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.

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.

October 26, 2011 - 12:16pm

Dr. Theodore E. Weltzin talks about ‘giving up’ eating disorders

"Many people with eating disorders don't want to give up their eating disorder," said Theodore E. Weltzin, MD, FAED, medical director of Eating Disorder Services at Rogers Memorial Hospital. In the more than 20 years he's spent specialized in working with eating disorders patients of all kinds, that's consistently part of the story.

Unlike a lot of problematic behaviors, someone with an eating disorder can't follow an abstinence path to wellness. Eating is ingrained in nearly every culture. Even modern nutritional science is not always exactly sure what is the best path to wellness for everybody.

"We pride ourselves being able to really figure out for that individual what are the issues that are going to help them get better," said Dr. Weltzin. "What we've found is that if we can bring together specialists who work in different areas for people who have problems that fit in both those areas, the treatment seems to be more efficient and more successful."

A great example of this is Rogers' combined eating disorder and anxiety disorder program. A big part of treatment at Rogers is aligning patients with the aspects of our treatment that will give them their best chances of getting better. Rogers' own outcome studies have demonstrated that patients with anxiety disorders respond to certain aspects of treatment better than others.

Rogers was, for example, the home to the very first treatment program in the nation specifically tailored to males. "We remain the premier program treating males with eating disorders and really provide a setting that is very comfortable for males," said Dr. Weltzin. "We want males to feel comfortable with the fact that they have a problem and they're here to get better. It isn't a 'black mark' against them, it doesn't mean they're any 'less of a man' because they have an eating disorder, but it does mean that they have some specific challenges."

October 10, 2011 - 3:41pm

Find out what Rogers patients are saying about eating disorders treatment at Rogers Memorial Hospital.

"This is the way to go," said one 17-year-old boy, color flush in his cheeks and a spark in his eyes that had been notably missing at the start of his stay at Rogers Memorial Hospital’s Eating Disorder Center three months prior.

"Rogers is the best help around," he said. "If you’re struggling, if you’ve had an eating disorder for a short or a long period of time, I would highly recommend seeking out the treatment here."

The emphatic support offered by this 17-year-old is unusually well spoken, but not atypical of the kind of appreciation our patients offer when they reflect on their treatment experience at Rogers. Many of our patients tell us that they cannot believe how busy they are while they’re in Rogers Memorial Hospital’s eating disorders treatment programs. Rogers’ program is packed full of therapy; our patients are immersed in a variety of therapeutic activities and approaches, including some of the most detailed cognitive-behavioral therapy you can get anywhere.

With so many different kinds of therapy and staff with years of experience providing evidence-based eating disorders treatment, there are endless opportunities for our patients to have “breakthrough” moments, where recovery really clicks. Unified in the task of helping our patients to obtain a long-term recovery, the treatment team’s approach encourages self-empowerment. From admission to discharge and throughout aftercare planning, a dedicated, experienced team is involved in every step of treatment. Personalized treatment plans address each patient’s needs and focus on changes in thinking, and overcoming obstacles for recovery.

Once a patient tastes recovery, they’re often ready for more: “I am ready to see the world and take life as it comes,” said the 17-year-old. “Once you get out of your eating disorder, life has a purpose again. Struggling one more day with an eating disorder is not worth it at all.”

 

September 17, 2011 - 12:00am

Warning signs for parents
Dr. Cornella-Carlson gave these warning signs for parents to watch for if they’re concerned that their child might have an eating disorder:

  • Weighs him or herself every day
  • Skips at least one meal a day
  • Counts calories and fat grams
  • Feels anxious or guilty after eating
  • Exercises because they “have to”
  • Become withdrawn
  • Possesses unusually detailed knowledge about food or exercise

Shortly after launching a new treatment program at Rogers Memorial Hospital, Dr. Tracey Cornella-Carlson was already seeing more children and families enjoy a quality of life that seemed lost within the tight grip of an eating disorder.

Even as young as fourth grade, children are becoming concerned with calories and fat grams and subjected to emotional bullying about their appearance.

Dr. Cornella-Carlson said that parents come to Rogers Memorial Hospital, not just because they are worried about their child’s health, but because they feel that they have lost their child emotionally. The disorder affects the child’s ability to participate in day-to-day activities with their friends and families.

The new child and adolescent inpatient program was developed under her leadership to provide a safe, nurturing environment where children and teens could be treated for medical and emotional stability by a specialized team comprised of physicians, dietitians, therapists, nurses, and other trained professionals.

Inpatient environment addresses behaviors

The Rogers Memorial Hospital inpatient program was designed to provide medical, nutritional, and emotional stability as it affects the needs of children and young teens.

Dr. Cornella-Carlson says that many children and teens being treated for eating disorders on an outpatient basis find it hard to eat what they should. “They really try,” she said, “They promise that they’ll eat their snack, pack it, but then ‘forget’ to eat it or say that they just weren’t hungry.” The inpatient program guides patients while eating and addresses any related behaviors.

