Program
The Eating Disorder Program is designed
to help individuals with Anorexia Nervosa,
Bulimia Nervosa or both. The etiology of an
eating disorder has multiple factors. A
bio-psycho-social-spiritual approach best
addresses these factors in an integrated
method that allows the patient to experience
a healthy change and a decrease of symptoms
in all four areas as quickly as possible. Valenta content is focused on providing the
patient with opportunities for recovery and
healing of body, mind, soul and
relationships through the following
structures. Valenta offers three levels of
care to meet the needs of the community:
partial hospitalization program (7 hours of
program daily), intensive outpatient program
(4 hours of program daily) and aftercare
program (outpatient therapy and treatment)
for adults and adolescents. Care provided is
consistent with the American Psychiatric
Associations Practice Guideline For the
Treatment of Patients with Eating Disorders,
the most comprehensive guidelines currently
available for the treatment of these serious
illnesses.
Valenta PHP is appropriate for those with
severe illness without medical compromise or
those who have completed an inpatient or
residential program. All patients enter into
treatment at this level of care for
intensive assessment and stabilization as
well as to assist the patient in
establishing the appropriate therapeutic
connection with staff and peers. The focus
is on stabilization in an outpatient setting
(no over night stay) by providing support
five (5) days a week, seven (7) hours a day
with structured programming including group
therapy, individual therapy and supervised
meals and snacks. The Medical Director and
the staff closely supervise the patients’
care as the resumption of nutritional intake
can be life threatening. The patient and
team work to identify the impact,
consequences and distortions of the eating
disorder.
Intensive Outpatient Program (IOP)
Valenta provides a transition from
partial program with fewer hours and fewer
days as the patient begins to resume their
daily life. Patients will continue to
receive the core components of group and
individual treatment. In this level of care
the focus moves to internalizing concepts of
health and applying them to actual
challenges faced in daily life. IOP starts
at 5 days per week and includes four hours
of highly developed therapy, other
beneficial activities, a meal and snack. As
noted above, attendance decreases as the
patient integrates back into their daily
lives.
Aftercare program
As appropriate for the resumption of
normal life and activity Valenta offers
multiple levels and services for the patient
and their support network (parents,
guardians, siblings, spouses, children,
etc.). These services include working with
the registered dietitian for meal planning;
working with the therapist for individual,
family and group socialization, or working
directly with the MD for treatment of
additional complex disorders.
More About Partial
Hospital Program (PHP)
Check-in: Vitals are recorded
every morning upon arrival (and prior to
breakfast). Patients then complete a
questionnaire regarding the previous
evening, or weekend, and any current
concerns they are bringing to program.
Self-Care and Body Image: Patients
learn about and examine cultural and social
messages regarding gender, body expectations
and beauty, the connection between one’s
view of their body and self-defeating
thoughts, the use of the body for well-being
through self-care skills and the importance
of accepting the body as having a function
beyond appearance.
Process groups: Group therapy
allows the patients to experience the 12
Therapeutic Factors cited by Irvin Yalom, to
increase recognition and regulation of mood,
to express internalized pain and to receive
support and accountability from peers.
Process groups are a key therapeutic factor
within the program to decrease isolation and
shame often associated with these illnesses.
Nutrition: Patients learn about
the nutritional needs of the body and brain,
nutrition myths, restaurant eating, grocery
shopping, meal planning and preparation,
social eating, health and exercise.
The registered dietitian also meets with
the patient for individual and family
sessions. The dietitian assists in
education and improvement of nutrition as
well as being present at meals facilitate in the
patient's recover of their eating
disorder.
Meal Planning: Patients complete and
submit program menus for the coming week and
review any questions/concerns regarding
their individualized meal plan
recommendations with the Registered
Dietitian.
Meal and Snacks
- Breakfast: Breakfast is eaten
together in a calm and relaxing
atmosphere. Potions are allocated per
patient as agreed upon as part of the
patient contract with the treatment
team.
- Lunch: Patients are served a meal
that they have pre-ordered to help
challenge and overcome the fears of
social eating. During the treatment
process patients will be accompanied
(escorted and supervised) to nearby
restaurants to address challenges of
choosing and eating meals in a public
setting. Patients have time after lunch
for journaling, assignments and/or a
walk.
- Snacks: Patients often struggle to
regulate their intake especially over
longer periods of time through the day.
