Residential Treatment

Residential Treatment:

Rogers is a comprehensive psychiatric hospital, nationally recognized for specialty residential treatment programs for eating disorders, addiction, obsessive-compulsive disorder and anxiety disorders for children, teens and adults.

Life. Worth. Living.

December 13, 2011 - 1:05pm

Patients at Rogers Memorial Hospital are already enjoying a brand-new experiential therapy center. The center was opened in the fall of 2011, and features a gymnasium, weight room, art studios and recreation and movement rooms designed to help Rogers’ experiential therapists work with patients in a comfortable and safe environment. In the weight room and gymnasium, for example, Dwight Steffes, MSRT, a long time experiential therapist at Rogers, helps patients learn how to exercise in a body-positive and healthy way.

By: Dwight Steffes, MSRTEating Disorder Treatment, Excercise, Experiental Therapy

Exercise is often an under-addressed component of eating disorders treatment. To most people, an exercise program may simply be an integral component to healthy living. However, for those who struggle with an eating disorder, maintaining a healthy exercise program can be exceptionally challenging. For patients in treatment at Rogers’ eating disorders programs, Emotional deregulation, disordered body perspectives, and avoidance behaviors can drive a lot of abnormal thinking in what otherwise might be a healthy physical exercise program.

Many in the eating disorders treatment community tend to avoid this issue or outsource the issue of healthy exercise to their client’s personal trainers. That approach can be problematic; most trainers know a lot about physical fitness but have little understanding of the cognitive and emotional connection between exercise and physical fitness. This is why the experiential therapists at Rogers are so crucial to a holistic recovery for Rogers’ patients. Rogers’ experiential therapists help patients identify what is, and is not, a healthy approach to exercise.

Exercise incorporated as part of an overall eating disorder treatment plan

Patients entering into the Eating Disorder Center at Rogers will soon meet with an experiential therapist who will conduct a brief interview related to the patient’s history with exercise. The therapist is looking to identify the patient’s exercise habits that may be associated with eating disordered thinking, obsessive-compulsive disorder, general anxiety and depression. These observations will be incorporated into the patient’s overall treatment plan.

Each patient is rated on an activity scale based on his or her general physical and emotional health. Exercise issues are addressed through individual sessions with Rogers’ experiential therapists. These sessions may lead to written assignments, readings, exposures by behavioral therapists, and programming in the hospital’s fitness facility or at the local YMCA.

Once patients are medically stable, they can begin working with an experiential therapist as part of their treatment plan. Patients who have compulsive exercise issues begin by working on assignments designed to help them identify underlying issues that drive their compulsive exercise behaviors.

Supervised, supportive settings

The new fitness room at Rogers, recently constructed as part of a new inpatient and experiential treatment facility, is an option available to individuals within the eating disorder programs. Experiential therapists work one-on-one with each patient to help them experience a healthy exercise program.

Patients are encouraged to focus on exercise from a physical perspective and are reminded that exercise is not about cognitive or emotional issues. A check-in is provided before each session to create awareness of personal feelings and thoughts that may push the patient into doing more than what is healthy. Each program is customized to address the particular issues and needs of each patient. For instance, patients who have never been in a fitness program before may experience some anxiety around being physically active or in a fitness room or gymnasium setting. In this case, the therapist would work with the patient to slowly acclimate them to the equipment and the environment.

The swimming pool at the nearby YMCA offers an excellent opportunity for our Eating Disorder Center patients to address body-image issues; and the YMCA’s exercise room provides an opportunity for patients with social anxiety to gain experience working out around others.

Each patient’s treatment plan is different

Patients are often given individual assignments that may help them come to understand how they came to be in treatment in the first place. Assignments can help the resident become more knowledgeable about how they may have used exercise in an unhealthy manner.

For example, these assignments may ask our patients to explore:

  • Exercise as an addiction,
  • Exercise as an avoidance behavior,
  • Obsessive-compulsive exercising,
  • The relationship between body-image and exercise, and
  • The relationship between depression or anxiety and exercise.

Each assignment asks a series of questions that may give a patient an opportunity to examine their own history with exercise and how it may have been influenced by an eating disorder.

