Levels of care include: Outpatient (individual lives at home and attends sessions at the office of provider), Intensive Outpatient (individual attends programming in a specialized setting, two to three times a week), Partial Hospitalization Program or Day Treatment (individual remains medically stable but requires more intensive, structured programming – typically occurs five days week for six to eight hours each day), Residential Treatment (individual who is medically stable, lives in a 24-hour supervised setting), Inpatient Treatment (individual requires 24-hour medical supervision), and Acute Medical Stabilization (individual is medically unstable and needs critical care).
At the outpatient level of care, the individual lives at home and attends weekly sessions at the office of the provider. The individual is medically stable and has fair to good motivation for recovery. Eating disorder behaviors are well-managed and the individual is self-sufficient in meeting nutritional needs. The outpatient treatment team should include a psychologist/therapist, registered dietitian, primary care physician, psychiatrist, and family therapist. The outpatient providers should be specialized in eating disorder treatment and work collaboratively with one another.
Intensive Outpatient Program (IOP) typically occurs in a specialized setting (i.e. treatment center, hospital, etc.) where individuals attend programming approximately two to three times a week for at least three hours each time. The individual remains medically stable but requires additional support to reduce eating disorder behaviors and achieve progress in recovery. All services are provided in one location and generally include individual therapy, nutrition counseling, group therapy, family therapy, and more. Individuals are able to maintain work and/or attend school while in treatment.
Partial Hospitalization Program (PHP) or Day Treatment typically occurs five days week for six to eight hours each day. The individual remains medically stable but requires more intensive, structured programming to reduce eating disorder behaviors and achieve progress in recovery. All services are provided in one location and generally include individual therapy, nutrition counseling, group therapy, family therapy, along with one or two supportive meals. The individual attends programming for the majority of the day but returns home or to transitional living in the evening.
Residential treatment provides 24-hour care/supervision for individuals who are medically stable but still engaging in eating disorder behaviors. Intensive supervision and support are required to help the individual reduce, and ultimately stop, self-destructive eating disorder behaviors (i.e. self-induced vomiting, restrictive eating, compulsive exercise, etc.). Services include multiple weekly sessions of individual therapy, nutrition counseling, group therapy, family therapy, and psychiatric care. All meals and snacks are supervised and provided in a supportive environment. Residential programs may be held in medical hospital settings or on home-like grounds or estates.
Inpatient treatment is most appropriate for individuals whose eating disorder is either not responding to treatment in a less intensive setting or clinical evidence strongly indicates that the individual requires a higher level of care. The individual may also be at risk of harm to self and/or others that requires treatment in a structured 24-hour medical or psychiatric inpatient unit. Services include medical management and intensive treatment of physically harmful eating disorder behaviors, medical complications, and co-occurring disorders, along with a focus on weight restoration, if needed.
Acute Medical Stabilization is the highest level of care for individuals with eating disorders. This level is critical care for individuals who are medically unstable due to the severity of their eating disorder and the resulting medical complications. It focuses on physical stabilization of the patient. Once achieved and maintained, the patient can transition to a lower level of care for further treatment.