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daughter20

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Reply with quote  #1 
My daughter has struggled with restricting for several years. Until 2 years ago, I took care of all meals for her, and brought her weight up to a barely healthy level. Once an adult she insisted that she control all of her meals. I did what I could. She has been seeing on-campus counselors and dietician for 4 years, but no other treatment. In the past year I've seen her weight go up slightly, then down. Although I have no way of knowing what she weighs she looks to me as if she has slipped 1 to 2 pounds below what she weighed when she took back control of her meals. She continues to somewhat restrict, stating that her dietician told her to only eat when she's hungry. In the past year, she has also begun binge-eating (no purging, but she exercises more than I think she should). I have little influence over her, except what I prepare for dinners. She lives at home, still. The binge periods go on for 3-5 days, and occur about once per month.

She wants to do a residential treatment, and has looked at the Emily Program in Seattle. I don't know if residential is really the right level of care for her. It feels extreme. Can anyone here provide some perspective for me, if you feel residential is truly the right level of care, or if you feel something else would be better? Does anyone here have experience with the Emily Program in Seattle? My daughter is easily influenced by professionals, and has little respect for my opinion. She went into her intake appt with Emily Program cheery and looking optimistic. Then she looked like she was about to burst into tears, and seemed angry with me, when it was over. I don't have a lot of influence over her, but I am paying for any treatment. Please ease my mind if residential with Emily would be appropriate level of care for her. I don't want her state, or my relationship with her, to deteriorate any further. Advice?
Torie

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Reply with quote  #2 
Hi daughter 20 - So sorry you needed to join us here.  I don't know about the Emily Program, but there is a members only page for reviews of treatment providers - let me know if you need help finding that.  It's great that you came here to ask because - as I and many others here found out firsthand - bad help is worse than no help at all.

I wonder how you have determined that she is not purging.  It can be really hard to tell since AN is so secretive and makes our ED-kids lie about stuff like that.  If she is secretly purging, that might explain why she thinks she needs residential.

Please feel free to ask all the questions you like. xx

-Torie

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"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
daughter20

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Reply with quote  #3 
Hi Torie,
Thank you for responding.
I haven't had any reason to distrust this information from her. She has confided other things in me before, and when I have asked her point-blank about purging she has said that she realizes how dangerous that is (thinking of Karen Carpenter) and doesn't want to go down that path. This is a trust thing between the two of us. She won't blatantly lie to me, but may avoid talking about something that she knows would upset me. All along, with refeeding, she has been honest when I asked if she finished meals on campus. I believe that she does know that I have her best interest at heart, but that as a non-professional my opinion carries little weight with her.

Her reason for wanting residential is she feels out of control when she has a binge period. These binge periods happen about once per month, and can span 3 to 5 days. Being out of control really scares her. And I think she feels if she is monitored 24/7 that she will be freed from the cycle. She sought an eating disorder specialist on her own a month ago, and this person said IOP would be about right for her. 

Thank you on the treatment center review page. I did look for other info on Seattle, and forwarded what I found to my daughter. 
sk8r31

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Reply with quote  #4 
Our family looked briefly at the Emily Program in Seattle some years ago when we were searching for the best possible treatment options for our then-17-year old.

Ultimately, after visiting and speaking with an intake specialist, we didn't feel this program would provide the best evidence-based care available for our d.

We chose to go to the UCSD 5 Day Multi-Family adolescent program in 2011, and haven't looked back since.  I would encourage you to investigate their adult program, now being offered.  

The Center for Balanced Living in Ohio also runs a 5 Day Multi-Family adult program.  In fact, it was developed in collaboration with the UCSD program staff, and adapted from their adolescent program.

My two cents' worth of advice: I would choose either of these options over the Emily Program in a heartbeat.

