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Intensive Outpatient Treatment offers a unique treatment resource during evening hours.


The Center for Eating Disorders’ Intensive Outpatient Program (IOP) is a unique treatment option that provides an additional step down from the intensity of Inpatient or Partial Hospital Program while still offering more structure and support than standard outpatient therapy.   The program is designed for individuals who are able to take responsibility for setting goals and working towards them in daily life but could benefit from the extra structure and group support each evening.  The IOP has many components and operates separately from, yet in conjunction with, the Inpatient and Partial hospital programs.

Important elements of IOP include:

  1. 4 days/week (Mon-Thurs) of intensive treatment during evening hours (3:30-7:30pm)
  2. A continued focus on normalization of nutrition and symptom blockade with enhanced education  around self-monitoring and understanding personal triggers
  3. A strong group therapy component including a combination of cognitive behavior therapy groups and dialectical behavior therapy groups.
  4. Therapeutic mealtimes with opportunities for family engagement and education for support people

When appropriate, patients can be engaged in school or work activities during the day while still attending intensive treatment during the evenings. This can be very important for individuals who are phasing back into life following discharge from inpatient or partial hospital program. This can also be  beneficial for parents, students or other individuals who are stable enough to remain engaged in their daytime roles but need the extra support in the evenings to prevent an escalation of symptoms.

The Center’s IOP offers the following therapeutic opportunities for individuals working towards recovery:

  • Treatment Plan & Individualized Goals – Once a week patients meet one-on-one with a psychiatrist and therapist to discuss treatment goals and personal progress. Patients are given an active role in developing their goals. The more an individual can share with the treatment team their struggles, progress and experiences, the more the team can work with the individual to achieve their established goals.  
  • Dialectical Behavioral Therapy Group – This group focuses on mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.  Each week, individuals will choose a new coping skill to practice each day in order to incorporate new knowledge, strategies and techniques to manage and navigate difficult and intense emotions.   

  • Therapeutic Meals – Breakfast, lunch and snacks take place outside of treatment hours, however, the dinner meal is provided each night during IOP.  This is an opportunity for patients to have a positive, pleasant group meal experience with the assistance and support of the treatment staff and fellow patients.  Throughout the time in IOP patients also receive guidance with re-connecting to their natural hunger and fullness cues.  
  • Cognitive Behavioral Therapy Group – Patients participate in group Cognitive Behavioral Therapy twice a week. It’s here that they develop and practice more effective and positive cognitive and behavioral skills. Since patients are functioning on their own for a significant part of the day, we strongly emphasize training that helps them cope and solve problems.

  • Body Image Group – This group helps patients build skills for tolerating intense feelings about their bodies, challenging distorted perceptions about shape and size, and understanding the forces that have impacted their body image development.

  • Interpersonal Therapy Group – This is an open-ended group in which patients are encouraged to process current and past struggles with the eating disorder in a way that improves each individual’s insight into the underlying causes and role of the eating disorder in their life.  Specifically, this group will focus on interpersonal relationships and healthy communication skills, as well as role transitions, complicated grief, etc.
  • Occupational Therapy Group – This group will help patients develop structure and time management skills outside of treatment.  It will also focus on developing helpful strategies and coping skills, such as grocery shopping, self-care, and clothes shopping, that can be very challenging tasks, particularly during the recovery process. 

  • Multi-Family Dinner Group – During IOP each patient has the opportunity to invite up to two family members, friends or supporters to attend dinner with them one night each week. After dinner, patients and their families attend a group together facilitated by a registered dietitian and a psychologist.  Patients and support people are invited to discuss questions pertaining to meal planning and structure as well as how to appropriately support loved ones in the process of recovery.
  • Art Therapy – Art therapy provides one with alternative coping skills that are beneficial when one is looking to self-soothe, contain emotions, challenge perfectionism, and/or express themselves in non-verbal ways.    Artistic skill or experience in not necessary.
     
  • Stress Management – This group offers educational and experiential components around stress relief and relaxation techniques. Tools include guided imagery, conscious breathing and progressive muscle relaxation.
  • Nutrition Group – During IOP, patients have the opportunity to check in with a Registered Dietitian individually to review their meal plan and set personal goals. Twice a week, patients attend a nutrition group led by a registered dietitian. The information learned helps patients make food choices based on knowledge, rather than assumptions, and on facts rather than misinformation. These groups also help patients process distorted thoughts about food and weight.  

Engaging in work, school or other life activities during the daytime hours and weekends provides in vivo opportunities to practice these newly learned coping skills, extend symptom blockade, and utilize personal support systems. When appropriate, IOP patients are encouraged to continue with existing individual therapy and family therapy on Fridays when IOP is not in session.

Intensive Outpatient Treatment can provide a much needed step towards independent stability and less intensive intervention

Average length of participation in the IOP program can vary depending on individual needs.  Typically patients continue in IOP for about 6-8 weeks. Before tapering out of the program, IOP staff will work with patients regarding a discharge plan and provide resources for continued outpatient treatment and support. If a patient does not already have an outpatient treatment team, the IOP staff will help them connect to outpatient treatment providers and support groups in their own communities.

If you have questions about the Intensive Outpatient Program, please call (410) 938-5252 or email eatingdisorderinfo@sheppardpratt.org


 

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Want to read more about Intensive Outpatient Programs? The Center for Eating Disorders' IOP Clinical Coordinator, Dr. Morgan Krumeich wrote a helpful guest post for Eating Disorder Hope about seven specific benefits of IOP in the journey to recovery.  You can read it by clicking on the link below.

IOPs and Their Benefits in Eating Disorder Treatment

by Morgan Krumeich, PsyD 

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