One of the changes in recent years in eating disorder care is the advent of transitional living centers.
Residential programs are a central part of treatment but have several limitations. One major concern is that very few patients can stay long enough to receive the full benefit of the treatment.
The longstanding malnourishment and diminished health from an eating disorder remain even after 6-8 weeks of residential care. Since prolonged starvation is the main catalyst for persistent eating disorder thoughts, every patient who leaves treatment after a short stay is at significant risk for relapse.
The typical reason people leave treatment is related to health insurance coverage. The companies, wary of the prohibitive cost, monitor health changes every day during a patient's admission and determine criteria to insist upon discharge as quickly as possible.
Often the medical monitoring in a residential program--less than a hospital but still very complete and costly--is unnecessary for many patients after 6-8 weeks. The high rate of relapse shows that day treatment programs are not sufficient either as the step down from residential.
Transitional programs provide an alternative to bridge the difficult gap from residential to outpatient treatment. Patients live in a setting with other people in recovery and with recovery coaches who are available twenty four hours per day. There is constant support and the expectation that each person will follow their meal plan.
Daytime hours however are flexible. Patients can attend outpatient treatment programs or transition to volunteer or part-time jobs. The experience allows a more steady and less suddenly shift from the inpatient bubble to the various stresses and uncertainties of daily life.
As of now, transitional programs are connected to individual residential programs and are not generally covered by insurance. It would behoove the eating disorder treatment world to offer transitional living as a viable and cost effective strategy to treat chronic eating disorders and increase the likelihood of recovery.
Extending the period of regular nourishment and improved health increases successful recovery dramatically, and transitional programs can be a key part of that process.