What happens when you send your teenager to an outpatient treatment center for an eating disorder

If you determine that attending a treatment center is necessary to keep your child safe and begin the healing process, you may consider a locally based day program rather than sending your child to a residential treatment center. I toured a day program based in Santa Monica, Rosewood Centers for Eating Disorders, to find out how it works.

We did not receive payment for this article, and it is not an endorsement of the facility. Each family should evaluate treatment options on an individual basis.

Rosewood is located in an office park in Santa Monica, California. It has two wings, one for adults, and one for adolescents ages 12-17. There are three kitchens with dining rooms: one for adolescents, one for adults, and a demonstration and experiential kitchen in which teens can learn cooking skills while simultaneously facing some of their food fears in a safe environment.

Rosewood offers three levels of care for teenagers with an eating disorder: Extended Day; Partial Day; and Intensive Outpatient. The average length of stay in each level of treatment is around 30 sessions, which means 30 days of treatment. This means that if a teen comes six days per week, each level will be complete in about five weeks, but timing will vary based on schedules and individual response.

Prior to joining any program, teens need to complete a comprehensive health exam in order to identify any underlying conditions. They will also meet with an intake coordinator for a thorough assessment to determine what level of care is appropriate, and to answer any questions the family may have.

“When working with adolescents, we are looking at the entire family system,” says Jennifer Reeder, Manager of Intake and Outreach. “Our goal is to provide a safe environment for our clients to heal their relationship with themselves, food, and their support system, and help parents with education, modeling, and support.”

Each child will be assigned a therapy team, which will include a psychiatrist, personal therapist, family therapist, group therapist and registered dietitian. The psychiatry is conservative and seeks, when possible, to avoid stimulants and controlled substances because when a person has an eating disorder it’s hard to judge exactly how medications will impact the body.

The treatment modalities used in psychotherapy include Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT) and Acceptance and Commitment Therapy (ACT), all of which have been shown to be very effective in eating disorder stabilization. The nutrition approach is Health at Every Size and Intuitive Eating.

“Our philosophy is that we want to gradually take the stress and anxiety away from food and eating so that while the child is at home, the parents can work on the relationship,” says Reeder. “We can monitor the food, and model healthy relationships to food with the client so that parents can serve a purely supportive role during the initial stages of treatment.”

Rosewood is in-network for many insurance plans and will work directly with insurance providers to ensure maximum coverage for the child.

All programs include:

Food: teens receive lunch and snacks catered by a trusted provider based on a meal exchange program. Clients bring their own dinner.

Parental involvement: Family or support system members are invited to join teens for a family meal. On Thursday evenings, the support system brings meals. This is weekly, followed by a multi-family group on a rotating schedule. Psycho-education around eating disorders is provided. A Registered Dietician runs dietary education. There are also family movement and family process groups. Parents also come in for weekly family therapy sessions.

Schoolwork: teens complete 1-2 hours of schoolwork M-F when needed. Teachers typically use online web-based portals to assign schoolwork. Staff will communicate with the school to review student progress and will supervise study, assignments, and tests.

Extended Day Treatment

This is a highly structured 11-hour day program that includes individual, group and experiential therapy, Monday-Saturday. This is typically the first level of treatment for adolescents who have eating disorders.

Focus: teens get support to rebuild self-esteem, develop healthy coping skills and treat co-occurring conditions.

Partial Day Treatment

This is a 6-hour day program that includes individual, group and experiential therapy, Monday-Saturday.

Focus: teens practice their skills; learn how to prepare meals, order in restaurants and function in social eating situations.

Intensive Outpatient

This is a 4-hour per day program that includes individual, group and experiential therapy that runs Monday-Saturday.

Focus: teens expand their focus to body image, mindful eating, and experiential therapies.

Post Treatment

Once an adolescent completes all three levels of care, Rosewood will make a recommendation to a local treatment team, which will typically include a psychiatrist, therapist and registered dietitian. It is strongly recommended that the parents continue with family therapy as well, to maintain the progress gained during treatment.

Inpatient Treatment

Rosewood also has an inpatient treatment center for eating disorders located in Wickenburg, Arizona. If a teen’s eating disorder symptoms do not stabilize while attending the day programs in Santa Monica, his or her treatment team will discuss whether an inpatient solution may be a better fit.

See Our Guide For Parenting a Teenager With An Eating Disorder