devised in consultation with the individual's doctor, nursing team and representatives from the REDP and /or other community care providers.
Clients first come to the REDP at all stage of treatment readiness. Many clients are dealing with doubts and worries about what treatment will entail and how recovery will change their lives. Clients may participate in motivation sessions to provide support and to guide them into treatment.
Outpatient Treatment Services
Level 1 – Psychoeducation
- Adolescent clients may begin treatment by participating in the "Why Weight" program. In this program consisting of 8 sessions the focus is education about eating disorders, their symptoms and consequences, and moving toward change/recovery. Family members are included in the program.
- Adults clients begin with Turning Points or a 3 session education series based upon the Ontario Outreach Program's "Turning Points" series. The program is designed to provide necessary education on a variety of topics pertinent to recovery from eating disorders.
Level 2 – Clients are re-evaluated at the end of Level 1 care and further treatment is negotiated. Options include:
- Cognitive Behavioural Therapy (CBT) – Pathways to Recovery consists of two – 6 week groups that follow a cognitive behavioural therapy model. The content focuses on addressing the relationship between the individual's thoughts, feelings and eating disordered behaviour. Participants are taught a variety of skills to address eating disorder symptoms including: how to use relaxation techniques to manage negative emotions, how to identify and challenge thinking errors, and how to face feared foods and food-related situations.
- Individual Psychotherapy – for those with complex psychosocial issues that might be better addressed in individual rather than group therapy. Individual therapy may also be offered to prepare clients for group therapies and to assist clients participating in groups to apply the content to their particular circumstances.
- Nutrition Counselling – geared to help normalize eating as well as to achieve a healthy, non-threatening relationship with food.
- Brown Bag Lunch – this mealtime activity creates an outpatient therapeutic environment where the client can experience consuming a normal balanced meal. The therapist can reinforce previous teaching related to normal eating, reduce the person's anxiety associated with eating as well as teach and practice distraction techniques useful in overcoming eating disorder thoughts and discomfort associated with eating.
- Dialectical Behavioural Therapy (DBT) Skills Group – The group focuses on assisting participants to lean to improve their coping skills in four core areas – mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness. While participating in the group, individuals are expected to work with an individual therapist on a weekly or bi-weekly basis to review group homework assignments and to work on applying the information from group to their particular circumstances.
- Family Services – Family Therapy is offered to clients under the age of 18. The preferred treatments is family therapy because parents are the key resource in the young person's life and therefore can most influence in helping them to eat normally and overcome the eating disorder. Family therapy typically involves the parents, the client and the siblings.
- Family Education Workshop – This group is offered to family members and significant others close to REDP clients. It has also been extended to include families who have a child with an eating disorder but not registered with the REDP. Friends and other supports are welcome.
- Caregiver Support Group – this group is offered via video throughout northeast Ontario. It runs on a monthly basis.
The Program also has protocols for clients who are at high risk, pregnant or desire supportive care.
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