Virtual Eating Disorder Treatment Programs: Are they effective?
Written by ‘Ai Pono Hawaii Staff Writer
Many treatment programs have shifted online during 2020, to mitigate the risk for the spread of COVID-19. As eating disorder treatment facilities are designed for physical closeness, it only makes sense to shift some treatment programs online.
Virtual eating disorder treatment programs are definitely going to be more common in the coming years, but they existed before 2020 as well. This is because there are many external barriers to eating disorder treatment: the lack of a treatment center anywhere close, the inability to find a therapist anywhere in the area, insurance issues, the inability to leave your home settings, and a number of other factors.
Virtual eating disorder support is a great way to access needed care from your treatment team. Other forms of eating disorder support simply offer you a safe space to speak freely with a community that understands and can guide you. There are many therapies out there as well to engage in.
And of course, online therapy is becoming commonplace for the entirety of the mental health realm. Telehealth has made it possible to have that same personal face-to-face connection as if you were sitting together in-person. Except, in this setting, neither of you have to trek to an office to see each other.
Kinds of Virtual Eating Disorder Treatment Programs:
Virtual Intensive Outpatient Treatment (IOP):
Virtual IOP meets anywhere from three to five days a week, usually for around three hours a day. You have access to a therapist, dietician, skills groups, and meal support for at least one meal or snack.
This is the lowest level of intense treatment, designed for those who have either stepped down from a higher level of care, or for those who are finding that virtual outpatient treatment is not enough support for them.
Virtual Partial Hospitalization Program (PHP):
Virtual PHP is much like virtual IOP, but participants meet on average five days a week and have meal support for more meals and snacks. It is designed for those moving up from virtual IOP as needed, and for those who have stepped down from an in-person residential level of care.
Virtual Support Groups:
These are online gatherings of those with an eating disorder who are reaching out to the online community for support and a safe place to talk about what's going on with their lives.
There are free support groups run by organizations such as Communities of Healing. All groups are facilitated by either a licensed professional, or by someone who is firmly rooted in their recovery and prepared to help others. There are also paid support groups, usually run by larger organizations or treatment centers.
It is important to note that virtual support groups are in no way a replacement for therapy or professional treatment. Listed below are some non-treatment based resources worth checking out:
Light of the Moon Cafe: From the site, “self-study and interactive courses so you can get why you do what you do with food. And learn how to feed your soul instead.”
MEDA’s Support and Recovery Groups: Free and paid support groups that are intended to augment outpatient therapy.
Communities of Healing: Several free weekly virtual support groups led by recovered moderators (several meetings each week over many time zones)
The Eating Disorder Foundation: Free weekly support groups for several different ages, stages in recovery, and kinds of treatment approaches; support groups for friends and family of those with eating disorders
For several more virtual support options, the National Eating Disorders Association has a list breaking down support groups by timezone.
Online Outpatient Therapy:
This kind of treatment is completely outpatient. You should at this point have set up an outpatient team to ensure you’re continuing to maintain your recovery. Your team should, ideally, consist of a therapist, nutritionist, PCP, and psychiatrist (if medication has proved to be helpful).
Online therapy is for those who have stepped down from virtual IOP, and for those who do not necessarily need or cannot access that level of treatment.
Pros of Virtual Eating Disorder Treatment:
Most importantly, virtual eating disorder treatment offers many more options for individuals to quickly and easily get into treatment programs. Location, waitlists, and treatment times can all be handled by simply choosing the program that works best for them in the moment.
All virtual forms of formal treatment allow you to step up or down from treatment levels without leaving your home. And they are all a little more flexible than in-person treatment. Engaging in treatment at home can also create a new relationship with a place that you once used behaviors. It’s easier to use your newly learned skills at home, since you don’t have to make that transition from the treatment environment to your “home life”.
There is also, unfortunately, a lot of comparison when it comes to individuals with eating disorders. Not having to be physically around other patients may help to cut down on that comparison, as you can’t physically compare yourself to someone else’s body, meal plan, or difficulty with treatment.
Online support groups cultivate a sense of connection, and allow you to meet people who understand what having an eating disorder is like. It’s comforting to talk about your recovery wins and losses throughout the week. And outpatient therapy sets up a structure in which you are monitored and made aware of eating disordered behaviors. They can also recommend a higher level of care if necessary.
Cons of Virtual Eating Disorder Treatment:
Naturally, it may feel harder to connect with your fellow patients and clinicians in treatment than if you were in-person. You won’t be watched over as closely, and it can feel easier to engage in behaviors when you’re at a distance.
Your home environment may not be geared towards your recovery. If there are triggering people in your household, or you feel pressure from others, it can be more difficult to engage with programming. Your home environment is also a place where you are likely to have engaged in behaviors. So while it may help to work on your skills in the moment at home, while having support, it may also have an adverse effect. Your home may be a triggering environment, so it may be hard to face challenges in surroundings that are already difficult to be in.
Who qualifies for online eating disorder treatment?
This treatment approach is only for those who are medically stable, in no immediate danger of severely harming themselves or others, and (ideally) those who have been working through recovery previous to joining a virtual treatment program or support group.
Many formal treatment facilities will accept clients who have stepped down from a higher level of treatment, such as a residential or partial hospitalization program. These programs are also a great “tune up” for those who have recognized that they are having some slips in recovery, and that the outpatient level of treatment is not providing them with enough support.
Virtual eating disorder support groups are a great option for those who just want to talk to others throughout the week, and want to feel connected and understood by the larger community. Again, it is extremely important to note: Eating disorder support groups are not a substitute for formal treatment. Facilitators at groups are not your dedicated therapists, and group settings do not replace your treatment team.
Related: Not sure how to pay for eating disorder treatment? Click here to learn how to pay for the treatment you need and deserve.
But does virtual treatment really work?
Virtual eating disorder treatment uses the same evidence-based treatment and protocols as on-site programming. Qualified professionals, who are also trained in telehealth, still manage treatment programs, so you can rest assured that the quality of treatment remains the same. You have to choose a program that is easy for you to engage with, in terms of technology.
You also have to make sure that you’re fully willing to engage with programming, and be honest with your treatment team when something goes wrong. This applies to in-person treatment as well, so there is no difference between in-person and virtual treatment on this front.
2020 has been an isolating year. It’s hard to not have in-person support to monitor and keep you from engaging in behaviors. But on the road to recovery, you are never alone are there are options available to keep you on track.
‘Ai Pono Hawaii currently offers Virtual IOP programming for residents of Hawaii or those who have completed a higher level of care with us and are remaining in Hawaii. Click here for more information.