Most of us were taught LITTLE or NOTHING about eating disorders before becoming parents or health care professionals or both! Even as we’ve fed our little ones and/or told parents of patients how to feed their little ones we most likely had no idea of the complexities of eating disorders and their treatment.
As a parent who has been down this long and winding road of eating disorders advocacy and coaching parents since 2003, I’ve coached many families through the terror, pitfalls and successes. I’ve seen how frustrating it can be for both parents and health-care professionals to not have all the data you need to understand what to expect when you send someone to a Residential Treatment Center (RTC).
I’ve made this as a quick reference for you to print off and keep or share as a PDF with families. Keep this list handy so you will be able to quickly reference the nuances and intricacies of sending someone to a RTC.
First, here are some basics that everyone needs to know:
● It’s hard.
● It’s only a start.
● It’s not ever long enough.
● Insurance often dictates how long RTC will be.
● People do not come home from RTC recovered.
● Parents/families need to be part of the treatment team.
● When parents/caregivers spend time getting support and learning skills, their loved one has a better chance at success when they return home from RTC.
● Step down, often called ‘aftercare’ is essential and needs to be set up before release from RTC.
● Parents need to be given support to create the ‘next’ for their child after RTC.
● Parents are TERRIFIED and need coaching to learn how to be calm and objective.
● Keeping expectations realistic can help prevent frustration and caregiver burnout.
● Ideally, location shouldn’t dictate which center a child goes to. The program fit is most important.
1. EMOTIONS: Be prepared for your emotions – they are all okay.
2. OXYGEN: Get support to get your oxygen mask firmly in place. This is essential for your health and your child’s recovery.
3. SUPPORT: Get support to fill your cup up. This is the next step to maintaining your physical and mental health and being able to effectively support your child in recovery, calmly. Support is available – reaching out for help for you is okay.
4. EDUCATION: Learn as much as you can about eating disorders. There are videos on my YouTube Channel that make it easy to learn, read articles, books, talk to other parents.
5. BLAME GAME: This is NOT your fault.
6. THE CALL: Be prepared for THE CALL(s) from your child – typically most kids will call about the 3rd day crying, begging you to pick them up. Knowing that this is coming will help you remain calm. And get help to prepare with responses that validate.
7. COMMUNICATION: Communicate with the treatment center. Find out from the admitting team what you can expect and what the protocol is for communication with you. Ask a lot of questions.
8. LEARN: Learn how to be an effective part of the treatment team and WHY that is essential.
9. RTC is a stepping stone, this is not going to cure them. This will just be getting them started. Sadly, insurance typically dictates how long your child is there. In a perfect world (with insurance that actually paid for full recovery) your child would stay at RTC for 6-18 months, but that isn’t how our health care system is set up at this time.
10. ENABLING: Enabling…jumping on the rollercoaster…it’s important to learn to tolerate your child’s distress. There will be many times they are not happy in RTC and will tell you that it’s awful. They’ll often try to tell you how they are not sick enough, people are mean to them, etc. Just respond simply: “Honey, I love you. That sounds hard. I know you can do this.” And then ZIP IT!!
11. VALIDATE: Learn how to validate and not fix. This is a lot of what I work with coaching clients on.
12. TRUST: Trust your gut.
13. BOUNDARIES: Learn how to set and follow through on boundaries. Therapists, coaches and others can provide support for this.
14. UNITED FRONT: Be united front with child’s other parent. Eds love to divide and conquer.
15. DO YOUR OWN HEALING: As the parent, you need to do your parallel process. To learn how to remain calm, manage your grief, fears, anger, and other emotions. Get support to do this.
16. ASK: Learn to; ask for help, ask how to be gentle & kind with yourself. Ask how to get support to do these things. Do NOT isolate, this will make it worse.
17. HOPE: HOLD ON TO HOPE.
18. COGNITIVE DISTORTIONS: Learn about them, realize the difference between Cognitive Distortions and lying. Another reason that COMMUNICATION is essential with the treatment team, together you can help your child to sort out what they’re malnourished brain is hearing and what was said. The team will hear horrible (not true) things about you as parents and vice versa. You will hear horrible (not true) things about the RTC team.
19. ROI: Get Releases of Information (ROI) with the RTC, with outpatient team, everyone. No matter your ‘child’s’ age.
20. SELF CARE: Cannot say this enough ways. This is absolutely essential.
1. Families are an important part of the treatment team.
2. Know the 9 myths/9 Truths about eating disorders. Including that they are not a choice and parents don’t cause them.
3. Anosognosia is real – the person with the eating disorder often won’t acknowledge that they are sick.
4. Parents are coming to you on one of the worst day of their lives.
5. Early diagnosis and referral improve treatment outcomes.
6. Be united with the family, and know that the eating disorder and co-morbid diagnoses can cause distortions in perceptions.
1. Parents are coming to you on one of the worst day of their lives. They had to break their hearts to bring their child to you.
2. When Parents are in an information vacuum, brains make up scary stuff. Create a plan for communicating with parents regularly – no matter what the age of the ‘child’.
3. Be sure to let parents know how they will be included in treatment.
4. On day one, work with parents on what the step down process will look like. Don’t discharge without a NEXT.
5. Strongly encourage parents to do their own “parallel process” while their child is in RTC.
6. Tell the parents that they will very likely get a call from their child about day 3 crying and begging them to come and get them.
Questions for Parents to ask the RTC:
1. What should I expect when I have questions, how do I best communicate with you, who is the contact person?
2. How often can I expect to receive updates and how will I receive those?
3. How often will I be able to have contact with my child and how will that occur?
4. Who is the person for me to collaborate with at your center to help me fight insurance for more time? And what is their phone number?
5. Who is helping me set up his/her NEXT for after RTC? And what is their phone number?
Questions for RTC Professionals to ask Parents:
1. How can we support you?
2. What will you commit to for getting your own support while your child is here?
3. Do you have someone you can call when your worries and fears get to be too much?
Watch for more articles here and on my blog going deep on each of these topics. Look for videos addressing these issues on my YouTube Channel, FB, LI and Twitter. And subscribe to my newsletter to learn about the upcoming E-book: “Survive Sending Your Child to Residential Treatment: How to Cope and Help Your Child Recover”