September 14, 2012 Heather Purdin

Day Treatment: Is it Right for You?

Mirasol is excited to announce a new adult day treatment program! Therefore, this blog will be dedicated to this unique level of care that can serve as a bridge to lasting recovery.

Level of Care

Often referred to as Partial Hospitalization (PHP), day treatment is a voluntary, intermediate level of care. Most programs vary from as few as 5 hours a day 3-5 days a week up to
as many as 12 hours a day 7 days a week.

At Mirasol, clients attend groups and therapeutic appointments from 7:00 AM to 3:00 – 3:30 PM, usually 5-6 days a week with an average length of stay ranging from 6-14 weeks. On the days when the evening intensive outpatient program meets, clients can attend those 3 hour sessions at night as well as a Thursday support group.

Whether transitioning down from a higher level of care, such as inpatient or residential treatment, or stepping up from traditional outpatient therapy, this schedule provides a nice balance of structure and support, while allowing for a healthy degree of accountability that empowers clients to own their progress.

To qualify for this level of care, the client is first assessed to ensure the program is appropriate for the individual's needs. This is for the best interests of the each client as well as the therapeutic community of all the clients participating in the program.

Clinical guidelines generally require the following:

  • The client is medically stable. No extensive, acute medical monitoring is warranted.
  • If suicidal ideation is present, it is determined that there is a low level of risk and there is neither a plan to carry this out nor any intent to do so.
  • Generally clients are at or above 80% of their ideal body weight.
  • Motivation: Though pre-occupied with intrusive, repetitive thoughts, the client is cooperative and able to follow treatment recommendations.
  • There is a need for structure to stabilize weight and reduce other behaviors such as bingeing, purging and over-exercising.
  • Any co-occurring disorders are secondary and able to be addressed without hospitalization.

Mirasol's Integrated Approach

Mirasol is one of few treatment centers that specializes in an integrated approach to recovery designed to heal the whole person — mind, body and spirit — by combining traditional individual and group psychotherapy with a multitude of experiential therapies.

The Mirasol philosophy is very adamant about nurturing the mind-body connection, especially through mindfulness movement. Therefore, healthy exercise can be practiced safely with supervision through grounding activities such as yoga, a nature walk, or other moving meditations of interest to the group.

Creative expression is often a favorite of clients. Through dance, art, music, and creative writing, clients are offered an "out of the box" opportunity to process thoughts and emotions, many of which may be overlooked during talk therapy sessions. Personally, my experience with an eating disorder lead me to discover how I manipulated my nutrition and body in efforts to communicate to the world my internal pain and suffering. My behaviors became my voice of protest, "Don't you see how unhappy I am?" Tapping into creative thinking not only provides an opportunity to find one's voice when words are not enough, but it is also a wonderful tool for problem solving, which is a great life skill for anyone.

Additional groups include process groups, skill building groups, and educational groups. Topics may include communication skills, nutrition, sexuality, inner child work, and dialectical behavioral therapy.

Though food and weight are an outward expression of the inner turmoil for those suffering with eating disorders, nutritional rehabilitation must be addressed. Without adequate nutrition, the body is at great risk of health complications and the mind is not able to optimally process and overcome the core thoughts, emotions, and beliefs that fuel the eating disorder.

The Mirasol Day Program offers 2 supported snacks and 2 supported meals each day. Those staying in the program's housing accommodations are provided further support with overnight supervision and additional meal support. Each day, the clients prepare their lunch, eat together in community, and then have an opportunity to discuss feelings and behavioral urges that may have been triggered during the meal. Clients are also provided opportunity to dine out once a week to challenge any fears surrounding eating foods prepared by others and eating in public. Grocery shopping can also be an intensely challenging experience for many, so the program helps build confidence through supported grocery shopping during the week ensuring the transition home is that much smoother.

Day Treatment Benefits

  1. Intensive inpatient and residential treatment certainly have their place in recovery. In the beginning of the recovery journey, some clients may need or prefer the psychological safety provided in a 24/7 structured program. However, imagine going from 168 hours of support each week straight home to outpatient therapy where there may be only 2-3 hours of contact a week with an aftercare team. This transition can be quite a shock and impede some of the progress made. Therefore, day treatment allows the client to ease into a sense of autonomy, reducing anxiety that may surround returning home.
  2. Whether clients commute home nightly or stay in housing provided by the treatment facility, clients are given a critical level of responsibility for their own recovery outside of program hours, where they can test the skills and tools they have learned by facing everyday experiences. Day treatment allows clients to bring these real life experiences back to the safety of the program, so they may process both their struggles and triumphs.
  3. The responsibilities of everyday living do not stop when one enters treatment. Whether the client needs to find a new job, locate an apartment, prepare for admission to school, pay bills, or tend to other personal business in order to settle back into life outside of treatment, there is room to tackle these activities of daily living outside of program hours. Accomplishing these task oriented goals further permit a sense of self-efficacy.
  4. For those who have been through multiple programs and have much of the education and nutritional knowledge under their belts, day treatment may provide a level of support that maintains motivation without leaving clients feeling overstimulated or burnt out. Day treatment can kick start the individual out of unhealthy behaviors and back into adaptive patterns they have already once demonstrated. If someone experiences a relapse, they do not have to start back at square one! They just need to begin again the journey of recovery.

Never Give In!

As Mirasol CEO Jeanne Rust wisely says, "If a person did not achieve full recovery in prior experiences at eating disorder treatment centers, this does not mean that the person has failed treatment — it means that the kind of treatment she received failed her!" ...Never give in and begin again!