Coming home with a roadmap to successful exercising

Before patients leave treatment, they are given an exercise plan that reflects the work that they have been doing with our experiential therapists. Recommendations about weights and cardio work are provided with the stipulation that a patient must stay within a healthy weight-range to be able to continue working out.

This discharge plan typically requests patients focus on three things. They must make every effort to:

  1. Be compliant with their meal plan, weight and physical programs.
  2. Address issues of self-esteem using thought challenging primarily to deal with their connection between self-worth and exercise.
  3. To increase social activities and leisure pursuits to avoid getting caught-up in an addictive cycle of exercise.

Ultimately, addressing and incorporating exercise into a patient’s treatment plan helps Rogers eating disorders patient develop an awareness of their approach to exercise as a whole and helps them to understand limitations or challenges they face personally.

With the knowledge and experiences of what healthy exercise programs look and feel like, Rogers patients discharge with the tools they need to continue to make choices that support their long-term recovery goals.

December 9, 2011 - 9:07am

By: Theodore E. Weltzin, MD, FAED
Medical Director, Eating Disorder Services at Rogers Memorial Hospital

Eating Disorder Treatment for Males

It is not unusual for a male to have an eating disorder, as a growing body of evidence indicates that men are as concerned about body image as women.

Males make up approximately 10% of anorexia nervosa and bulimia nervosa eating disorder patients. If you include binge eating disorder, as many as one in four of all eating disorder patients are males.

Why males?

There are many reasons why a male might develop an eating disorder. Exercise and athletic competition, especially sports that require low body fat or extreme weight loss, represent a risk for developing exercise dependence and eating disorders in males. Anxiety disorders and perfectionism have also been shown to be contributing risk factors. Other factors that may increase males’ risk of developing an eating disorder include alcoholism, history of obesity, teasing and physical abuse.

Males with eating disorders often engage in activities that increase their muscularity as the perception is doing so will increase their masculinity, boost confidence and improve their attractiveness.

More likely to binge

Negative attitudes and restrictive eating increase binge eating in both males and females. Males are more likely than females to binge as a result of body image concerns. Feeling anger can also trigger binge eating in males, whereas females tend to binge in order to suppress negative feelings.

Excessive exercise

For males, “excessive exercise” is often brought about as a way of either counteracting the effects of eating or attempts at weight loss. The need to excessively exercise is, in many ways, seen as similar to purging by self-induced vomiting, as both can be reactions to a real or imagined uncomfortable or “full” feeling.

Specialized treatment for males

The treatment of males involves nutritional interventions aimed at normalizing eating and, in most cases, normalizing weight. Treatment may also include cognitive-behavioral therapy that aims to identify and challenge errors in thinking, reduce preoccupation and overvaluation of food and weight, and to normalize behaviors related to eating disorders. An important part of treatment involves addressing co-occurring psychiatric concerns.

Anticipating and developing alternative ways of dealing with anger and irritability is an important aspect of treatment for males. In treatment, feelings of anger and irritability may increase for males who abstain from binge-eating.

While men and women have a similar response to treatment, males seeking treatment for eating disorders also often have to overcome the misconception that eating disorders are a female phenomenon. A common belief is that the treatment environment and clinical approach is primarily geared towards women. Males also report much less support from family, friends, school, coaches, and employers than they believe is given to females struggling with the same disorder.

Rogers can help

Rogers Memorial Hospital offers specialized eating disorder treatment for males. You can request a screening at 800-767-4411 or the online screening request form.

December 7, 2011 - 10:30am

add, adhd, children, gifts, holidaysThe key to finding the “right gift” for a child with attention deficit hyperactivity disorder (ADHD) is as varied as the child. A little time invested in learning about the child’s specific interests and strengths will help you discover a good match for any child. There are also many hobbies or crafts that emphasize a child’s creativity and make good gifts for children with ADD/ADHD.

Read the full article for a list of tips and suggestions for gifts that will generate interest with children who have ADD/ADHD.

December 2, 2011 - 1:20pm

Children and teens with eating disorders find ways to manage their triggers

By Jessica J. Witt MSN, RN, CPNPEating Disorders and the Holidays: Coping for Children and Teens
Clinical Services Manager - Eating Disorder Services Milwaukee

December 1st has arrived – and it’s difficult to believe that only a week has passed since Thanksgiving, family get-togethers, and, of course, Black Friday shopping! These are all normal and fun things for children and families to look forward to.

