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UCLA Eating Disorders Program

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UCLA Eating Disorders Program

Adult Partial Hospitalization Therapeutic Program

A comprehensive and intense multimodal therapeutic program is used during partial hospitalization.

Staff from each discipline, including Psychiatry, Psychology, social work, nursing, and occupational therapy all have expertise in the treatment of patients with eating disorders and contribute to the development of treatment goals and interventions for each patient. 

Therapeutic modalities, which are described in depth below, include:

  • Individual psychotherapy
  • Family or couples therapy
  • Psychotherapy process group
  • Cognitive assertion group
  • Body image group
  • Dialectical Behavior Therapy skills training
  • Family issues group
  • Healthy boundaries group
  • Occupational counseling
  • Relaxation group
  • Mindfulness meditation
  • Occupational therapy
  • Recreation therapy
  • Pharmacotherapy, as needed

Individual Psychotherapy

Every patient in partial hospitalization eating disorders program meets with his or her psychotherapist three times per week.  The focus of individual therapy is identifying and exploring psychosocial issues that influence the patient's sense of self and subsequent levels of functioning at home, school, or work, and in interpersonal relationships. Patients become aware that they have been using maladaptive eating behaviors in lieu of appropriate, healthy mechanisms for coping with difficult emotions or with stressors.  Through individual psychotherapy, the patient gains an awareness of the relationship between maladaptive eating behaviors and deficits in other areas of psychosocial functioning, and how to modify eating behaviors while simultaneously developing more adaptive strategies for coping with stressors and preventing relapse.

Family or Couples Therapy (optional)

Family therapy explores the structure of the family and the relationships among family members, and aims to enhance the direct communication of thoughts and feelings among family members.  The emphasis of family therapy for the patient is on attainment and expression of a sense of self that is distinct from that of other members of the family while maintaining a sense of family cohesion.  Marital or couples therapy addresses the dynamics within the couple's relationship, including aspects of the relationship impacted by the patient's eating disorder, and aims to enhance the communication of thoughts and feelings within the couple.

Psychotherapy Process Group

The psychotherapy process group provides an opportunity for patients to collectively explore issues that are meaningful to the group, experience group support and validation, and participate in generating solutions to common concerns.  Particular emphasis is placed on examining the relationships between psychosocial issues and eating disorder symptoms and behaviors.  Patients are encouraged to examine the nature of their eating disorders and the ways that each individual's disorder is used to manage significant life issues such as social and/or romantic relationships, achievement, feelings of dependency, self-doubt, self-control and individuation from one's family of origin.   

Cognitive Assertion Group

This group promotes the awareness and understanding of thoughts and feelings, as well as learned beliefs, as they relate to distressing situations.   With this exploration, the negative automatic thoughts that interfere with self-perceptions, social interactions, and other activities of daily living can be identified.  Corrective thinking is then developed and behavioral changes (for example, developing and practicing assertion skills) can be made, leading to improved coping and movement toward better functioning.  The discussion allows for each individual to identify an area of difficulty in which he or she is motivated to create change, and feedback is provided by both peers and therapist.  A log book is provided to each patient for independent reflection and to work toward the goals established in group. 

Body Image Group

This group works toward identifying patterns of thought, behavior and relating with oneself that produce a negative body image, and toward making different choices to create new patterns with more positive responses.  Activities and topic-related discussions in the group involve exploration of thoughts and feelings centered on body image and how body image influences one's mood, self-concept, and engagement in and/or avoidance of daily activities.  Various strategies are taught to increase comfort with body image including corrective thinking, relaxation, problem-solving to cope with distressing situations, getting rid of clothing that does not fit/shopping for new clothes, and exposures to activities the patient has been avoiding.

Dialectical Behavior Therapy Skills Training

The Dialectical Behavior Therapy (DBT) skills group is devoted to the development of coping mechanisms that help individuals navigate life's challenges effectively.  Four skills modules (core mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance) are taught in rotation.  Group sessions are didactic and address skills acquisition and mastery.  

Family Issues Group

This is a psychoeducational discussion group that utilizes the creation of a three-generation genogram as a vehicle for exploring family dynamics, communication patterns, and responses to stressors.

Healthy Boundaries Group

This is a psychoeducational discussion group that deals with recognizing, protecting, and maintaining interpersonal boundaries.

Occupational Counseling

This group focuses on discussion of the occupational choice process and on developing concrete strategies and plans with regard to work and/or school.

Relaxation Group

Relaxation group offers instruction in variety of techniques that can be used to alleviate symptoms of stress, including guided imagery, awareness of breath, and listening to quiet music.

Mindfulness Meditation Group

This group promotes awareness of, and connection with, one's present experience; helps participants develop greater mind-body awareness; and reduces stress.  Mindfulness meditation may include focus on the breath and/or on thoughts, emotions, physical sensations, or activities. 

Occupational Therapy

Occupational therapy helps the patient identify skills, interests, and capabilities, and to develop additional skills.  Occupational therapy also includes art groups, in which patients have the opportunity to work on creative self-expression through participating in painting, drawing, and ceramics.  In this setting, our occupational therapists assess patients' task performance and mediate areas of difficulty, such as problem-solving.

Recreation Therapy

Recreation therapy focuses on developing leisure and interpersonal skills in a group setting.  For patients with a history of excessive or compulsive exercise, emphasis is placed on helping the individual develop and practice a flexible program of moderate exercise.  Participation in physically strenuous activities during recreation therapy is contingent upon reaching a weight at which exercise is appropriate and then continuing weight gain as needed.

Pharmacotherapy

The multidisciplinary assessment process for each patient in the program includes evaluation by a UCLA faculty psychiatrist to determine whether medication treatment is appropriate.  This evaluation occurs on an ongoing basis throughout the patient's partial hospitalization.  Medication may be prescribed to target eating disorder symptoms and/or symptoms of other co-existing psychiatric disorders (e.g., depression, anxiety disorders).

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