treatment center
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soopaj ...@aol.com (SoopaJess)
currently my treatment team is advocating for me to get into Remuda Ranch.
Though this may or may not be a possibility, i am becoming less certain about it, as i am NOT Christian (but i am willing to get whatever else i can out of the program).
my insurance will only cover the NY Hospital-Cornell Medical Center in White Plains, NY. i was there once before in '98 and got about as much support as a broken bra strap.
i am likely to end up withdrawing from school at the end of the semester (to save my high GPA) but its pretty much agreed that i need treatment.
Any suggestions?? Does anyone have comments about either cornell or remuda (anyone been to Long island Jewish?). please dont tell me you get out of treatment what you put into it, because i think that is only true to an extent.
and i AM going to get better.
Bulimia sucks.
jessica
"ClixPix" clix...@cox.net
Jess, how about Laureate, in Tulsa, Oklahoma? Their program sounds very good and they are careful about the refeeding protocols, they don't rush people through the program. They provide several levels of care, starting with the acute inpatient unit. The next step down is residential, within the same building, I think, and then a patient moves to Transitional Living, in another building. All therapy and recreational groups are done in the Clinical Building and patients are not in their sleeping rooms except in the evenings and nighttime. Laureate uses several treatment modalities, not focusing on any one thing as being "the" way to help patients. The ED program is for women only and there are usually about 12 patients on the adult unit and another 12 or so on the adolescent unit. The adults and the adolescents do not have any interaction and do not have groups together.
A couple of people from the newsgroup have been at Laureate and could give you more information about it as well. Check out the website at http://www.laureate.com .
--Connie
--
"Starving the flesh wastes the spirit."
--Kandis Elliot
"Meow" norei...@nkjbr.com
NO! Do not go to LIJ unless all you need is refeeding and no therapy from what I have heard.
-E ...
soopaj ...@aol.com (SoopaJess)
i am so exhausted with treatment finding.
the process is long and discouraging and draining...
now my team is looking at River Centre in Ohio. But im 21 and its a partial program. meaning 2/3 of the weekdays and all weekend i will be on my own. Um, ok. Yah right.
if i lived in Ohio and could live at home, it looks like a great program. and i've heard good things about it. but why the hell would i go all the way to ohio for a partial program???? if i could control my eating on my own, i woudlnt NEED a clinic!
dlrs ...@hotmail.com (debbie)
I spent a good bit of the summer in Oconomowoc, Wisconsin and Rogers Memorial. I really do think they have a good program, I just had a big problem with their strict rules against exercising too much. But it is a good place, and the people are nice...
if you want more info, just ask me and I will tell you what I know.
(I went to Laureate years ago and it was really good, but from what I hear it's very different in structure now... though I am sure it's still good!)
-Debbie
megand ...@loik.com (libby)
I am just curious to what a typical day at a treatment hospital is like. I don't know if I could ever go through with such a thing. I am so stubborn in my ways, I don't think I could give in and follow rules regarding how my day goes; food, exercise, free time etc ... I sometimes wonder if I need a real dramtic change and help in order to overcome my ED, but I'm afraid to give up all my freedom. I also don't think or know if my disorder is really that bad. To me it seem unbearable at times, but then at others it's okay. What are some guidelines as far as when a person may need inpatient care. I know if you are near death, but what else?
I am so desparate now, I just want out of this hell, but don't know how to do it.
arghg ...@hotmail.com (Argh Girl)
Libby You sound a lot like me. I am _really_ stubborn and don't like _anyone_ telling me what to do. If you told me not to jump off a bridge, I probably would just to spite you. I had the same fears when I went into the hospital...and for the first few days was a total pain in the arse, refusing to do anything they wanted me to.
After a few days, though, I realized that it was pointless and I decided to just go with the flow and do what they want. You know what?
It felt IMMENSELY good to be able to let go of my control for a while.
It was a huge relief and helped me realized what a huge burden my always having to be in control and being so stubborn was on me.
It would be really hard when you first go into treatment, but I bet that if you can let yourself let go, it will feel really really good.
Sometimes we need to just let ot hers take care of us and do what they say.
I am still really stubborn now and the hospital certainly didn't take that away. But it was a nice and much needed break and I think the only way that I could really get any better.
As far as needing treatment, I think that if you feel like it is unbearable well then treatment would help. It sounds like everything in your life is pretty stable and you have a good support system so now might be a good time.
Hope this helps?
ag
"ClixPix" clix...@cox.net
Libby asked: These are the criteria used by one health insurance company (Magellan Behavioral Health) and they pretty much match up with the criteria established by the American Psychiatric ***ociation in their Practice Guidelines for the Treatment of Eating Disorders:
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Hospitalization, Eating Disorders Criteria for Admission The specified requirements for severity of need and intensity and quality of service must be met to satisfy the criteria for admission.