However, for people with eating disorders the Thanksgiving holiday is one of the most dreaded. The spread of food, the relatives that have not been seen in a long time, the desserts, the inactivity, and the likelihood that other family members know nothing about one’s eating disorder is terrifying and triggering for people with eating disorders.

In my family, our celebration includes two Thanksgiving meals – a lunch at my in-laws and a dinner at my parents’ home. My children, therefore, will do the same. This is the reality for children in other families as well.

Imagine yourself in the shoes of a child or teenager with an eating disorder. How would one cope or not cope? Many kids and adolescents get admitted to the inpatient unit during this food overwhelmed holiday. Others – who are at less intensive levels of care, have developed coping skills in residential or partial treatment here at Rogers.

Coping skills at this juncture are crucial for these kids --- diversions include playing games with families, looking at old photo albums, journaling, reading, drawing, and even being able to talk to family members. It can be extremely helpful to talk about what they are experiencing, having an eating disorder and their treatment experience. Thanksgiving is the food focused holiday.

It is a grueling challenge for most kids – regardless of level of care. They have to be very strong and use those learned coping skills and lean on their families and support systems to make it through the day, and even the weekend. The Eating Disorder Partial Hospitalization Program is open the Friday after Thanksgiving and inpatient is always open 24 hours a day.

This time of year is quite stressful – but we are here to help children and teens to make it through the seasonal challenges of Thanksgiving dinner, St. Nick’s Day and, of course, Christmas and New Year’s.

November 30, 2011 - 2:16pm

BullyingParents commonly ask about the steps they could take to confront and manage bullying behavior and its consequences. The staff at Rogers work with adults to help them learn about the different roles that emerge in any bullying situation and how to identify more subtle forms of bullying behavior, such as gossiping and excluding others. The staff work closely with the children in our programs to help them learn about what bullying is and teach them strategies for coping.

Head over to the Rogers Child and Adolescent Day Treatment Website for the full story.

November 16, 2011 - 2:20pm

By: Jessica J. Witt, MSN, RN, CPNP
Clinical Services Manager - Eating Disorder Services Milwaukee

Be alert to children who are afraid to eat, touch, or be around candy.Eating Disorder Treatment

Halloween is the black and orange day that inaugurates the season of food-centered holidays in our nation. Children and teens get dressed up in their favorite costumes and gather as much candy as humanly possible in a two to three hour period. You have seen kids running from door to door and grabbing handfuls of candy, taking it home, and competing with brothers and sisters by counting how many pieces each one gets. This is totally normal and enjoyable…that is for most kids.

Some children and adolescents, however, do not partake in this event on all Hallows’ Eve. Not due to religious reasons or cultural beliefs, but because they are terrified to eat, touch, or even be around candy. Children and adolescents with eating disorders have extreme fear of eating foods high in calories and fat.

Recently, I asked children and adolescents in our program for eating disorders about their experiences with trick-or-treat and candy-eating in the past weeks. I asked, “How did Halloween and trick-or-treating make you feel?” the answers I received were:

  • “not good”
  • “guilty”
  • “anxious”
  • “excited”
  • “bored”
  • “weird/awkward/annoyed”
  • “unhappy, sad, mad, depressed”
  • “sick and gross”

One particular teenager stated “I felt guilty trick or treating, taking candy that I wouldn’t eat, and seeing it make people happy to be giving it, thinking it was making me happy to be getting candy”.

These are not typical post trick or treating comments! When asked how eating pieces of candy made them feel, some of the comments were:

  • “Bad, I felt fat afterwards.”
  • “I felt disgusted with myself afterward.”
  • “I ate candy and binged so not very well and I felt disgusting.”
  • “I felt terrible, unhappy, guilty and mad.”
  • “I got a headache and felt sick, I felt really bad about eating candy.”
  • “It made me feel anxious.”

Help is available for kids who focus on food, instead of fun

Children and teens with eating disorders really struggle at this time of year. Be aware of comments. Be concerned when they are not acting “like a kid should act” around the holidays. Halloween is just the beginning of a difficult fall and winter season that is so focused on treats and food.