“Once their nutritional intake is increased, they have a better ability to understand their situation, that they are separate from their disorder and are able to express themselves in a healthier way,” Dr. Cornella-Carlson said.

Jessica Witt, RN, CPNP, clinical services manager for the program, explained how the treatment team at Rogers Memorial Hospital continually monitors patients to pinpoint their diagnosis and manage any other medical issues common to eating disorders. “Patients may have developed symptoms that affect their gastrointestinal system, bones, heart or limit their physical activity,” she said.

“We work to stop the behaviors and provide an environment where they can heal while they discover that they are separate from their disorder.” One of the key elements of the program, Witt added, was the group therapy component.

Complex and challenging disorder

Dr. Cornella-Carlson explained that certain characteristics of eating disorders make it especially complex to treat them in children. Individuals with eating disorders often suffer from obsessive-compulsive disorder or other anxiety disorders and are more likely to focus on a thought pattern that compares them to others in a negative light.

Group and cognitive behavioral therapy are used to help patients recognize and change the distorted thought patterns. In a group therapy setting, they are able to see how their behavior looks from the outside and begin to recognize it from the inside.

Dr. Cornella-Carlson said that patients with eating disorders are highly attuned to their environment and behaviors. They find it hard to relate to those who do not understand food or activity in the same ways.

As a result of their disorder, they tend to be withdrawn and avoid mealtime, a common social point for patients. They are often perfectionists and intellectualize certain aspects of treatment. An example might be a patient who wants to satisfy their sweet tooth with an apple, instead of ice cream.

Knowing they’re not alone

Within the specialized eating disorder program at Rogers Memorial Hospital, patients can be with others their age who have first-person experience with eating disorders and can support each other. Mealtimes are supervised by trained dietitians who observe which mealtime issues patients struggle with and also ensure that patients are eating the right amount of food.

Dr. Cornella-Carlson also said that a key element of the program, which admits patients from throughout the United States and Canada, is the education and involvement of the patient’s family. “They may bring food in so they can eat together, participate in the recovery process and improve communication,” she said.

Dr. Cornella-Carlson said that parents are relieved to see their son or daughter’s unique personality reemerge and interact with the family again. “So many parents say, ‘Thank you for bringing our child back.’”

When patients leave the program, they have a much better understanding of how they can control their behaviors in a healthy way, explained Dr. Cornella-Carlson. “We teach them skills and techniques that we hope will help them for the rest of their lives.”

September 13, 2011 - 3:07pm

School can be stressful and challenging.School can be stressful and challenging for many young people, and, in some cases, school-related activities can trigger an eating disorder. Nearly 15 percent of the patients at the inpatient eating disorders treatment program for children and adolescents at Rogers Memorial Hospital trace triggers for their eating disorders to school programming.

Much of the conversation around nutrition in schools and health and wellness classes centers on “good foods vs. bad foods,” teaching kids how to read food labels and count calories, and the “destructive nature” of unhealthy foods. Some nutrition classes also use gross-out tactics (like visceral demonstrations of globs of fat) to scare children into healthy eating.

The problem lies not in the need to educate children about nutrition, but that this education is not simultaneously delivered alongside body-image awareness. It’s possible to teach nutrition in a body-positive way; nutritional education is a large part of all of the eating disorders treatment programs at Rogers. Scaring kids, making strong generalizations about health and nutrition, focusing as body images and stereotypes all pile pressure on kids to approach food and nutrition in unhealthy ways.

The good news is that there are some easy ways to continue the educational conversations about nutrition in ways that reduce the risk of pressuring kids into making unhealthy choices. Rogers recommendations include:

  • Avoid scare tactics – Teach kids about food variety, moderation, making smart choices, and promote a healthy lifestyle following the nutritional guidelines and age appropriate exercise.
  • Teach parents as well – Parents are in charge of grocery shopping, meal planning, and cooking, and ultimately responsible for a child’s nutritional experience, they need to be on the same page as their children when it comes to nutrition.
  • Avoid sweeping generalizations – Be mindful of your word choices and developmental level of your students. If you tell five-year-olds that eating red meat will make them have a heart attack – they may take this as truth and likely be fearful of that food for themselves and family members.
  • Remain body positive – Avoid comments about body weight, shape, and size when describing nutrition. Proper nutrition is about so much more than weight and shape and size. Instead, focus on overall wellness as a goal.

As our nation becomes increasingly concerned with obesity, the desire to improve children’s nutritional habits is understandable. However, as we are attempting to help combat obesity we must simultaneously be aware of the possibility that how we present this information can trigger disordered eating in children and adolescents.

The inpatient eating disorders treatment program for children and adolescents at Rogers Memorial Hospital was developed by Tracey L. Cornella-Carlson MD and Theodore E. Weltzin, MD, FAED along with a treatment team with unprecedented experience treating eating disorders in young people.

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