The Provincial Specialized Eating Disorders Program team has designed a number of innovative programs to deliver high-quality health care to clients with eating disorders and their families. Inter-professional team collaboration is the cornerstone of the program. These programs include:
Our assessments generally involve a day. If possible at the end of that day, we will share the recommendations of the Provincial Specialized Eating Disorders Program team with you and your family and options will be presented to you. We encourage you and your family to return home to discuss the events and the information given during the day. Written material regarding the Eating Disorders Program at Children’s and general information regarding eating disorders will also be given to you. A letter of the assessment and recommendations will be sent to you and your doctor or referral source. We encourage you to contact us after the assessment with any questions, concerns or comments.
Our outpatient clinics offer medical and dietary monitoring and treatment as well as individual and family psychotherapy. Our services are oriented towards helping individuals gain increased control over their eating difficulties while addressing problems with self-image and family dynamics. These programs also provide after-care and relapse prevention for individuals who have attended our intensive treatment service. The clinics are available three afternoons a week. This pamphlet explains what to expect in outpatient clinics.
Parent group
The parent group runs most Thursday evenings, along with a psycho-educational group called “Questions, Answers & More”. These groups run on a 12-week rotation. During the 12 weeks there are 4 weeks of “Questions, Answers & More” which include these topics:-- What is an eating disorder? The process of change.
-- How did we get here? Preparation for change: issues on the road to recovery.-- What’s normal and why? From preparation to action. Looking forward.-- Impact of an eating disorder on the family and the role of helping relationships.
Call our reception at 604-875-2200 for more information.
The Intensive Treatment Service consists of up to twelve patients including ten who reside at the hospital as inpatients and two patients who are able to commute from home and attend the Program during the day. The Intensive Treatment Service provides treatment for patients from outside of the Lower Mainland, as well as additional support and therapy on evenings and weekends. All patients attend the day treatment programming as soon as they are able, usually within a day or two of admission. Programs during the day operate seven days a week from 8:00 am to 6:00 pm.
Treatment involves group, individual and family therapy. Recreational activities are also a key component. Our teacher supervises the child or teen’s school program and provides a link between their school and our Program.The children and teens receive daily meals and snacks, and participate in group therapies in the afternoons. We emphasize educating patients and families about eating disorders. Patients and their families receive pre-care before coming here. Length of stay in the program varies depending on treatment needs and the individual’s achievement of goals.
Motivation is an important part of recovery. Click here to read “About Motivational Enhancement.”
Pre-care
If you are referred for admission to the Intensive Treatment Service, a Clinical Nurse Coordinator will contact you for a Pre-care appointment.
Our treatment approachesEating disorders result from many factors. We address each factor according to your child’s needs and your family’s needs. We approach use several approaches, many based on a Motivational Enhancement model.
1. Working one-to-one with youth We ask all patients to engage in individual therapy. These are one-to-one therapy sessions with a therapist. This could be a staff from our clinic or a community therapist. Our goal is to make the patients active participants in their recovery.
1. Working one-to-one with youth
We ask all patients to engage in individual therapy. These are one-to-one therapy sessions with a therapist. This could be a staff from our clinic or a community therapist. Our goal is to make the patients active participants in their recovery.
We use Cognitive-Behavioural Therapy (CBT). Psycho-dynamic approaches could also be used.
deal with difficulties in relationships with others; learn to start recognizing their own needs; express those needs or feelings to others. 2. Working within a group of youthGroup therapy is a well-known and effective way of helping patients with eating disorders. The focus of our groups varies. Some are about: life skills (assertiveness, management of strong emotions); developing a positive body image; expressions of feelings in the here-and-now; psycho-education (providing information to patients to become informed participants and consumers of health care); recreational activity groups such as ceramics or indoor climbing; expressive therapies such as art, drama, music; learning self-awareness through yoga. The unifying milieu principle is to strengthen the adolescent’s self-reflection, self-appraisal, and self-responsibility 3. Family therapy Since most of our patients live at home, eating disorders have a major impact on the entire family. There may be particular stresses at home, such as conflict at meal times. Family members may blame themselves or other family members. Family therapy improves communications within the family. Together, families will find solutions to best help the recovery of their family member. 4. Medications No specific medications exist for the treatment of restrictive anorexia nervosa. Medications such as anti-depressants have been shown to be helpful for patients who binge-eat and purge. If your child has another condition in addition to the eating disorder, this will be treated with the appropriate medication. Bowel function is often affected and slowed. Your child may be given a medicine that helps motility and reduces bloating. If your child has a problem with constipation, we may provide a stool softener or bulk-former. 5. Nutritional rehabilitation — meal support The best psycho-therapies cannot be effective as long as the body is neglected. The effects of starvation affect your child’s physical and emotional well being. Repeated binging and purging have similar effects. These need to improve in order for recovery to begin. With the help of our dieticians and trained staff, your child will be gradually introduced to normal eating patterns and healthy nutrition. Weight gain, if necessary, is done in a careful and gradual way.|Meal support treatment is an important aspect of our Program. .........What is meal support?Meal support therapy is one of the most critical components of the nutritional rehabilitation process in eating disorders. Effective meal support is not just sitting down and watching someone eat. It’s an active process that needs to be planned, then carried out with compassion and care. It is eating with the patient, supporting them throughout their meal, and then being there with them after the meal to provide gentle support and distraction at this critical time post-meal. ......... Trained staff support and encourage your child during meals and snacks. This mode of treatment is effective in avoiding more intrusive means of weight gain. We will help you learn to provide meal support at home through our parent support groups. We also have a DVD on how to provide effective meal support. It can be purchased from the hospital bookstore, here.
