Eating Disorder Referral - Montecatini Eating Disorder Treatment Program

Five years prior to starting Montecatini, Dr. Liaghat and I had been working together at an inpatient hospital-based treatment center for women with eating disorders. By in large these were exciting times. Having recently completed our Ph.Ds in clinical psychology, we were filled with idealism and ready to make a difference in people's lives. My doctorate dissertation topic focused on eating disorders; hence I had the opportunity to work in an inpatient hospital specializing in eating disorders.

It became immediately clear that this was going to be very challenging work. Upon admission, our patients were so physically sick and their psychosocial profiles were so complicated that it was initially inconceivable that we could cure these women. However, after months of therapy and working hard to get enough calories into our patients to get there body weights back up to normal, we would proudly discharge them. We would see these patients regularly during routine follow-up visits. Slowly, however, a painful realization became glaringly evident. By 1-year post-discharge, 7 out of 10 patients had relapsed!

Discouraged, we began to think critically about why so many of our patients were relapsing. After a few years, we felt we had discovered the problem. In that treatment program, the patients were given their meals, given their medications, given their therapy; however, they were never given a choice. They were never given an opportunity to take an active role and assume responsibility for their own recovery. They remained passive throughout the treatment process and once their bodies started to look normal again, they were discharged from the sterile hospital ward where we held their hands, and they were put back into their lives completely on their own. Who could blame them for failing treatment?

We eventually came to the conclusion that the ideal treatment program would include the following components:

	A small patient population- to avoid collusion among residents and to provide an opportunity to know each resident thoroughly.
	Individualized treatment plan- no two patients are the same, hence cookie-cutter therapy does not work.
	A clear treatment plan and path to discharge from the day of admission- so each resident is aware of what they need to do to hasten their own recovery.
	Maximal individual responsibility- so residents can learn and practice the skills necessary to maintain long-term recovery.
	An intense Family Treatment program- there is no sense in treating a patient and discharging them into an untreated environment.
	Residents living in a home environment- where a structured setting can be established, while allowing the individual to do the types of activities they need to do following discharge, such as shopping, cooking, cleaning, and working through daily conflicts and problems.
	A transition program- - where an increasing level of independence is given while the individual is still connected to therapy.

From these ideals, Montecatini was established in 1991, as the first residential inpatient treatment program for women. Our Mission has remained the same: to provide the highest level of care possible and to send the resident back into the real world as a productive, self-reliant, and functioning adult or adolescent. From its inception, we have successfully and proudly helped hundreds of women free themselves from the entrapment of their eating disorders and addictions.