Transitioning from a higher level of eating disorder care to a lower one—such as moving from a Residential Treatment Center (RTC) to a Partial Hospitalization Program (PHP) or from PHP to an Intensive Outpatient Program (IOP)—can be challenging. While the move is often seen as a sign of progress, it can bring its own set of difficulties.
The Complexity of Transitioning to a Lower Level of Care
When a patient steps down to a lower level of care, there is an expectation from friends and family that things should become easier. However, the shift from a more intensive treatment environment to a less intensive one often involves significant adjustments. Changes in daily schedules, new treatment teams, different meal plans, and reduced programming time can make it feel like you’re taking a step back, rather than forward.
The Shift in Responsibility
One of the most significant changes is the shift in responsibility. Moving from a RTC, where care is provided around the clock, to a PHP, which typically involves at least 5 hours of daily programming, means that patients need to start taking more responsibility for themselves. This transition to PHP can feel overwhelming, as RTC patients are used to having a team available to them at all times.
Similarly, transitioning from PHP to IOP can be daunting. In PHP, there is a structured schedule and at least two meals and snacks are prepared and served to patients daily. In IOP, patients will experience more free time, have to manage their own meals, and navigate multiple meals a day without the same level of support. These changes can be daunting even for those who are well-prepared.
Traveling or Relocating for Treatment
For many, particularly in regions like Montana where treatment options are limited, receiving care for an eating disorder means traveling long distances daily or relocating entirely for a time. Patients might find themselves hours away from home, friends, and family. This can add an additional strain to an already hard situation.
Adapting to a New Facility
Starting at a new facility can be a major adjustment. Even when stepping down to a lower level of care is beneficial, the process of integrating into a new group, adapting to a new team of providers, and adjusting to a new routine can be overwhelming. This period of transition might cause a temporary setback, but it’s a normal part of the process with the overall goal of continuing to build resiliency in recovery at the lower levels of care.
There are also opportunities for connection and growth within a new treatment program, including meeting peers at the new facility and building skills like cooking and grocery store shopping or going to coffee shops or the farmers’ market. All of these new experiences can help to reinforce recovery and build a strong future.
Tips for Navigating the Transition
Here are some strategies to help manage this transitional phase:
- Establish a Routine That Works for You
Creating a daily routine can provide a sense of control and stability. Consider incorporating practices that help ground you, such as journaling each morning, engaging in hobbies, or meal prepping according to your dietitian’s plan. Consistent grocery shopping and setting regular times for meals and snacks can also help establish new habits and patterns.
- Build a Support System at Home
Identify people you can rely on when you’re at home between treatment sessions. This could be a family member or friend who can offer emotional support, join you for grocery shopping, or simply be there when you need to talk. Ensure that your support system is informed about your needs and aware of how to avoid discussions around food or body image, such as calories or weight. Your team can help you manage the expectations of being back at home, alongside ways to identify your allies and reinforce your recovery community.
- Reflect on Your Progress
Remember that your treatment team recommended this step down because they have seen significant improvement in your condition. Reflect on how far you’ve come and recognize the progress you’ve made. This can help reinforce your motivation and remind you of your achievements during challenging times.
Transitioning to a lower level of care is a major step forward in your recovery journey, even though it may come with its own set of challenges. Embrace the changes with patience and self-compassion, knowing that each step forward is a testament to your progress and resilience.