Rogers Memorial Hospital

The Eating Disorder Center at Rogers Memorial Hospital treats both males and females age 12 and older. Treatment services specifically designed to treat anorexia, bulimia and other eating disorders. The center is an internationally recognized leader in the treatment of eating disorders for males, and is the only center in the United States to offer specialized cognitive-behavioral therapy treatment for adults with co-occurring diagnoses of severe eating disorders and anxiety disorders.

The length of stay at the Eating Disorder Center is open-ended; the average length is 60-90 days. Our overall goal is for patients to achieve at least 85% of their ideal body weight. Primary treatment goals are to achieve nutritional stabilization (abstinence from binge/purge behaviors; weight restoration), identify and correct of errors in thinking, and address obstacles, including co-morbid illnesses, affecting long-term recovery.

Why Treatment Is Effective

• Treatment services directed by a nationally recognized expert in eating disorders treatment
• Separate units and programming for:
• Males
• Females
• Adolescent females
• Adults with co-occurring anxiety disorders
• Experienced multidisciplinary treatment team
• Comprehensive assessment and personalized treatment plan
• Individualized length of stay
• Emphasis on patient and family education
• Comprehensive case management/coordination of continuing care
• Access to onsite experts for additional clinical consultations

Admissions and Insurance Coverage

The Eating Disorder Center can effectively treat adolescents and adults who meet the following criteria:

• Have a primary diagnosis of an eating disorder
• Demonstrate a willingness to receive treatment and a desire to recover
• Have a level of cognitive and psychological functioning that allows him or her to benefit from residential treatment
• Be declared medically stable by a licensed physician
• Meet the admitting criteria for residential treatment

An initial screening with the prospective patient starts the admission process. Based on a review of this screening and recent lab results, a psychiatrist will recommend an appropriate level of care. After the review, admissions staff will share the psychiatrist’s recommendation with the individual.

As a courtesy to prospective patients, admissions staff will contact the individual’s insurance carrier to obtain a quote of insurance benefits. Benefit availability, service providers, and medical necessity criteria vary with each insurance plan. We recommend that potential patients check with their medical insurance carrier to determine what is covered and if there are any exclusions. After admission, patient care specialists can provide assistance with remaining questions or concerns.

Treatment Outcomes

The Eating Disorder Center conducts ongoing studies to evaluate program effectiveness and increase knowledge in the field of eating disorders. Patients who agree to participate are asked at admission and discharge to complete a series of questionnaires, and follow-up calls on progress are made periodically after discharge. Study findings are presented at national and international conferences and published in peer-reviewed medical literature. Our outcomes studies show strong results in three key areas:

1. Nutritional stability
2. Positive cognitive changes
3. Improved levels of functioning.

Treatment Team

The center provides comprehensive, multi-modal treatment with 24-hour-a-day supervision under the direction of board-certified psychiatrists who specialize in the treatment of eating disorders.

Other members of the treatment team may include:

• Primary care physicians
• Consulting psychologists
• Master’s-level therapists
• Behavioral specialists
• Registered nurses
• Registered dietitians
• Experiential therapists
• Certified substance abuse counselors
• Certified teachers
• Spiritual care coordinator
• Residential counselors

On admission, each patient meets with members of the multidisciplinary treatment team for a comprehensive evaluation to assess the history and severity of the addiction and related psychosocial factors. This information forms the basis of a personalized plan of care.

Treatment Components

The treatment team uses a number of treatment components to help each patient deal with the psychological issues that underlie and brought them to our program. According to the goals and objectives of their individualized treatment plan, patients may participate in the following components:

Cognitive-Behavioral Therapy

Our program uses cognitive-behavioral therapy (CBT) treatment to help patients identify and challenge their eating disorder symptoms with the goal of developing alternative coping skills and more appropriate responses to stressors. Initially in treatment, the emphasis is on behavioral changes primarily centered on eating normally and stopping the eating disorder behaviors. Once the behavioral changes have been in place and weight is normalized, the emphasis shifts to the environmental, social, or internal psychological symptoms that lead to eating disorder behaviors.

Community Outings and Therapeutic Passes

With physician approval, patients have opportunities to apply what they have learned to “real life” settings. Through supervised grocery shopping trips, meal outings and therapeutic passes with family members, patients practice strategies that reduce their anxiety and ease their transition back into the community.

Daily Living Skills

Patients have the responsibility of maintaining their bedrooms, washing their personal laundry and jointly being responsible for care of their living areas. Practicing these independent living skills on a daily basis helps create a sense of belonging to the residential community.

Experiential Therapy

Patients participate in a range of experiential therapy groups several times per week to examine the role their eating disorder plays in their life, to challenge their physical and emotional body image distortions, to develop trust, self-esteem and confidence. Through creative expression, guided imagery, relaxation and grounding techniques, patients develop a new set of skills they can use to deal more effectively with their anxiety and triggers and learn how to incorporate a healthy balance of physical fitness into their lifestyle.

