1. What levels of care does The Renfrew Center offer?
The Renfrew Center is unique among treatment centers in offering not just inpatient programs, but a full continuum of care that supports patients well beyond their residential stay. This comprehensive range of services - which is available throughout the country and includes day, intensive outpatient, outpatient and extended care programs - is tailored with each patient and her referring therapist to develop treatment plans and goals based on her unique needs.
Renfrew maintains continuity in philosophy and approach throughout the individual’s treatment, all while facilitating timely transitions from one level of care to another in order to maximize treatment and insurance benefits.
Click here to read more about our levels of care and all of our services.
2. Can you explain The Renfrew Center’s treatment philosophy and recovery process?
The Renfrew Center’s philosophy is established on the belief that eating disorders are complex illnesses with biological, genetic, psychological, social, and developmental roots. While there is no single cause for the development of an eating disorder, we believe effective treatment must target the factors that are responsible for maintaining the symptoms once they develop. We conceptualize eating disorders as largely perpetuated by emotional avoidance and relational disconnection. Our innovative Unified Treatment Model integrates an emphasis on the healing potential of empathic relational connection with evidence-based, emotion-focused treatment interventions. We help our patients achieve a sustainable recovery through targeted interventions designed to increase emotional tolerance, psychological flexibility and interpersonal effectiveness.
Recovery takes place in phases or steps. Renfrew’s continuum of care provides gradual movement from a highly structured and intensive residential treatment program to increasingly less structured levels of care. These steady transitions are important moments in the process of recovery as this “step-down” progression helps to minimize the risk for relapse.
All levels of care are built upon The Renfrew Center Unified Treatment Model for Eating Disorders®, which integrates our relational approach with an evidence-based transdiagnostic model.
- Our integrated treatment addresses the important interplay between emotion regulation (intra-personal factors) and authentic engagement in mutual relationships (interpersonal factors).
- Within an empathic relational context, patients learn to courageously approach, rather than avoid, painful, anxious and uncomfortable events.
- As emotional tolerance and psychological flexibility increase, the need for maladaptive behaviors decreases.
- Building emotional competence allows for an enhancement of self-empathy, self-efficacy and one’s capacity for interpersonal connection.
Re-establishing a pattern of healthy eating, nutrition, emotional and physical well-being is the foundation of treatment. The motivation to recover is also a critical element in the recovery process. Healing and motivation are sustained and nurtured through a patient’s involvement in the process of the Renfrew community and Renfrew’s treatment approach stresses these essential connections. As physical and nutritional health are gradually regained, treatment can begin to focus on other aspects of successful recovery such as self-esteem and broader aspects of the quality of life.
3. Does Renfrew treat ARFID patients?
Yes. The Renfrew Unified Treatment Model for Eating Disorders® is a transdiagnostic treatment approach that is designed to treat underlying causes of eating disorder symptoms, including those of patients struggling with ARFID. We treat the whole person by:
- Building emotional awareness through recognition and acceptance of thoughts, physical sensations and behaviors and urges associated with food avoidance behaviors
- Create flexibility in the way one thinks about and, thus, responds to food and fears of eating
- Incorporating feared, avoided food slowly and progressively through carefully-planned exposure activities to build emotional tolerance into the experience of eating
- Normalizing eating patterns through individualized structured nutrition planning
ARFID patients at The Renfrew Center work with a multidisciplinary team to address the medical, psychiatric, sensory, nutritional and behavioral aspects of their disorder. The goals of treatment are to increase one’s flexibility around food and eating and build tolerance to difficult emotions, sensations and situations. As tolerance and flexibility increases, so does one’s ability to live a value-driven life, free of the confines of an eating disorder. Families are provided with the education and skills to better understand and support the patient throughout her recovery and beyond.
4. When should I refer my patient for treatment?
The Renfrew Center recommends eating disorder treatment in the following circumstances:
- Weight changes of concern
- Rapid or persistent decline in food intake
- Inability to decrease eating disorder symptoms (purging, restricting, diet pills, laxative, diuretic, or emetic use, excessive or compulsive exercising, binge eating, etc.)
- Lack of progress with current level of care
- Co-occurring psychiatric disorder (Major Depression with or without suicidal features, Anxiety, OCD, PTSD, Substance Abuse, etc.)
- Decreasing ability to function in daily responsibilities
- Lack of support system; dysfunctional support system
- Ambivalent or uncooperative with treatment recommendations
- Physical symptoms such as lightheadedness, chest pain, syncope, palpitations, and GI bleeding
Medical Complications such as the following may indicate a need for intensive treatment:
- Unable to maintain adequate weight
- Acute weight decline with food refusal
- Bradycardia (typically HR < 60 bpm)
- Greater than a 20 bpm increase in HR with position changes
- QTc interval > 440
- BP 90/60 mm HG for adults and 80/50 mm HG for children
- Orthostatic changes > 20 mm HG for adults or > 10-20 mm HG for children
- Hepatic, renal, cardiovascular, or organ compromise
- Glucose < 60 mg/dl
- Potassium < 3 meq/liter
- Other electrolyte imbalance
- Type 1 diabetes (poorly controlled or involved with eating disorder symptom use)
- Osteopenia or osteoporosis
- Amenorrhea or oligomenorrhea in females
Source: American Psychiatric Association Practice Guidelines for the Treatment of Eating Disorders, third edition, 2006.
5. How do I start the process of getting my patient into treatment at Renfrew?
To start the admission process, professionals should call 1-800-RENFREW. Your call is answered by a Program Information Coordinator who needs approximately 10 minutes to gather demographic information, insurance information and some basic ED symptoms. Once this has been completed, and we have spoken directly with the referred patient to confirm that she is voluntary for treatment, it generally takes one to two business days to check insurance benefits. As soon as benefits have been verified, we can proceed with scheduling the patient for an assessment. Once a clinical recommendation is determined and she has been medically cleared for admission, an admission date can be provided.
6. How soon can my patient be assessed?
We can schedule your patient for an assessment as soon as we have spoken to her to confirm she is voluntary for treatment, ask some basic symptom questions and verify benefits. Insurance verification usually takes between one to two business days and, once verified, we can proceed with scheduling your patient for an assessment.
7. How soon can my patient be admitted?
An admission date can be provided once we have received all of the required medical clearances and lab work, and our medical practitioner has cleared the patient for admission.
8. As the referring professional, how will I know when my patient is admitted and subsequently discharged?
The Renfrew Center encourages collaboration with all referring professionals. Before admission, we will explore your treatment goals for your patient and, once she is admitted, we will discuss with you our plan of care and the patient’s progress. We are always interested in your feedback and welcome your collaboration. When the patient is returned to you for ongoing care, you will receive a discharge summary that fully briefs you on her progress, treatment success and our recommendations.