I. Admission - Severity of Need Criteria A and one of criteria B, C, D or E must be met to satisfy the criteria for severity of need.
A. The patient has a primary diagnosis of Anorexia Nervosa, Bulimia Nervosa, or Eating Disorder Not Otherwise Specified. The illness can be expected to improve significantly through medically necessary and appropriate therapy, by accepted medical standards. Patients hospitalized because of another primary psychiatric disorder who have a coexisting Eating Disorder should be reviewed according to the criteria below only if the primary psychiatric disorder no longer requires hospitalization.
B. The patient has a body weight less than 75% of Ideal Body Weight (IBW) or Body M*** Index (BMI) of 16 or below. If body weight is greater than 75% of IBW (or BMI > 16), this criterion can be met if there is evidence of any one of the following: . weight loss of >15% in one month, or . weight loss ***ociated with physiologic instability unexplained by any other medical condition, or . the patient rapidly approaching a weight at which physiologic instability occurred in the past, or . a child or adolescent patient having a body weight <85% of IBW during a period of rapid growth.
C. In anorexia, the patient's malnourished condition requires 24-hour medical/nursing intervention to provide immediate interruption of the food restriction, excessive exercise, purging, and/or use of laxatives to avoid imminent, serious harm due to medical consequences or to avoid imminent, serious complications to a co-morbid medical condition or psychiatric condition (e.g. severe depression with suicidal ideation). Existing medical consequences are not of a severity to require a medical hospitalization.
D. In bulemic patients, the patient's condition requires 24-hour medical/nursing intervention to provide immediate interruption of the binge/purge cycle to avoid imminent, serious harm due to medical consequences or to avoid imminent, serious complications to a co-morbid medical condition (e.g.
pregnancy, uncontrolled diabetes) or psychiatric condition (e.g. severe depression with suicidal ideation). Existing medical consequences are not of a severity to require a medical hospitalization.
E. The patient's eating disordered behavior is not responding to an adequate therapeutic trial of treatment in a less intensive setting (e.g., residential or partial hospital) or there is clinical evidence that the patient is not likely to respond in a less intensive setting. If in treatment, the patient must: [Because of the severity of co-existing medical disorders, the principal or primary treatment of some eating disorders may be medical/surgical.
In these instances, medical/surgical benefits and criteria for appropriateness of care will apply.] . be in treatment that, at a minimum, consists of treatment several times per week with twice weekly individual and/or family therapy, either professional group therapy or self-help group involvement, nutritional counseling, and medication if indicated, and . have significant weight loss (<85% IBW), and . have significant impairment in social or occupational functioning, and . be uncooperative with treatment (or cooperative only in a highly structured environment) despite having insight and motivation to recover, and . require changes in the treatment plan that cannot be implemented in a less intensive setting.
II. Admission - Intensity and Quality of Service Criteria A, B and C must be met to satisfy the criteria for intensity and quality of service.
A. The evaluation and ***ignment of the mental illness diagnosis must take place in a face-to-face evaluation of the patient performed by an attending physician prior to, or within 24 hours following the admission. There must be the availability of an appropriate initial medical ***essment and ongoing medical management to evaluate and manage co-morbid medical conditions.
Family members should be included in the evaluation process, unless there are specific contraindications to their involvement.
B. This care must provide an individual plan of active psychiatric treatment that includes 24-hour access to the full spectrum of psychiatric staffing. This psychiatric staffing must provide 24-hour services in a controlled environment including but not limited to medication monitoring and administration, other therapeutic interventions, quiet room, seclusion, intermittent restraints, and suicidal/homicidal observation and precautions.
C. A discharge plan is initially formulated that is directly linked to the behaviors and/or symptoms that resulted in admission. This plan receives regular review and revision that includes, as appropriate, timely evaluation of post-hospitalization needs.
Criteria for Continued Stay III. Continued Stay Criteria A, B, C and either D or E must be met to satisfy the criteria for continued stay.
A. Despite reasonable therapeutic efforts, clinical evidence indicates at least one of the following: . the persistence of problems that caused the admission to a degree that continues to meet the admission criteria (both severity of need and intensity of service needs), or . the emergence of additional problems that meet the admission criteria (both severity of need and intensity of service needs), or . that disposition planning, progressive increases in hospital privileges and/or attempts at therapeutic re-entry into the community have resulted in, or would result in exacerbation of the psychiatric illness to the degree that would necessitate continued hospitalization, or . a severe reaction to medication or need for further monitoring and adjustment of dosage in an inpatient setting, documented in daily progress notes by a physician.
B. The current treatment plan includes documentation of diagnosis (DSM-IV axes I-V), individualized goals of treatment, treatment modalities needed and provided on a 24-hour basis, discharge planning, and intensive family involvement occurring several times per week (unless there is an identified valid reason why such a plan is not clinically appropriate or feasible).