Sending warm support,
sk8r31

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It is good to not only hope to be successful, but to expect it and accept it--Maya Angelou
daughter20

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Reply with quote  #5 
Thanks sk8r31,
I will ask her to consider the UCSD program. She feels very anxious to begin something and I don't know how long she is willing to wait for any program, right now. I did ask her to contact EBTCSeattle, but I've heard they have a waitlist. 
Again, thank you for responding.
Mamaroo

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Reply with quote  #6 
Hi, sorry to hear your d is struggling. The only piece of advice is to encourage your d to eat 6 times a day and concentrate on protein and fat. Both my daughters binged, so spreading out the meals have helped a lot (I used to binge as well, so I ensure that I est often before I get hungry). Best of luck!
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D became obsessed with exercise at age 9. Started eating 'healthy' at age 9.5. Restricting couple of months later. IP for 2 weeks at age 10. Slowly refed for a year and WR at age 11 in March 2017. Challenging fear foods and behaviours now.
sk8r31

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Reply with quote  #7 
It may be helpful for you to contact UCSD yourself, to gather the info to present to your d.  Or tell your d that you will dial the number and then hand the phone to her to speak to an intake specialist.  I know for some, the fear of actually making a first move is hard.  The support you give at this point may be just sitting with her while she makes those calls and looks at next steps.

EBTC of Seattle has a great reputation as well.  Perhaps there might be an option of getting on a cancellation list.  Sometimes during the holidays can actually be a good time to begin with a program or therapist, as their regular clients may be taking a holiday break.  For our family, that's actually how we started with our FBT therapist in Seattle, after our week at UCSD.  She was totally booked up, but because it was during the summer holidays, we were able to begin seeing her right away.

Sending warm support,
sk8r31

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It is good to not only hope to be successful, but to expect it and accept it--Maya Angelou
daughter20

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Reply with quote  #8 
Thank you, Mamaroo. I will try encouraging her.

Thank you, sk8r31. She is waiting to hear back from EBTC. I mentioned UCSD to her, and she was mildly interested. She also did an intake with Opal. She liked their PHP. I am trying to be as encouraging as possible. Have you heard anything about Opal?
melstevUK

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Reply with quote  #9 
daughter20,

'She continues to somewhat restrict, stating that her dietician told her to only eat when she's hungry.'

YOur daughter has been let down big time by this instruction.  She may not even know when she is hungry until she feels as if she is starving - which will then lead to over-eating.  She needs to return to a three meal three snack structure, have no fears about over-eating at the moment, and just think about enjoying food and eating again. Her appetite is unlikely to be a reliable indicator of when and how much she needs to eat - in fact whose appetite is reliable these days?  It's one of the reasons why we have obesity - so many people follow hunger and desire and eat way more than they need.

At least your d knows that she is struggling - and while she relies on professionals, this dietician may have been able to help her get her weight up and to recover, but maybe does not understand how very long it takes for hunger cues to either return, or be relied on or able to lead to eating behaviours which keep someone healthy.  When ever there are difficulties around restricting/bingeing - the recommendation is always to return to structured eating to normalise behaviours around food so I totally echo what Mamaroo has said above.

I would suggest she tries this first, rather than goes IP.  And reassure her that in time everything will even out again.  Your confidence in her ability to restore regular eating patterns may help her. 

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Believe you can and you're halfway there.
Theodore Roosevelt.
judehat

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Reply with quote  #10 
Hi Daughter 20. This is my first post, but we also have a 20 year old daughter with RAN. My loving, golden-soul girl has been taken over by ED. She has had to take a leave from university and has just returned home from a residential stay at Veritas in North Carolina. I cannot recommend Veritas enough. It is a strict environment, but the staff are knowledgeable and loving. My daughter loved her team there and speaks very highly of the program. She was WR there, taught to plate for herself and increasingly given more freedom. Unfortunately, she refused to stay and do the day program (PHP) and has come home too early. She was so homesick that she thought she could manage. She is still eating, but struggling with negative thoughts and we are trying to get her back on track. A visit back to Veritas may be in order, to complete the full program. Time will tell. I hope this helps!

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