When it comes to eating disorder recovery, each client needs a unique structure in place as they transition out of treatment. Collaboration between the treatment center, outpatient team, family, and individual is imperative when developing this plan.
Necessary Elements of Aftercare Support
Generally speaking, there are 11 components of aftercare support, which include:
Advocacy: Aftercare can be a lonely and scary time, but it’s important to remember that you are not alone! For instance, an advocacy group helps to give those in recovery a voice and also allows them to connect with each other for support and additional resources.
Fun and Self-Care: It’s important to find balance during aftercare. There needs to be enough structure that the client feels supported but not to the point where they feel stuck in the role of patient. Self-care, fun, and relaxation are as equally productive as school and work (more on that below!).
Family Support: Family therapy is key. The family needs to feel supported and also able to address issues within the family system that may have contributed to the eating disorder. This component often overlaps with advocacy, support groups, meal support, and treatment team.
School and Work: Here’s, it’s imperative to consider the environment: Is the patient entering a new setting or reintegrating into an old one? Is it conducive to recovery or a barrier? Note the access to meals and food, the daily schedule, and the course or work load and intensity. If possible, taper back into school or work, allowing for some exposure to potential challenges before full immersion. Using an educational consultant may be helpful.
Support Groups: Support groups are very important for both the client and the client’s family. They also offer an easy opportunity for socialization each week.
Recovery Coach: Additionally, a recovery coach may be a valuable member of the support team. They can work with a client alone or with the entire family. They may come into the home and/or workplace to better understand the client’s environment. They can take part in cooking meals, sorting through “sick clothes” or disordered items, and more.
Meal Support: If a family can add meal support, this component is a great opportunity to continue food exposures and work with a nutritionist. It maintains the consistency of the meal plan established during treatment and also makes room for practicing correcting behaviors in real time and “getting back on track.”
Socialization: Establishing a connection with others is a major part of aftercare success. Think about the barriers to social engagement and set realistic goals. Make time for scheduled and unscheduled socialization. Think ahead to what reintegration into their group of friends will be like, and come up with a plan for handling any potential challenges or awkward moments.
Treatment Team: Each person needs to own their defined role. For example, I often tell parents that they can’t be both the recovery coach and the parent. When they try to handle both jobs, it can be confusing, exhausting, and ineffective, particularly for aftercare support for older children. An outpatient treatment team consists of a therapist, a nutritionist, possibly a psychiatrist, and a primary care doctor, in addition to other supports mentioned throughout this blog.
Spiritual: Much like socialization, a client may desire to reestablish their spirituality and relationship with a higher power. Whether that’s attending church on a regular basis or taking a mindful walk out in nature, make space for this quiet time and personal growth.
Co-Occurring Support: Many eating disorder patients struggle with other mental health issues, like substance use. The aftercare support plan must address all areas of need for each patient to avoid symptom substitution and to address the relationship of the substance use with the eating disorder, impulse control, hunger and fullness cues, and more.
Eating Disorders and Suicide
September is Suicide Prevention Month, so I want to take a moment to discuss the link between eating disorders and suicide. While complications related to malnutrition are the leading cause of death for eating disorder sufferers, suicide is a close second. In fact, according to a recent study, suicide is the most common non-natural cause of death for these patients. Another reason why aftercare support is so important!
Individuals with anorexia nervosa, bulimia nervosa, and binge eating disorder are at a higher risk for suicidality, which refers to a wide range of potentially-dangerous thoughts and behaviors. Between 20 and 43 percent of patients with anorexia nervosa reported suicidal ideation, and these individuals are two to nine times more likely than their peers to attempt suicide. Similarly, female patients with bulimia nervosa are seven times more likely than other females to die by suicide.
Check out last year’s blog post for the six steps for suicide prevention.
If you or a loved one is struggling with an eating disorder, reach out to Dr. Kelli Malkasian, PsyD, CEDS at Coral Reef Counseling, and schedule a free consultation or telehealth appointment today.