July 12, 2016

WATER FIGHT

Mirasol's teen residential eating disorder treatment program has always been a trend-setter, not only for its extraordinary individual attention, but for its emphasis on experiential therapy and strong bonds between staff and clients. In this interview, Clinical Director Jodi Tudisco discusses in detail the program's underlying philosophy and how that philosophy plays out in day-to-day interactions with the clients and their families.

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JODI TUDISCO

Young people in Mirasol's teen program aren't just struggling with an eating disorder; they're also going through all the other physical and emotional turmoil that is part of being a teenager — hormonal changes, separation anxiety, establishing their autonomy, and, of course feeling like no adult could possibly understand what they're feeling.

So although the philosophical underpinnings are the same, there are fundamental differences between Mirasol's adult and teen eating disorder treatment programs. And that includes filling the need for a supportive family environment for young clients who may be away from their parents for the first time in their lives.

"We do everything we can to create a warm, loving, family environment," says Mirasol Adolescent Program Clinical Director Jodi Tudisco. "We all share the same physical space — there's no separate building for staff — so we're interacting constantly with clients between sessions. We also intentionally spend unstructured time with them, working on puzzles, shooting baskets or just hanging out."

We do everything we can to create a warm, loving, family environment. We all share the same physical space, so we're interacting constantly with clients between sessions. We also intentionally spend unstructured time with them."

Jodi believes that those casual interactions with staff play an important role in building trust. So staff and clients may organize an impromptu water balloon fight, or join in a "pajama day", or spend a hot day exploring a cool cave in the mountains above Tucson.'

"You forget that they're kids, too, and they're missing out on all that fun and all that life that kids their age are experiencing, and they know it."

Dialectical behavioral therapy is a cornerstone of Mirasol's teen eating disorder treatment program, but Jodi finds that certain experiential therapies work particularly well for teen clients.

"I think the teen are especially responsive to art therapy," she says, "and of course equine therapy is a consistent favorite."

Mirasol has recently begun incorporating more individual body therapy. "Touch is important for the teens," says Jodi. "This may be the first time they've been away from their families. Many come into to treatment with attachment issues, and feeling unloved and unworthy. We are always very careful to ask first before touching the teens, but eventually they begin asking for hugs. A few months back, one of our clients said to me, 'Don't you know, Jodi, that we miss our Moms? We need hugs!' And of course they do!"

Teens also appreciate Mirasol's healthy exercise program, which includes yoga, kickboxing, hiking, caving and even backpacking. Anthony Hackworth is the dietitian and exercise coordinator at the teen unit, and his vision is to switch the focus from "exercise" to "activity."

"Sometimes going to the gym, and similar organized activities are all 'going to exercise' rather than 'going to live,'" says Jodi. Anthony tries to incorporate more playfulness and spontaneity in a variety of outdoor activities.

Jodi recalls that when they went caving recently, they asked the clients, 'Where's your eating disorder now?' and 'Where's your relationship with exercise right now?' And she was thrilled to discover that they weren't even thinking about it, and that, at least for that moment in time, they were experiencing what it's like to not be totally focused on appearances or on how many calories they have to eat.

The thing that I always say to the parents is, the longer you wait, the stronger those negative voices in their head become. The sooner your child gets treatment, the greater the likelihood that they will make a complete recovery. If your child has an eating disorder, don't wait!

It's midsummer now, and many families are taking long-planned summer vacations that may not be working out exactly the way they expected.

"What kind of vacation can you have when you are with somebody who can't focus on anything other than what they're eating or not eating?" Jodi wonders. When teens with eating disorders go on vacation, they may be triggered by a whole other set of complicated situations involving food.

"Since they're not at home, they can't control what they're eating, or hide what they're not eating. They may experience more mealtime stress than normal because the family is eating out a lot. And it affects the other family members as well. Resentments can form because this was supposed to be their vacation, too, and all the attention is focused on the one unwell person."

"The thing that I always say to the parents is, the longer you wait, the stronger those negative voices in their head become. The sooner your child gets treatment, the greater the likelihood that they will make a complete recovery. If your child has an eating disorder, don't wait!"