Questions to ask eating disorder treatment centers

It’s not easy making the decision to send your child to an eating disorder treatment center – you probably have a lot of questions. There are so many factors to consider and so many options out there. And right now there’s added stress because so many centers are at capacity and have waiting lists. 

I’ll review the basics of what it means to send your child to an eating disorder treatment center. Before we dive in, it’s very important to say that this decision is yours to make. Nobody should make the decision on your behalf.  My goal is to help you weigh your options. And I have confidence that you will make the best choice for your unique situation.

Sending your child to an eating disorder treatment center will be hard no matter what. But ideally, you should feel on some deep level that this is the best right decision for you, your child, and your family right now. It doesn’t have to be a perfect decision to be the best right decision right now. Just do your best – that’s all anyone can do!

To write this article I consulted with John Levitt, Ph.D., an eating disorder therapist who has been in the field for more than 40 years. “Treatment centers represent a lot of money and a lot of time, and a lot of heartache and concern for your child,” he says. “You definitely want to make sure that you understand your options.”

Why send your child to an eating disorder treatment center?

I’ll give you the questions to ask an eating disorder treatment center. For now, let’s start with the reasons why you might be considering an eating disorder treatment center for your child. Here are the top three reasons I hear:

1. Your child is in danger. You have the help of professional dietitians, doctors, and therapists, but there is no reduction in the behaviors. Despite your best efforts and professional care, your child is in serious physical and/or emotional danger.

2. You don’t know what to do. You feel overwhelmed by your child’s eating disorder and simply don’t know what else to do. It seems like a treatment center is the only choice. 

3. You are burnt out. You have been working hard to stabilize your child’s behaviors. You’re driving all over town to appointments, and facing endless arguments and stress over meals. At this point, you are overwhelmed and frustrated by the disorder. You have reached the end of your rope. 

I support parents who are facing one or all three of these conditions. And I see eating disorder treatment centers as one tool in the toolbox of recovery. They are definitely an option to address these issues.

The benefits of an eating disorder treatment center

“Treatment centers are places where your child can stabilize their eating disorder symptoms,” says Levitt. “Their weight will hopefully improve and likely stabilize. And their eating disorder symptoms will likely be reduced or even eliminated completely while they are staying at the treatment center.”

This is very good news! The main benefits of an eating disorder treatment center are: 

• Medical and psychological stabilization
• Your child will be assessed and monitored
• They will feed your child regular meals and snacks
• Your child will be physically safe and prevented from acting on purging and self-harm behaviors
• They will provide activities and skills training to support recovery

A treatment center is ideally a safe place to get into remission from eating disorder behaviors. Your child will most likely be stabilized and make some progress toward recovery. 

The drawbacks of an eating disorder treatment center

One of the benefits of treatment centers is that your child is stabilized in a safe environment. But a drawback is that eating disorders develop in the outside world. So returning home after treatment can sometimes trigger a relapse. 

“Even if the eating disorder behaviors and symptoms get under control in a few weeks or months, there may be many more months, or even years, required to achieve remission and, ideally, full recovery,” says Levitt. “When they get home, they are faced with the same life stressors and conditions that were associated with the eating disorder prior to going to treatment. Home is where the true treatment begins. Your child needs to learn to live with a sense of self-worth and self-efficacy that is enduring and resilient across people, places, and situations, and they often won’t find that in a treatment center. You just can’t practice all of the requirements of life in a controlled setting. Full treatment does not happen in a program, it happens in life.”

In addition to the fact that there will still be work to do when they get home, there may be other drawbacks. I’ve interviewed many people who have spent time in treatment centers, and some of their complaints include:

• It felt abandoned, isolated, and/or traumatized
• Inadequate treatment and support
• Being scared by/not liking the other residents
• Developing unhealthy relationships and learning new behaviors from other residents
• Feeling controlled and dominated
• Not liking the staff and therapists

These drawbacks aren’t meant to discourage you. And many treatment centers actively try to counteract these drawbacks. But it’s important to consider them as you weigh your options.

Questions to ask an eating disorder treatment center

“Treatment centers are run by good people who are generally doing good work,” says Levitt. “That said, treatment centers are businesses, and you as parents are the consumers. Don’t be afraid to be a smart consumer. Ask a lot of questions. Ensure you understand what you are getting into. That is, make sure you know what you will be paying for and what outcomes you can expect. Parents should become the experts on what they are “buying” before taking the leap to send their child anywhere.”

It’s best to interview treatment centers before making a commitment. Here are some questions to ask:

• What is your treatment approach? On what evidence is your treatment approach based? What is the data suggesting the effectiveness of your program?
• Specifically, how do you treat people with my child’s type of eating disorder? What is the general treatment plan/approach?
• How long does it usually take to stabilize a child’s eating disorder, including issues related to mood etc.
• What is the daily schedule, and who specifically will be working with my child?
• Can I see my child’s clinical team’s credentials and interview them?
• In addition to the clinical team, who else will be working with my child? What are their credentials?
• How do you control for the fact that sometimes eating disorder treatment clinics are learning opportunities for how to become better at eating disorder behavior? What control systems do you have in place to avoid this?
• What is your success rate in terms of full recovery after a person leaves the treatment center? What are your extended outcomes? What is your relapse rate?
• How do you involve parents in treatment? What are we to do while the child is in treatment?
• How will you ensure that I am an essential part of the treatment, and how will you prepare my child, and the parents, for the child’s return home?
• What will my child need following their stay at the center?
• How will you know when what you’re doing with my child isn’t being effective? If such a situation were to arrive, what are the alternatives?
• How do you ensure that a person who goes through your program is successful beyond the program?
• How much does treatment typically cost? How much is usually the parent’s share of costs? What happens if we are unable to afford the treatment or continued treatment?

“You should not receive vague answers to any of these questions,” says Levitt. “Because they are critical to efforts to achieve full recovery.”

What about the cost of eating disorder treatment centers?

Of course your primary concern is your child’s health. And your child’s health is priceless. That said, treatment centers are very costly, which is why you want to be a smart consumer here. Not because you are nickel-and-diming your child’s health. Not at all. But because this is a major commitment and it makes sense to ask questions. 

I wish treatment centers had a 100% success rate. But the truth is that eating disorders are complex and challenging to treat. And residential treatment is typically just one step on the path to recovery. So it pays to be a thoughtful consumer.

“Don’t be afraid to ask about the costs involved,” says Levitt. “Many treatment centers are running 60 days. That’s a long time for your child to be away from home and away from school. It can also be about $60,000 plus. That doesn’t take into account post-center treatment. That can be equivalent to your child’s college tuition.”

The point here is to ask questions. Of course if your insurance company will cover everything that’s a different situation. But if the cost of treatment will fall on you and impact other financial goals that you have for yourself, then weigh the costs and benefits as clearly as possible. 

Making a decision

I wish there were a simple answer to whether to send your child to a residential treatment center and which one to pick. This is something many of my clients grapple with. And the truth is that it’s a difficult decision to make. In the end, the best you can do is do your research and make the best choice you can right now. 

Remember: it doesn’t need to be a perfect decision to be the right decision for you at this moment. Your best decision may be to send your child to residential treatment. And also, it’s OK if that doesn’t feel right for you right now.

The quotes from John Levitt, Ph.D. are from a series of articles published in 2017 including this one.

See Our Eating Disorder Treatment Guide For Parents