July 14, 2015 Jenna Jarrold

My Child is Coming Home. Now What?

If you're nervous about your child's return home after residential treatment, you're not alone. Transitioning to life in the real world can be very challenging. You want to recreate everything that worked during treatment, but how do you do that and still live a normal life?

It might help to remember that a big part of your child's successful treatment began with a solid plan. The same holds true for life after treatment. Your loved one needs a recovery plan that incorporates realistic goals and ongoing support.

At Mirasol, we do everything to make the transition as easy as possible, for both the child and the parents. Prior to discharge, Mirasol's aftercare coordinator will assemble a team of specialists in your home town who can provide the services you need to help your child stay in recovery. As the discharge date approaches, your treatment team will make a recommendation regarding the next level of care, be it PHP, IOP, or outpatient care.

  • Partial Hospitalization Program (PHP): Typically involves full days of programming (4-7 days per week) while the client lives at home or in a peer-supported residence.
  • Intensive Outpatient Program (IOP): Programming can be anywhere from 10-15 hours per week, consisting mostly of groups and individual counseling.
  • Outpatient Care: Minimum level of care typically includes individual therapy 1-2 times per week, a weekly support group, individual nutrition counseling and other modalities (acupuncture, Reiki, etc.).

Continuity of care is extremely important, so your teen will go home with a full record of the stay in residential treatment, including meal plans, weight progression, medical notes and psychiatric evaluations. The Mirasol team will stay in touch with the new treatment team, sharing information regarding the client's overall progress, challenges, barriers to recovery, specific interventions and goals.

As parents, you are the most important members of your child's recovery team! Your ability to support your child will depend on your ability and willingness to seek support for yourself. Mirasol often offers referrals for parents as well, such as therapy, Al-Anon meetings or support groups where you can hone the healthy coping, emotion regulation, and improved communication skills introduced during our family therapy program.

Red Flags

Before your child goes home, the Mirasol team will make sure you are aware of any "red flags" or warning signs that may signal a return to eating disorder behavior.

Red Flag Examples:

  • isolating from friends and family, or events
  • more prominent or obsessive exercising
  • becoming secretive, especially about food or meals
  • increasing criticism of their body or others' bodies

If you notice these (or other) red flags, contact your teen's new treatment team and alert them to your concerns. Additionally, parents and other family members can always reach out to Mirasol's aftercare coordinator, who will remain in contact with your child for one year after discharge, with any questions or concerns they may have regarding their child's eating disorder recovery.

Don't Panic

An occasional return to maladaptive behavior — skipping a meal, engaging in a binge or purge episode, or over-exercising during a workout — is often part of the recovery process, and it doesn't mean your child is relapsing. Mirasol clients leave treatment with a "Slip Plan," which includes steps to take immediately following a slip:

  • exploring why the slip happened
  • reaching out (telling someone)
  • getting back on track (back on meal plan, exercise plan, etc.)
  • forgiving yourself

For parents, it's important to support your child during this tough time. Be careful not to shame your child. And remember, if you have questions, contact your child's new treatment team or the Mirasol team!

Dos and Don'ts

As a parent, you want to make your child's transition home as smooth as possible. Every client is unique and each transition is different, but there are a few things that parents should keep in mind:

  • Make sure your child has agreed to a daily routine/schedule (this can include school, activities, therapy appointments, chores, leisure time, etc.)
  • Identify the difficult times of day for your child and the supports can you put in place.
  • Determine the level of independence you should give your child (ask the Mirasol treatment team if you need help).
  • Discuss your own fears about your child's transition with the Mirasol treatment team.
  • Make sure you have adequate support systems for yourself.
  • Most importantly, talk with your child about what you can do, and how you can make coming home easier.
  • Make sure you have contact information for the aftercare coordinator in case you have questions or need assistance.

Reduce Mealtime Stress

Mealtimes can be one of the most stressful times for families with a child returning home from residential treatment. However, preparing yourselves in advance for potential difficulties can reduce the stress level.

  • Establish and maintain a routine around mealtimes, especially in the early weeks of recovery.
  • Plan meals in advance and invite your child to grocery shopping with you.
  • Try to eat with your child to demonstrate that eating a meal is a normal and necessary part of the day. Try to normalize the act of sitting down to a meal.
  • Avoid any comments on calorie content, weight and portion size.

Build Your Relationship

Building a better relationship with your child is the key to long-term recovery. Here are simple things you can do to establish and maintain a healthy relationship:

  • Spend time with your child, doing things the child enjoys.
  • Listen when your child is speaking, and show that you value your child's opinions.
  • Acknowledge abilities and talents your child has, particularly ones that aren't "physical."
  • Focus compliments on your child's personality and individuality rather than on appearance.
  • Work with your child to identify friends who can provide support and respect. Encourage your child to spend time with those friends.
  • Examine your own attitudes to body image, and to yourself (your child will pick up on these).
  • Keep lines of communication as open as possible.