Be mindful of what you say to these kids and if you have concerns with their eating habits or weight discuss it with them and/or their family. There is help – all it takes is a phone call!

For admission information or a free screening, call 800-767-4411, or 414-327-3000

November 15, 2011 - 11:47am

Rogers Foundation, Build-A-Bear team up to find fluffy friends for kids with OCD

Build-A-Bears to find homes with Child Center children

The Rogers Memorial Hospital Foundation and Build-A-Bear Workshop have teamed up to make sure that patients at the Child Center at Rogers Memorial Hospital are welcomed with a fuzzy new friend. 

The bears are a gift of the Build-A-Bear Workshop and Kristine Johnson of Oconomowoc, who worked with OCD Twin Cities to arrange the donation.

“All the kids coming into the Child Center receive a new stuffed toy,” said Tom Doughman, Child Center manager. “It’s usually waiting for them on their bed when they first get admitted. It’s been a long day, it’s a new place, and they’re about to spend the night alone in the center for the first time. Families have told us this is a very nice gesture,” he said.

The Child Center treats kids from age 8 to 13 with OCD and other anxiety disorders, disordered eating, and many other illnesses.

“It was very kind of Build-A-Bear to make this donation,” said Stephanie Eken, MD, FAAP, medical director of the Child Center. “We have many treatment team members who spend hours upon hours with our kids while they’re getting used to being in the center. The gift of the stuffed toy is one of the ways we let the kids know that while they’re at Rogers, they’re not without people who care about their well being,” she said.

Pictured are (from left to right): Child Center nurse Lisa Texeira, Kristine Johnson, Lydia Johnson and Child Center Social Worker Erin Olson.

Kristine Johnson of Oconomowoc of teamed up with Build-A-Bear and the Rogers Memorial Hospital Foundation to make sure that a child staying at Rogers’ Child Center have at least one fuzzy new friend to greet them. Pictured are (from left to right): Child Center nurse Lisa Texeira, Kristine Johnson, Lydia Johnson and Child Center Social Worker Erin Olson.

 

More about the Rogers Memorial Hospital Foundation can be found at its website. Rogers offers a free screening for prospective Child Center patients.

November 14, 2011 - 10:44am

Eating Disorders TreatmentPictionary, food models and meal outings are just some of the eating disorder treatment tools the 16 dietitians at Rogers use to help each patient learn tools they can use to make healthy food choices in any situation.

Theodore E. Weltzin, MD, FAED, medical director of Eating Disorder Services for Rogers, explains the importance of including dietitians on the specialized eating disorder treatment teams at Rogers. “Normalizing nutrition is such a fundamental foundation of recovery. It isn’t defining recovery, but without it your recovery is pretty shaky. Building a strong foundation through nutritional changes is an important aspect of our treatment in all of our programs.”

“I’ve been doing this for 20 years and worked with many, many talented dietitians and therapists,” he said. “I need to rely on the dietitians and the therapists to be strong team members, as well as the rest of the staff, because these are very complex illnesses. The work of our dietitians shows that this kind of comprehensive team approach is the most effective to getting people on track to recovery.”

Wide range of treatment experience

“First and foremost, we view each person as a whole person, not a diagnosis. Each patient has their own unique challenges and concerns,” said Kari Johnson, lead dietitian at Rogers. Whether it’s a food allergy, aversion or eating disorder, the dietitians make sure each patient knows that they are there to help. “Many times,” Johnson added, “the dietitian might just listen to the patient and support them.”

With 16 dietitians on staff at Rogers, there is a wide range of talent, treatment experience and perspectives collaborating to help patients in any program with their dietary needs or challenges. The dietitians at Rogers are also expected to achieve and maintain their professional credentials. Rogers requires that all dietitians are registered through the American Dietetic Association and credentialed by the Commission on Dietetic Registration.

Therapeutic approach helps instill nutritional awareness

With the number of dietitians, it’s no surprise that children as young as eight are incorporating good nutrition practices into their individualized treatment plans. Dietitians work with patients in every treatment program, including residential, partial hospitalization and inpatient programs. And, because each person is different and has different treatment goals, the dietitian on that person’s treatment team uses numerous strategies to help the patient have a healthy relationship with food and meals.