deal with difficulties in relationships with others; learn to start recognizing their own needs; express those needs or feelings to others.
2. Working within a group of youthGroup therapy is a well-known and effective way of helping patients with eating disorders. The focus of our groups varies. Some are about:
The unifying milieu principle is to strengthen the adolescent’s
self-reflection, self-appraisal, and self-responsibility
3. Family therapy
Since most of our patients live at home, eating disorders have a major impact on the entire family. There may be particular stresses at home, such as conflict at meal times. Family members may blame themselves or other family members. Family therapy improves communications within the family. Together, families will find solutions to best help the recovery of their family member.
4. Medications
No specific medications exist for the treatment of restrictive anorexia nervosa. Medications such as anti-depressants have been shown to be helpful for patients who binge-eat and purge.
If your child has another condition in addition to the eating disorder, this will be treated with the appropriate medication.
Bowel function is often affected and slowed. Your child may be given a medicine that helps motility and reduces bloating. If your child has a problem with constipation, we may provide a stool softener or bulk-former.
5. Nutritional rehabilitation — meal support
The best psycho-therapies cannot be effective as long as the body is neglected. The effects of starvation affect your child’s physical and emotional well being. Repeated binging and purging have similar effects.
These need to improve in order for recovery to begin. With the help of our dieticians and trained staff, your child will be gradually introduced to normal eating patterns and healthy nutrition. Weight gain, if necessary, is done in a careful and gradual way.|Meal support treatment is an important aspect of our Program.
.........What is meal support?Meal support therapy is one of the most critical components of the nutritional rehabilitation process in eating disorders. Effective meal support is not just sitting down and watching someone eat. It’s an active process that needs to be planned, then carried out with compassion and care. It is eating with the patient, supporting them throughout their meal, and then being there with them after the meal to provide gentle support and distraction at this critical time post-meal.
.........What is meal support?Meal support therapy is one of the most critical components of the nutritional rehabilitation process in eating disorders.
Effective meal support is not just sitting down and watching someone eat. It’s an active process that needs to be planned, then carried out with compassion and care.
It is eating with the patient, supporting them throughout their meal, and then being there with them after the meal to provide gentle support and distraction at this critical time post-meal.
.........
Trained staff support and encourage your child during meals and snacks. This mode of treatment is effective in avoiding more intrusive means of weight gain.
We will help you learn to provide meal support at home through our parent support groups. We also have a DVD on how to provide effective meal support. It can be purchased from the hospital bookstore, here.
Eating Disorders Program - inpatient unit FAQ Questions & Answers - by patients:
Can I recover from an eating disorder?Yes, you can recover from an eating disorder. You just have to be willing to try hard and be accepting to change. What do you do all day?We attend school every day and there are a number of different group therapy sessions, fitness class and outings. We are kept pretty busy. If I don’t like something do I have to eat it?You’re allowed to have one food dislike. There is more than one choice for each meal and big list of different snacks to choose from. Is it like a mental hospital?I think that this program is really a good balance for what it is…because an eating disorder is mainly to do with mental health. I think that they make the atmosphere very normal and comfortable. Can I continue my hobbies, like playing the guitar?Yes, you can continue your hobbies as you can bring any of your personal belongings and things you like to do to occupy yourself in the free time given. Is it co-ed?Yes, it is co-ed but the majority of patients are girls and everyone has their own room. Where would my family stay?Your family would stay at home and you could visit them on your passes and they can visit during the evenings and weekends. Will my family learn to understand what an eating disorder is?There is family therapy and parent group most Thursday nights which helps your family to understand you and what an eating disorder is about. Can you come and go…..can you go out to a movie or shopping with friends while you are an inpatient?Yes, as you move up to higher levels and you get more privileges you will start to do more things outside the program like going out with friends, so you can practice before you go home.
