If I had a loved one who needed inpatient treatment for an eating disorder, I would recommend that they seek treatment at one of the following programs:

Kartini Clinic (Portland, Oregon)
Children’s Hospital in Denver, Colorado
Eating Recovery Center in Denver, Colorado

There are very few inpatient treatment programs, and no residential programs (to my knowledge), with treatment philosophies congruent with mine.

If you had a loved one that needed inpatient treatment, who would you recommend that is like-minded like us?

Thank you again Dr. Ravin.

Karen Barber

What a wonderful post! I am a psychologist who also specializes in eating disorders in the St. Louis area. I find the assumption that clients can’t fail treatment so helpful. That loss of hope is so understandable when one has struggled for so long, but it is definitely not a helpful way to view treatment. We have a DBT program for ED and I wanted to share a recent blog post about the assumptions of DBT. We review these weekly in team, and I must say these assumptions have made me a much better therapist, and person really, as I do firmly believe there is hope for everyone. Thank you for your post… we may add it to our site if that’s alright with you!

http://mccallumplacestl.blogspot.com/2012/01/what-dialectical-behavior-therapy-dbt.html

I did a post on my blog where you were mentioned. Thought you would like to see:

http://wp.me/s1RmwR-bloggers

I continually recommend you because I believe you care and you are on the right track.

Fondly,

Karen

There is hope for everyone if they can get to the right Doctor and have adequate support.

I have referred to Doctor Ravin in recent times. If I would have known about her when my child was going from place to place all over the country, I would have moved to Florida.

My heart goes out to all the sufferers and families and I still sleep lightly as our Recovery has only been about 6 months.

Anyone who needs someone to talk to, email me and we will setup a call. I am here to help anyone I can with encourage and support.

Karen Barber, a Mother, Writer, Eating Disorder Actionist
Blog/Website: http://AnorexiaTreatmentExposed.com
Email: Karen@AnorexiaTreatmentExposed.com

Desensitization involves first learning skills to cope with anxiety (this is where the mindfulness and distress tolerance components of DBT are helpful, along with deep breathing, visualization,and progressive muscle relaxation from CBT). Then, once you have acquired anxiety management skills, you construct a hierarchy of feared foods and feared eating situations (e.g, restaurants, eating at a friend’s house, eating between mealtimes) in order from least scary to most scary. Then, you gradually begin exposure therapy, starting at the bottom. Once you have mastered a lower item (e.g., can do it with minimal anxiety), you move up to the next scarier item. It usually takes repeated exposure to each item in order to desensitize – maybe 10 or 20 or 30 exposures. Once you have mastered an item, you work to incorporate it into your daily life. For instance, my patients typically have an exposure log which requires them to eat at a restaurant once a week and enjoy a fun food (such as ice cream) once a week. Some patients need anti-anxiety meds at first in order to enable them to even contemplate doing the exposures. As time goes on, they taper off the meds and do the exposures without them.

Arnie,

I am so sorry to hear that your daughter has suffered for so long. To answer your question, yes, it is possible that no further treatment would help her. It is also possible that she could recover with better treatment, and I choose to believe the latter. I would recommend reading June Alexander’s blog and books: http://www.junealexander.com. She suffered from AN and BN for 40 years, beginning at age 11, and then finally recovered in her 50′s or 60′s. It is possible. There is hope.

I believe that labeling someone as “treatment resistant” is a disabling and self-perpetuating myth. We are not talking about ALS or Huntingtons or terminal cancer. We know for a fact that AN can be successfully treated when a patient is required to consume full nutrition, full time, maintain 100% ideal body weight for long enough for the brain to heal, and engage in therapy to learn coping skills and build a life worth living.

I wish you and your daughter all the best.