Patients work with dietitians to learn the exchange system. This helps them learn about portion size, meal plans and daily intake goals. Using this system, patients can choose options that work for them and meet their treatment goals.

Patients who are in treatment for eating disorders learn that any food can be used to meet their meal plan. Dietitians encourage them to view various types of foods, including desserts or other “fear foods” as options that can meet their nutritional needs.

Treatment using cognitive-behavioral therapy for children, teens or adults with anxiety or OCD may include a dietary element that is reviewed by the behavioral specialist, the dietitian and the patient. The treatment team uses the same, graduated approach used for treatment of anxiety disorders so patients are not overwhelmed by food characteristics or choices.

People affected by alcoholism and other substance-use disorders benefit from working with a dietitian as they relearn self-care and guidelines for healthy living.

Skills for a lifetime

Johnson said that the great benefit that comes from patients working with a dietitian is that everyone leaves Rogers with skills they can use every day for the rest of their lives. “They become very knowledgeable about which foods they can choose, without having to avoid foods that may have been challenging for them,” she said.

November 14, 2011 - 10:25am

Fitness and nutrition makes the difference for eating disorder patients Fitness and Nutriton are part of Eating Disorders Treatment

Part of treatment at Rogers Memorial Hospital’s Eating Disorder Center includes nutrition and fitness experiences that help prepare patients for some of the most challenging aspects of returning home, including fitness and meal planning.

“A big part of residential treatment is developing a tool set that works for patients when they leave our center” said Dr. Theodore Weltzin, FAED, Medical Director of Eating Disorder Services at Rogers Memorial Hospital. “You should come out of residential treatment with tools for dealing with your challenges.”

Introducing “daily living skills” as well as “fitness and wellness” programming to patients while they are still in treatment helps them to prepare for the eating, grocery shopping, menu planning and exercise routines that will undeniably be part of their life once they get home.

At least three times a week, patients at the Eating Disorder Center at Rogers participate in groups that promote the role that food plays in everyone’s day-to-day life. Meal planning, trips to the grocery store, cooking, eating as a group, and etiquette are all part of the life-skills that a patient gets to experience while they are in treatment.

Working in these “real life” situations, patients participate in cooking and grocery shopping with direct and immediate access to support from their peers and Rogers experienced staff.

“We want to give them a chance to ‘try out’ an experience that they’re going to have at home. We want to help them master and be successful with those tasks while they’re in treatment, so that they can expect that they’re going to be successful later, at home,” said Weltzin.

Along those same lines, fitness and wellness programs, including yoga stretching, relaxation and other fitness activities are, as appropriate, developed for each patient in treatment at the Eating Disorder Center.

Treatment for patients with compulsive and addictive exercise issues includes a therapeutic plan that helps them learn to exercise healthfully. “The goal is to increase awareness and implement a healthy and enjoyable level of wellness in the individual’s life,” Weltzin said.

Find out more about other aspects of Rogers’ treatment approach , or request a screening.

October 26, 2011 - 4:20pm

With the support of lead dietitian Kari Johnson, a group of teens in treatment for eating disorders recently tried a seasonal treat: caramel apples. For this particular food challenge, a variety of caramel apples were provided for the group’s snack, including some with nuts and chocolate. The group’s objective was to eat a portion of the caramel apples to fulfill their meal plan. This activity caused the group to become apprehensive at first, because many feared the caramel, nuts and chocolate, thinking that those foods would cause them to gain weight.

“We teach variety and moderation,” Johnson said. Patients don’t often realize they can feel comfortable going to seasonal activities and parties that often include challenging foods. A number of people who have eating disorders are also diagnosed with obsessive-compulsive disorder (OCD) or other severe anxiety disorders. The food challenges provide them with an opportunity to expose themselves to foods that they would normally avoid.

Often, during the challenge, patients will encourage each other. With this supportive approach, patients in the eating disorder treatment programs have tried birthday cake, donuts, fried foods and other “fear foods.” Johnson said, “I tell patients, ‘At the very least, you should be able to eat a piece of birthday cake on your birthday.’”

Learn more about treatment components for treating eating disorders at Rogers Memorial Hospital.

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