Family Therapy

As eating disorders affect everyone, a patient’s family is considered an important part of their recovery. Generally, family sessions are provided once weekly. During these sessions the patient’s eating disorder is considered within the context of the family’s communication patterns, value and belief system, rules, roles and expectations. Families are encouraged to participate in the monthly Family and Friends Program, which includes presentations and activities.

Group Therapy

Each week patients participate in about 10 hours of group psychotherapy in their designated unit. Led by a master’s-level therapist, the group sessions are designed to identify destructive and self-defeating behavior patterns, to identify and express feelings, and to help patients focus on problem resolution and the development of healthy coping strategies.

Individual Therapy

Each patient has an individual psychotherapy session at a minimum of once weekly with his or her primary therapist. Starting with a comprehensive developmental and family history, the therapist works to establish a healthy therapeutic relationship and identify the core issues related to the eating disorder. The patient has an active role in developing his or her treatment goals and objectives, discharge plans and follow-up care.

Nutrition Therapy

Under the guidance of registered dietitians, patients learn about nutritional health and meal planning. Starting with a detailed dietary assessment, a registered dietitian develops an appropriate meal plan based on the diabetic exchange system, and then monitors the patient’s calorie intake, weight and ability to follow the meal plan. In addition, education takes place during mealtime as patients directly confront their fears about eating. Patients meet individually with a registered dietitian at least once weekly. Dietitians provide nutrition education groups once weekly, and coordinate grocery shopping outings, cooking groups, meal and snack challenges, and meal outings during their treatment stay.

Pharmacotherapy

Rogers Memorial Hospital has three full-time board-certified psychiatrists who specialize in the treatment of eating disorders. Initially, a psychiatrist will meet with the patient to complete a comprehensive psychiatric evaluation, which includes history, diagnosis and treatment recommendations. Subsequently, the psychiatrist will meet once or twice per week with the patient to monitor medications and review medical status. During these sessions, the psychiatrist also challenges the patient’s cognitive distortions related to the eating disorder.

Spiritual Care

For patients who request it, an individual consult for pastoral support that embraces their faith tradition is available; in addition, an optional spiritual reflections group is offered weekly. Local faith-based organizations make ecumenical services available to patients.

Substance Abuse Counseling

A certified substance abuse counselor is on staff to provide assessment, treatment recommendations and therapy to patients struggling with substance use or abuse. A group therapy session is offered once weekly for patients who would benefit clinically. Patients may also attend on-campus Alcoholics Anonymous meetings as well as off-site Narcotics Anonymous meetings.

Typical Daily Schedule

The Eating Disorder Center provides structured therapeutic programming seven days per week. A typical weekday schedule is shown:

Morning

• Vitals/Weights; Medications
• Supervised Breakfast; Post-Meal Observation
• Experiential Therapy Group
• Supervised Snack; Observation
• Process Group Therapy

Afternoon

• Supervised Lunch; Post-Meal Observation
• CBT Group Therapy, Art Therapy or Nutritional Therapy
• Supervised Snack; Observation
• Monitored Leisure Time, Substance Abuse Group, or School (adolescents)

Evening

• Supervised Dinner; Post-Meal Observation
• Goals Review
• Assignment Work; Daily Living Responsibilities or Community Outing
• Supervised Snack; Observation

In addition to the individual sessions with the psychiatrist and other treatment team members scheduled throughout the day and week, residential counselors are available 24 hours a day on each unit. The residential counselors provide assistance and one-to-one support to patients on treatment compliance, setting daily goals, problem solving, feelings identification and other issues that are part of each patient’s treatment plan.

Family Program

As an adjunct to the family therapy sessions, this monthly educational program gives family and friends an opportunity to interact with members of the treatment team and participate in a variety of presentations and activities. The program is designed to help individuals who are part of the patient’s support system learn about eating disorders and how eating disorders affect them. It also provides the chance for family members and friends to get to know each other and receive support.

Continuing Care and Discharge Planning

Rogers Memorial Hospital is committed to providing smooth transitions for patients so they may continue their recovery after discharge from The Eating Disorder Center. Plans for continuing care begin shortly after the patient’s arrival.

With proper consents the treatment team works closely with the referring professionals to communicate treatment progress and assist in making discharge plans. If necessary, staff will assist with locating resources needed to provide continuing care.

The treatment team monitors each patient’s progress and level of participation. If, based on the patient’s behavior, the center is no longer a helpful or appropriate form of treatment, or if the patient needs a different level of care, the treatment team will explore options with the patient and his or her family.

Should they become necessary, Rogers Memorial Hospital provides short-term acute stabilization of psychiatric symptoms on its inpatient units. Oconomowoc Memorial Hospital, located approximately two miles away, provides pharmacy and laboratory testing services, as well as emergency medical care.