Can I recover from an eating disorder?Yes, you can recover from an eating disorder. You just have to be willing to try hard and be accepting to change.
What do you do all day?We attend school every day and there are a number of different group therapy sessions, fitness class and outings. We are kept pretty busy.
If I don’t like something do I have to eat it?You’re allowed to have one food dislike. There is more than one choice for each meal and big list of different snacks to choose from.
Is it like a mental hospital?I think that this program is really a good balance for what it is…because an eating disorder is mainly to do with mental health. I think that they make the atmosphere very normal and comfortable.
Can I continue my hobbies, like playing the guitar?Yes, you can continue your hobbies as you can bring any of your personal belongings and things you like to do to occupy yourself in the free time given.
Is it co-ed?Yes, it is co-ed but the majority of patients are girls and everyone has their own room.
Where would my family stay?Your family would stay at home and you could visit them on your passes and they can visit during the evenings and weekends.
Will my family learn to understand what an eating disorder is?There is family therapy and parent group most Thursday nights which helps your family to understand you and what an eating disorder is about.
Can you come and go…..can you go out to a movie or shopping with friends while you are an inpatient?Yes, as you move up to higher levels and you get more privileges you will start to do more things outside the program like going out with friends, so you can practice before you go home.
Cooking Group Provides participants with an opportunity to develop and practice skills for daily living. Meets weekly to plan, shop for, cook, and then eat a balanced meal while being supported by group leaders and peers. Explores personal attitudes, beliefs, behaviors, and anxiety associated with abnormal food relationships. Restaurant Group Allows participants to re-establish and normalize the relationship between food, socialization, and leisure. Meets every four weeks. Participants are encouraged to help select the venue. Participants challenge their fears of eating in public and increase their confidence in choosing and completing a healthy-portioned size of a meal which may not be considered a “safe choice.” Nutrition Group Meets weekly and is composed of two parts: Part 1 is used to select food choices for weekly menu planning and the Cooking Group, along with discussion of venue options for the Restaurant Group. An open forum is encouraged for participants and staff to discuss and solve food-related issues occurring around meals and snacks. Part 2 is devoted to nutrition education and covers a number of topics including effects of starvation, nutritional requirements for adolescents, bone health, and iron requirements. Media Group Encompasses a variety of media forms such as videos, magazines, music, newspapers, and photography, to provide participants with tools to analyze and develop critical thinking skills. Is interactive - encourages participants to share observations and feelings about the impact media has on culture, society, and individual perceptions. Participants learn to identify and question the persuasive methods used by the media. Art Therapy Group Is a form of psychotherapy that uses various visual art forms such as drawing, painting, sculpture, and collage. Allows participants to express themselves and address common issues by drawing on their own creative resources. The central belief of this group lies in the idea that all individuals are creative. It is through this creative process that individuals can enhance well-being, gain insight and self awareness, and express needs, feelings, choices, and goals. Individual art therapy is also offered. Community Meeting Occurs weekly or more often as required. Staff members and patients discuss any physical or emotional safety concerns in the Eating Disorders Program community. Also a time to discuss and problem-solve any issues there may be with group dynamics so that the climate of the unit can be friendly and positive. Dialectical Behaviour Therapy (DBT) Group Is a psycho-educational group in which participants learn concrete skills to deal with negative emotions, change unhealthy behaviours, and improve interpersonal effectiveness. The core concept in this 12-week course is ‘mindfulness,’ which is being aware and conscious of our thoughts, feelings, and experiences rather than being impulsive or reactive. Following each weekly session, participants are expected to put into action the new skills presented in that session by using the practice exercises provided. The following week participants’ experiences are reviewed and discussed within this supportive group. Open Talk Is bi-weekly group activity, which encourages participants to share their thoughts, feelings, and experiences to gain insight into how they relate to others. Encourages participants to practice empathetic skills by listening to others and providing feedback and support to their peers, as well as becoming more comfortable and confident in expressing themselves verbally. Our psychiatrist facilitates this group. Psycho-education Group Encourages participants to become educated as mental health services consumers. Uses an interactive approach in which participants learn about causes and treatment of eating disorders, current medications, personal values; they gain an understanding of psychological concepts and terminology. Is facilitated by various members of our team an duses a variety of multimedia materials, including videos, slides, and overheads. Recreation therapy and outings Facilitates the development of a more meaningful and healthy leisure lifestyle through both leisure education and community integration. Benefits include assisting participants to explore positive leisure alternatives and coping strategies to replace unhealthy and unwanted activities and patterns associated with eating disorder behaviour. Our recreation therapist plans a variety of activities in the community, ranging from trips to the aquarium to indoor rock climbing. An opportunity to engage in the Arts, Crafts & Leisure Group to express creativity, develop skills, and have fun. Fitness for Life group Many individuals with eating disorders have issues with over-exercising or exercise abuse. Part of our treatment philosophy is to help these patients, as well as those who do not exercise, with a graduated, supervised approach to exercise. We have a Fitness for Life group as part of our Intensive Treatment Service. Our goals with this group are several and include helping participants to deal with their over-exercise issues through becoming reconnected with their bodies. Patients are usually able to participate shortly following admission, once they are medically stable and are actively working on getting better. Activities initially may include gentle cardiovascular activities, some sports, yoga, flexibility and core exercises, and introductory weight training. For patients who have made demonstrable progress in treatment, including with their exercise abuse issues, we offer more challenging weight training, cardiovascular, and flexibility activities. As patients near discharge, we are able to assist them with developing an exercise program that they can continue to follow. Our work on treating exercise abuse has been presented at international conferences.