For those who have restricted, they
often benefit from nutrition distributed
evenly throughout the day to meet
dietary requirements, while for those
with Bulimia the snacks reduce the
tendency to binge and help create a
healthier eating pattern.
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Treatment
The following treatment
programs or methodologies are used
throughout the PHP, IOP and Aftercare
programs. Cognitive-Behavioral Therapy groups:
CBT is a core component of program in
helping patients address the symptoms
and cognitive distortions of their
eating disorders. CBT didactic groups
occur almost daily with reinforcement
throughout the therapeutic milieu.
Rational Emotive Behavioral Therapy, by
Albert Ellis, is the foundation for
basic CBT techniques to help patients
recognize the connection between their
thoughts, feelings and behaviors, to
dispute/replace irrational or distorted
thinking and to choose healthier
behaviors.
Goals groups: Patients set
concrete and realistic goals for the
week and weekend, identify means of
receiving support/accountability and
review goals to increase recognition in
reaching these goals. Individual (one-on-one) sessions:
The psychiatrist, primary therapists,
and dietitians schedule individual
sessions in order to supplement the work
done through groups. Interventions used
include cognitive-behavioral therapy,
psychodynamic therapy, insight-oriented
therapy, attachment therapy, EMDR,
behavioral therapy, exposure therapy,
motivational therapy, narrative therapy,
emotion-focused therapy, systems
therapy, psycho-education, contracts
and skills training.
Family/Support Sessions:
Treatment Coordinators work to educate
patients and families and other social
supports about the dynamics of recovery.
A primary objective is to consolidate
family support for the patient and to
help families address the factors that
allow the eating disorder to exist
within the system.
Mindfulness groups: Patients learn
and practice various skills designed to
increase awareness of their immediate mood
and physical state and to enhance their
ability to distinguish between these states.
The treatment team also assists the patient
to better manage sensory stimulation from
their environment. Through mindfulness,
patients will increase their ability to
regulate mood, decrease anxiety and to
remain grounded despite while the patient
manages their internal or external distress.
- Expressive therapy: The
following expressive groups provide
patients with a variety of opportunities
to address treatment goals through
creative self-expression:
- Art: Patients engage in
multiple therapeutic projects designed
to assess and treat patients.
Self-exploration through non-verbal
media helps increase personal insight as
well as insight into the eating
disorder. Group members then assist in
processing their peer’s art giving the
patient a different “voice.”
- Movement: Patients experience
the integration of their internal
dialogues and outward expressions
through the structure of music and
movement thereby increasing self-
expression, creativity and an enriched
relationship with their bodies.
- Progressive Muscle Relaxation:
Patients are exposed to different
techniques of relaxation in an effort to
reduce stress and increase
self-management within the safe
environment of program. Through the
experience, patients become increasing
aware of their hyper vigilance and how
to appropriately deal with these issues.
Yoga: Patients learn the
importance of the mind-body connection,
establish a sense of grounding in the
presence of external stimuli, identify
tension and increase relaxation skills
and flexibility while remaining present
in the moment through the components of
breathing, posing and stretching. Spiritual Care groups: Patients
learn about the importance of nurturing
their own spirituality as they connect
with God. The groups are designed to
increase meaning, purpose, and hope.
Topics include: grace, freedom,
forgiveness, shame, guilt,
perfectionism, motivation and being.
Alternate therapies: As appropriate
(age and cognitive ability) for the patient,
the treatment staff may incorporate
alternate forms of expressive therapy from
dance to sand tray therapy. These are
determined individually for patients to
reach specific therapeutic goals
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PRACTICE
While attending the
program, patients will be seen by a
multi-disciplinary team led by the Medical
Director, Jeffrey N. Mar, M.D. Dr. Mar is Board
Certified in Psychiatry, Board Eligible in
Child Psychiatry and Board Certified in
Pediatrics. He is a Fellow of the American
Academy of Pediatrics.
During the program, Dr. Mar is actively
involved in all aspects of patient care:
-
Assigns each patient to a primary therapist
to provide continuity with individual,
group
and family sessions.
-
Participates in the success of his
patients in overcoming daily and weekly
challenges.
-
Engages regularly in scheduled group
and in alternative therapeutic sessions.
-
Develops patient graduation and
discharge plans for their continued
recovery.
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