I will always remember my first meeting with “Bob,” a young adult male being admitted into our adult residential eating disorder program. What really struck me was his initial expectations about residential treatment. He thought he would be confined to a room, cut off from the outside world and be taking part in frightening therapy sessions. Little did he know, he was about to be pleasantly surprised.

It’s the type of surprise I see almost every day with my clients. Frankly, it’s one of the best parts about my job. I love witnessing the reaction of adults who achieve what they may think to be small milestones, yet carry much more significant meaning. I love seeing them open their eyes to just how far their hard work is taking them in their own recovery journeys. And like Bob, it can be exciting to hear someone say, “Wow, treatment is totally different than I thought it would be.”

The latter understandably happens a lot with residential treatment. The term “residential treatment” itself might not elicit the very warmest of feelings, or visions of something groundbreaking or innovative. But don’t be fooled – as our understanding of eating disorders evolves, so does the makeup of the programming designed to best treat them.

Here’s a look at some more innovative components to residential treatment for adults with eating disorders:

Specialized Groups:

Residential treatment is never the same experience for any two people. Each individual enters with their own unique set of skills and needs. Often times, eating disorders accompany other conditions such as depression, anxiety or trauma. Many residential programs today are designed to help treat those conditions too.

At Walden, for instance, we’ve developed curricula for both a trauma group and a substance use group. They each run bi-weekly and aim to support residents as they discover the connection between their eating disorder and their trauma history or substance use. These groups allow for discussion and support, as well as invaluable education and skill building. They are held in comfortable and confidential settings, which can help eliminate any feelings of shame or embarrassment. Being in a group with people who may have had similar experiences can also help clients feel more connected and less alone.

Increased Exposures:

Many residential facilities prepare you for life outside of treatment. Exposure therapy plays a big part, providing the skills and strong mindset to persevere through experiences that may previously have caused high levels of anxiety and/or stress. Exposures within residential programming may mean trips to the grocery store–with the support of staff helping you shop for certain types of foods or ingredients. It might also mean shared dinners, where residents cook dinner for everyone then eat together family style. Exposures are designed to increase comfort around food and flexibility when eating meals prepared by others. At Walden, we have a full-time diet-tech to assist with meal planning, cooking skills and problem-solving during the exposure.

Level Systems:

Many residential programs now operate on a level system, fostering a more motivating and goal-oriented environment. Here at Walden, we have three levels. Each individual enters the program on level 1. After five days they can apply for level 2, and then after another week, they can apply for level 3. Each level has its own set of privileges and exposure activities. We understand that exposures can be challenging, and so want to ensure we are doing it in a thoughtful manner.

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Rebecca Rubin, LCSW, is an adult clinician at Residential Treatment, providing individual, group, and family therapy to adults with eating disorders. Rebecca received her Bachelor’s Degree in Psychology and Leadership Studies from The University of Rhode Island, and her Master’s Degree in Clinical Social Work from Simmons College with a Clinical Concentration in Children and Families, and an additional license as a School Social Worker/Adjustment Counselor. Rebecca works to meet each individual where they are at by using a strengths-based approach, and incorporating cognitive and dialectal behavior therapies. Rebecca also runs a group based off of SMART recovery, aimed to assist those working towards or questioning sobriety of addictive behaviors. In her spare time, Rebecca enjoys spending time outdoors and reading.