Cooking Group
Restaurant Group
Nutrition Group
Media Group
Art Therapy Group
Community Meeting
Dialectical Behaviour Therapy (DBT) Group
Open Talk
Psycho-education Group
Recreation therapy and outings
Fitness for Life group
Patients who are admitted into the intensive treatment program at BC Children's Hospital have the opportunity to continue their school studies in the program's schoolroom. The school program has two full-time certified Vancouver School Board teachers who work closely with students, parents, and schools to coordinate individualized academic plans throughout the patients' hospital admission.
While the Program's philosophy is primarily related to patient health and wellness, the school program is offered as a way for students to continue to work towards their academic goals.
Eating Disorders Program - School FAQ
How long is the school day? The length and timing of the school day is determined by the Clinical Director, and this can vary throughout the year. What resources does the school have? There are two teachers; computers, Internet access, some basic science equipment, and a range of grades 5–12 textbooks. There is also a video and DVD player, and television for watching educational materials. What happens when a student is admitted? Students in the school may study coursework through correspondence from the BC Ministry of Education’s South Island Distance Education (SIDES). Alternatively, work can be sent in from a student’s home school. If the home school is going to provide work, then our teachers will arrange to collect and return work with the help of the parents. What will happen during the student’s time in the Vancouver School Board (VSB) classroom? The teachers contact the home school counsellor to help make the transition as smooth as possible. We continue to liaise with the counsellor during the admission, and will plan with them the return to school after discharge. As part of this process, the VSB teachers talk to the student about any issues that may have arisen at school that may be contributing to feelings of stress. What about exams? Students studying by distance education or who are receiving work from their home school may take exams in the VSB classroom.What happens in the summer?There is no school program over the summer. For more details about what happens during the summer months, please contact the Program Coordinator, Kit Standish at 604-875-2173.The teachers are happy to talk to you about general academic progress or any other matter you wish to discuss.
How long is the school day?
The length and timing of the school day is determined by the Clinical Director, and this can vary throughout the year.
What resources does the school have?
There are two teachers; computers, Internet access, some basic science equipment, and a range of grades 5–12 textbooks. There is also a video and DVD player, and television for watching educational materials.
What happens when a student is admitted?
Students in the school may study coursework through correspondence from the BC Ministry of Education’s South Island Distance Education (SIDES). Alternatively, work can be sent in from a student’s home school. If the home school is going to provide work, then our teachers will arrange to collect and return work with the help of the parents.
What will happen during the student’s time in the Vancouver School Board (VSB) classroom?
The teachers contact the home school counsellor to help make the transition as smooth as possible. We continue to liaise with the counsellor during the admission, and will plan with them the return to school after discharge.
As part of this process, the VSB teachers talk to the student about any issues that may have arisen at school that may be contributing to feelings of stress.
What about exams?
Students studying by distance education or who are receiving work from their home school may take exams in the VSB classroom.What happens in the summer?There is no school program over the summer. For more details about what happens during the summer months, please contact the Program Coordinator, Kit Standish at 604-875-2173.The teachers are happy to talk to you about general academic progress or any other matter you wish to discuss.
The Kelty Resource Centre works to link children, youth and their families with appropriate resources in all areas of mental health and addictions.