The Importance Of The Outpatient Treatment Team In ED Recovery

Whether you’re just starting to consider that you might have a problem with eating, you’re newly diagnosed with an eating disorder, or you’ve struggled for years, the benefits of working with an outpatient treatment team cannot be underestimated. Finding a team can be confusing and frustrating, so if you’re just starting out, where do you begin? How do you find outpatient providers? What do they do?

WHO?

As with many elements of eating disorder treatment, there is not one definitive answer to who makes up the ideal treatment team. The specific disciplines may vary from one person to the next depending on individual needs and circumstances, but generally speaking, the following individuals would be considered critical members of a full outpatient treatment team for someone struggling with an eating disorder:

• Primary Care Physician (PCP) – Depending on your symptoms, you may need to be seen monthly or even weekly and need a physician who is familiar with eating disorders. PCPs will often track weight, vital signs, and do frequent blood work to monitor for abnormalities. Sometimes, especially with adolescents, an additional physician with expertise in eating disorders (“ED specialist”) may be added to the team.
• Individual Therapist – the recommendation is typically for weekly individual therapy, and it is helpful to see someone who specializes in EDs, though they may also need to work on depression, anxiety, and other co-existing issues.
• Psychiatrist/Psychiatric Nurse Practitioner – If you take psychotropic medications, or think you may need medication, it is recommended that you establish a relationship with a specialized prescriber, though sometimes PCPs are comfortable prescribing some medication.
• Registered Dietitian – you may see outpatient dietitians weekly or less often for support with nutrition education, meal planning, guidance around exercise and accountability.

Depending on your individual needs, you may also benefit from family therapy, group therapy, or other treatment modalities such as expressive therapy, yoga, or meditation. Additionally, you may need more specialized medical treatment from an endocrinologist, gastroenterologist, cardiologist, or other professional.

WHY?

It is widely agreed upon that recovery from an eating disorder is extremely challenging under any circumstances, but the success rates are much higher for those individuals who are surrounded by positive support. Family and friends play a crucial role, but it is important to include specialized professionals in each of these areas to provide guidance, medical management, and to allow loved ones to provide support without playing doctor or “food police” around the clock. Eating disorders impact individuals physically and emotionally in many ways, and there’s no one person equipped to safely manage all aspects of recovery alone.

 WALDEN

Here at Walden, we are committed to working closely with the outpatient providers of our patients, and we work hard to put treatment teams together when individuals come in without adequate support. We believe that the best treatment teams are collaborative and communicative, and we appreciate that while we may work with you for a short time, you may have strong and lasting relationships with your outpatient providers who can help us understand your needs.

HOW?

Putting a treatment team together on your own can be a daunting task, so where do you begin? The following resources can help connect you with providers in your area. It can often be helpful to start by calling your insurance company to make sure you understand your benefits and determine whether or not you need referrals for specialists (like registered dietitians). Insurance companies can often supply you with lists of providers and let you know if specific individuals and treatments are covered by your plan.

• MEDA (Multi-Service Eating Disorder Association) – medainc.org – Online resource that includes a directory of professional members in the greater Boston area in a variety of disciplines, including location, contact information, and insurances accepted. They also offer events and weekly support groups in several locations.
• NEDA (National Eating Disorders Association) – nationaleatingdisorders.org – Online resource that includes screening tools, national provider/treatment directories, and information/referral hotline, and much more.
• PsychologyToday – psychologytoday.com – Online directory of therapists, psychiatrists, and groups. You can sort by primary issues, location, insurances accepted, etc. and read bios of all providers.
• Academy of Nutrition and Dietetics – eatright.org – Online directory of registered dietitians and nutritionists, including those who specialize in eating disorders.

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About the author

Emily Slager, M.Ed., LMHC, is director of Walden’s Hickory Drive Clinic. She is responsible for providing clinical, administrative and fiscal oversight as well as development for the clinic. Previously, she was director of residential, partial hospitalization and intensive outpatient programs for adolescents and adults at Walden’s Waltham location. In that role, she oversaw all aspects of these programs including administrative, fiscal and clinical management. Formerly, she was a clinician on Walden’s inpatient eating disorder and psychiatric units. Ms. Slager earned her master’s degree in counseling psychology from Boston College. Her professional interests include the development of eating disorders in athletes and in the lesbian, gay, bisexual and transgender community.