Exploring the different levels of eating disorder day treatment
The options for eating disorder treatment can be overwhelming. We understand that the different names and acronyms may be confusing to navigate, and that is why we’re here to help you understand the options so you can make the right decision for your treatment.
While Walden offers 24-hour care in the form of our inpatient and residential programs, we also provide day treatment options through our partial hospitalization program (PHP) and intensive outpatient program (IOP).
Learn the differences between PHP and IOP levels of care for eating disorder treatment and why they might be helpful for you or your loved one.
What is Partial Hospitalization Program (PHP) eating disorder treatment?
Partial hospitalization program, or PHP for short, is a day treatment program that despite its name does not take place in a hospital setting. Walden’s PHP means clients live independently at home while having structured daytime programming for five to six days per week.
We provide separate PHP programs for both adults and adolescents. Both programs include six hours a day of treatment in-person at one of our locations, as well as virtually for the convenience of in-home treatment. Our Massachusetts clinics are in Braintree, Waltham, and Westborough, and we have a clinic in Middletown, Connecticut and Alpharetta, Georgia.
PHP patients have individual therapy twice weekly and meet with their dieticians once weekly to establish a meal plan and discuss nutritional guidelines. They are also evaluated weekly, monitored medically and complete lab work and other necessary testing by a nurse practitioner. There are opportunities for medication management as well.
Goals of PHP
PHP helps clients to better understand the impact of their eating disorder on biological, social and psychological functioning. This involves identifying the activating thoughts and feelings that can often drive behavior. Clients learn and practice skills that are designed to replace disordered behaviors and manage the stress of change.
The primary goals of PHP are to:
- Establish (or re-establish) regulated patterns of eating
- Understand and manage activating events
- Interrupt and reduce the use of eating disorder behaviors
PHP reaches these goals through Dialectical Behavior Therapy (DBT), Cognitive Behavioral Therapy (CBT), group therapy, expressive therapy, nutrition education and many other electives on specific topics such as co-occurring disorders, self-compassion, guided journaling, and many more. In addition, our adolescent program uses the evidence-based model Family-Based Treatment (FBT), which has been proven to support lasting recovery as part of the PHP programming.
What is Intensive Outpatient (IOP) eating disorder treatment?
Intensive Outpatient Program, or IOP for short, is a day treatment program that consists of three-hour long sessions three times a week for both adults and adolescents. Just like with PHP, our IOP is offered in-person at one of our locations in Massachusetts and Connecticut as well as virtually for the convenience of in-home treatment.
We offer additional IOP programming in the evening for adults, and for adolescents to provide the flexibility to remain at work and/or in school while getting the specialized eating disorder care they need.
Goals of IOP
Our IOP runs three mornings or three evenings every week in most locations for three hours each day.
The primary goals of IOP are to:
- Establish (or re-establish) regulated patterns of eating
- Learn, practice and apply adaptive coping skills to replace disordered behaviors in environments outside of the treatment setting
- Problem solve day-to-day stressors that may be getting in the way of lasting recovery
Like the types of therapies and groups utilized in in our PHP programming, IOP utilizes DBT, CBT within the group therapy setting, and electives featuring topics such as expressive therapies, body neutrality, and relapse prevention. Just as we do in our adolescent PHP, our IOP for adolescents also uses the evidence-based model Family-Based Treatment (FBT), which has been proven to support lasting recovery, weight restoration and behavior cessation.
IOP also includes individual case management, as well as a coached therapeutic meal where clients and staff eat together providing clients the opportunity to practice eating in a social setting. Unlike other levels of care, IOP does not offer medication management services. Dietary services are not typically offered in IOP unless indicated as a part of specialized programming detailed below.
Eating disorder treatment for adolescents and their families
Walden utilizes the Family Based Therapy (FBT) model in both our PHP and IOP levels of care. FBT is the only evidenced-based treatment for eating disorders in adolescents. We use it because it works. While it is effective, it does require a commitment from parents and caregivers that may not be feasible for all families. We recommend caregivers review our Transition Guide for Families to familiarize yourself with the programming and parental/caregiver commitments prior to beginning treatment.
Specialty PHP & IOP programming for individualized care
More than just tracks, Walden offers a variety of specialized PHP and IOP virtual day treatment programs that cater to specific diagnoses and identities. These unique specialty programs are staffed by carefully chosen clinicians, dietitians, and medical providers selected for specific expertise and specialized training.
ARFID IOP
Avoidant Restrictive Food Intake Disorder (ARFID), often conceptualized as “extreme picky eating,” is an eating disorder characterized by highly selective eating habits, disturbed feeding patterns, and/or food aversion. Walden’s ARFID IOP is a treatment program specifically designed to meet the needs of clients with ARFID. We utilize CBT-AR, a unique approach to CBT therapy created by ARFID experts at Massachusetts General Hospital.
B’SHALOM IOP
Walden’s B’SHALOM IOP is specifically for adult and adolescent members who identify with the Jewish faith and see religion as an integral part of their healing process. B’SHALOM offers guidance in balancing nutritional needs, faith, and eating disorder recovery.
Free to Be: Adult Binge Eating Disorder IOP
Our Free to Be IOP is for adults with binge eating disorder, emotional eating, night eating syndrome (NES) and/or overeating and provides the nutritional and emotional support needed to increase control and decrease binge eating behaviors.
GOALS: Adult IOP for Competitive Athletes with Eating Disorders
We developed the GOALS IOP with the unique needs and experiences of athletes in mind. Welcoming individuals of all genders ages 18+, this program provides athletes with the support needed to understand the thoughts that drive disordered behavior.
Rainbow Road: Adult PHP & IOP for LGBTQIA+ Community
Walden’s Rainbow Road PHP and IOP are unique treatment programs that provide support for LGBTQIA+ patients by LGBTQ+ providers because we believe that positive attachment, modeling and community is how people heal.
What is outpatient eating disorder treatment?
Outpatient treatment may be the term or concept that most people are familiar with and consists of regular one-on-one therapy and medical sessions taking place at various intervals such as weekly, every other week, etc. Walden does not offer outpatient eating disorder treatment services; however, we are here to support our clients with the goal of connecting them to specialized outpatient treaters. We often work with outpatient providers when that time comes to ensure a smooth transition and long-term recovery.
We’re here to help
Seeking help for an eating disorder can be difficult, and Walden is here for you to help determine the level of care that is best for you or your loved one.
If you have questions about our levels of care or your future treatment at Walden, please fill out the form on this page or email intake_coordinators@waldenbehavioralcare.com to connect with a member of our Welcome Center. Begin your journey to recovery today.
Rebekah Bardwell Doweyko, LPC, CEDS-S (she/her/hers) is Assistant Vice President, Clinical Operations at Walden, where she is responsible for program development and clinical, administrative, and fiscal oversight of all of Walden’s virtual programs and ambulatory clinics. Bekah has over 20 years of eating disorder experience. Prior to joining us, Bekah was an Intensive Care Manager at the Connecticut Behavioral Health Partnership (Value Options, Inc.) in Rocky Hill, CT. She also founded and directed the Intuitive Eating Program (IOP) at Hollywood Pavilion Hospital in Hollywood, FL, and held various clinical positions at The Renfrew Center in Coconut Creek, FL. Bekah composed the foreword to the highly acclaimed “Maintaining Recovery from Eating Disorders” self-help book by Naomi Feigenbaum and was featured in the Emmy Nominated HBO Documentary “THIN.” Bekah earned her master’s degree in mental health counseling from Florida Atlantic University and is a Licensed Professional Counselor in the State of Connecticut and is a Certified Eating Disorder Specialist.