C. The patient's progress confirms that the presenting, or newly defined problem(s) will respond to the current treatment plan and this is documented by daily progress notes, written and signed by the provider.
D. The patient's weight remains <85% of IBW and he/she fails to achieve a reasonable and expected weight gain despite provision of adequate caloric intake.
E. There is a continued inability to adhere to a meal plan and maintain control over urges to binge/purge such that continued supervision during and after meals and/or in bathrooms is required. In order to satisfy this criterion, there must be evidence that patient is unable to participate in ambulatory or residential treatment, lacks significant insight into the symptoms of his/her illness, and has regressed in response to progressive increases in privilege level.
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This is for inpatient treatment; they have another criteria for other levels of care (ie, partial hospitalization/day treatment, Intensive Outpatient (IOP), regular outpatient...
--Connie
--
"Starving the flesh wastes the spirit."
--Kandis Elliot
"ClixPix" clix...@cox.net
As far as what a "typical day" is like in an EDU, well, most places have a lot of group therapy sessions, and the days are spent in groups, with consultations with one's individual primary nurse several times a week and with the dietitian and the therapist at least twice a week. Some places offer "outings" at the weekend, where those who are physically and emotionally stabilized can go somewhere, again as a group, to a store, a museum, a park or some other place as a way of getting out of the hospital for a little while. The primary focus is upon group therapy and isolating oneself is definitely discouraged. In the group and individual therapy sessions, the idea is to begin identifying underlying core issues so that later when back at home with one's own therapist the patient can work on those in earnest.
Family sessions are also encouraged and recommended, and in some instances when the family lives far away, these are done by telephone. Some places have "Family Week" where families come to the facility and have intensive therapy sessions with their patient and also with other families.
Depending upon one's insurance, a patient may be able to take therapeutic p***es further along in treatment (some insurance companies won't permit this, reasoning that if someone is well enough to go out into the community alone or with friends, then (s)he is well enough to be discharged or transferred to a lower level of care).
There are three meals and three snacks per day, and depending upon the individual's situation, the snacks are mandatory.
Many patients who years ago would have been admitted to an inpatient EDU are now instead admitted to a day treatment program and even when someone is admitted to the hospital, inpatient care is considered more as an acute, short-term situation rather than a lengthy period such as it was in years past. Usually someone is on an acute inpatient unit for a brief time, say ten days or a couple of weeks -- perhaps longer, depending upon the situation which caused them to need admission in the first place. Then they move to the next level of care, which is less intensive, less structured and less expensive. In some instances people cannot afford to pay out-of-pocket for room and board in order to remain in a program's day treatment (Renfrew, for instance, offers DTLA, which is a transitional living arrangement where out-of-town patients remain at the facility and pay their room and board while insurance pays for the day treatment), and so may have to be discharged and return home. If someone is in treatment in their own home community, then it's easy enough to live at home and go to the day treatment program each day.
There is some time for relaxation, too, during each day of an inpatient stay, but most good treatment centers keep people busy most of the time, optimizing the time that they are there so that the patient gets the insurance company's money's worth out of the program. There are not a lot of hours free to just veg in front of the TV.
An inpatient stay is definitely NO vacation, it can be emotionally draining, but can also be very helpful in breaking free of a cycle and beginning to recover one's life again.
If you go to the Laureate website at http://www.laureate.com you can see a sample of what the weekly and daily schedule is like for patients. It is similar to many other programs so will give you an idea of the types of group sessions which are offered.
Hope this helps!
--Connie
--
"Starving the flesh wastes the spirit."
--Kandis Elliot
greta gertie_har...@hotmail.com
hi jess, i do hope you're able to find a program suited to your needs, wants and goals.
i personally, don't believe you get out of treatment what you put in to it, well to a certain extent. I really do think it is 50/50, 40/60, 80/20 - whatever!
i do believe that how well you do in treatment is based on several factors. two that come to mind for me based on personal experience a re1) the community you are inpatient with, 2) the protocol of the particular program you're in and 3) the philosophy of the program and also, 4) the staff. So as not to point the finger at any program there is also the aspect of where you, yourself, are at, how geared you are towards recovery, your attitude, willingness to challenge your beliefs, etc.
i personally believe that you may do yourself a disservice by going to a christian program when you do not have religious beliefs, as from what i know about remuda ranch, their program is very christian based.
isn't there *any* other programs your insurance company is willing to send you to?
my two cents worth,
- g
takingupspac ...@hotmail.com (olivia)
remuda is on its way to going under anyway.....i really wouldnt go there....
they are having major problems with staff too.....
.02 cents
takingupspac ...@hotmail.com (olivia)
jess..
do not go to remuda.....take it to email if you want more.....just please dont go there.....
olivia
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