So maybe you’ve just completed a higher level of care for your eating disorder such as a residential or partial hospitalization program. You’ve gained skills and tools to help you combat the eating disorder. You’ve met goals set by your treatment team. With that, maybe it’s time for another transition to an Intensive Outpatient Program (IOP) or outpatient care. (Click here to learn more about levels of care) This is definitely something to celebrate! It is an important milestone in your recovery journey. However, there may still be some work to be done. With that being said, it is important to know what to expect when stepping down in treatment.
In a higher level of care such as residential or PHP, it is a little easier to focus a majority of your energy on recovery. With stepping down to IOP or outpatient care, you may be faced with the added challenge of balancing recovery with your typical daily routine (think work, school, a social life, etc.) Now, do not let this intimidate you - you have already faced hard things in recovery, and you will conquer this too, especially with the right team in place!
Why it’s important to step down to outpatient treatment
When stepping down from residential or partial hospitalization it is easy to feel like the work is done. While you have surely done some tough work in higher levels of care and acquired some important tools and skills to combat the eating disorder, stepping down to an Intensive Outpatient Program and/or outpatient care is an important step.
Of course, when you step down to IOP or outpatient, you are stepping back into your “normal life.” However, it’s likely that you’re not the same person that you were before going into treatment. Acclimating back to your old routine can feel like trying to fit a round peg into a square hole. It takes some adjusting to adapt back to your life outside of treatment.
Outpatient treatment can help with this transition. Working with a registered dietitian and a therapist, or even seeking community support through the NourishRX PATH for Eating Disorders can help you develop confidence and structure. With a team and community in place, you can increase independence, but you don’t have to do it alone.
What to Expect in Stepping Down in Treatment
1. Continuing to follow your meal plan
It is common (and very helpful) to continue to use the meal plan that you were using in treatment. I know what you’re thinking - “I STILL have to use a meal plan?!” As a matter of fact, yes. Sure, it’s easy enough to follow a meal plan in higher levels of care because in many cases, food is being prepared for you, and you may have 1-1 meal support.
What about when you have to prepare the food yourself? Or how do you balance work or school with a meal plan? When transitioning to outpatient care, there are a lot more variables to account for. Your meal plan will actually be your friend when it comes to providing some structure for daily intake.
2. Team Collaboration
We always recommend having a full-team approach. We’re talking primary care physician, therapist, and registered dietitian. The whole nine yards. You will more than likely be asked to fill out a release form so that all of your providers can talk to each other. This is so that everyone (including you!) can be on the same page about your treatment goals and how to get you there.
3. The Need to Set Boundaries
Now, this is a big one. It is important to prioritize your recovery even after stepping down to outpatient treatment. In order to protect your recovery as you step down, it may be necessary to set boundaries for yourself. Need some ideas: Click here!
4. The possibility of relapse
Real talk - relapse happens. We’ve all heard the saying, “progress is not linear,” right? And you know what? Relapse is okay! It doesn’t mean that you have failed, or that you are back to square one.
This is where your treatment team and the NourishRX PATH community comes in. First and foremost, it is important to work with your team to identify your personal triggers for relapse. From there, you can work together to come up with strategies to prevent it. If you do, in fact, relapse, your team and PATH community are there with you to help you get back on track.
5. Progression to Intuitive Eating
Remember when we said that meal plans are not forever? It’s true! As you progress through treatment, it is natural to begin to progress towards Intuitive Eating (click here to read more about that). You may begin to find that your hunger and fullness cues return, or that you begin to honor your cravings more often.
Our goal for you is to get to a place where you are able to listen to and trust your body; where you can find freedom from tracking and measuring. We want you to be an Intuitive Eater! Again, this is something that happens naturally, and can be facilitated by your registered dietitian. Once you feel that you are ready to shift your focus to Intuitive Eating, your team may recommend the NourishRX PATH for Intuitive Eating.
We know that a shift in levels of care (up or down) can be intimidating. That’s why we are here to help ease the transition that comes with stepping down in treatment. We encourage you to reach out for support by contacting our office to help find community in our NourishRX PATH for Eating Disorders.