Integrated Program for Eating Disorders and Substance Use Disorders
Many individuals with an eating disorder also struggle with alcohol and drugs. The co-occurrence of eating disorders and substance use disorders may have profound negative effects on health and quality of life. Because the relationship between the two conditions is complex and intertwined, The Emily Program has designed a program that addresses the eating disorders and substance use disorder at the same time. Dr. Jason Reed, Director of the Integrated Eating Disorder/Substance Use Disorder (ED/SUD) program, answers a few questions for us about the program's philosophy and structure.
Q: Why does TEP address eating disorders and substance use disorders together?
A: At least one in four individuals with an eating disorder may also struggle with alcohol and drugs at some point in their lives. Eating disorders (EDs) and substance use disorders (SUDs) have many similarities but also have important differences. They are similar in that they affect the reward and motivational systems in the brain and make it less likely for the client to want to stop the behavior entirely, despite negative consequences. Behaviors related to both EDs and SUDs, while harmful in the long run, also have often served to help a person cope with problems and feel more in control of their lives.
This makes it more likely that while one disorder is being addressed, the other may intensify and complicate treatment. It also may seem to family, friends and other healthcare professionals that the client isn’t “motivated” for treatment. The ED/SUD program aims to reduce this harmful cycle by focusing on the unique aspects of each individual's ED and SUD problems and also begin to address the underlying factors that make it feel to the client that these behaviors are necessary to cope with life.
A key difference between EDs and SUDs is the fact that you can avoid addictive substances entirely but you cannot avoid food and the importance of eating with others as an important part of a healthy life. Given the complexity of the interaction between the disorders and the significant impact on the client’s life, ED/SUD co-occurring disorders are best treated at the same time, in the same place, and by professionals who are trained to treat both conditions.
Q: What does a typical week look like for someone participating in the program?
A: A typical week in the ED/SUD program starts with setting goals for the week that are specific to the client’s own values and what they want their life in recovery to start looking like. Once these intentions are made clearer to the client, they can begin to make changes and practice new ways of living. To help with this process, each day starts with a yoga class specifically designed to get group members focused and centered on the treatment day ahead.
Participants are then immersed in supportive and therapeutic group programming that includes learning about addiction, building new skills and learning new ways to express and manage emotions, giving and receiving feedback from peers, telling their story, and developing a sustainable recovery management plan. Clients participate in 1-3 therapeutic meals or snack experiences throughout each programming day and receive individualized case management services specifically designed to help with the eating disorder and substance use problems.
Q: What are the main objectives of the Integrated ED/SUD programming?
A: The initial goal of the ED/SUD Program is to help the client interrupt the problematic cycle of behaviors that have led them to treatment, and begin to restore regular eating patterns and nutrition. This may include weight stabilization when necessary and also safely stopping substance use. Clients then begin to learn how eating disorders and addictive behaviors are related, and better understand how their own unique pattern of behaviors have actually been attempts to cope in the short-term that have or will have significant long-term negative consequences.
ED/SUD staff then collaborates with clients to find their unique and personal motivations to change and begin to identify underlying problems that made these old behaviors seem necessary in the first place. Once a client learns how these behaviors were used to help them function, clients then can begin to learn more adaptive skills to replace old ED/SUD behaviors. Clients begin to delve more deeply into the emotional and behavioral difficulties that had been interfering with long-term recovery through individual and group psychotherapy. Finally, clients begin to adapt to life situations in more flexible ways, start making new connections within themselves and with others, and develop a recovery plan that will help them move toward the life they want.
The Emily Program offers different levels of care to meet clients where they are in treatment. We offer an ED/SUD Intensive Outpatient Program (IIOP), Intensive Day Program (IIDP) and step-down groups. Treatment programs are currently offered in St. Paul and St. Louis Park in Minnesota. To learn more or to refer a client, please call 1-888-364-5977.