Eating Disorder Treatment Programming:
Our Outpatient Eating Disorder Program (EDP) provides evidence-based support to guide individuals toward recovery. We have two treatment streams, one for adults 18+, and another for adolescents. All clinicians working within our EDP are extensively trained in the treatment of disordered eating through specialized continuing education and hospital training.
OUTPATIENT EDP FOR ADOLESCENTS:
This Outpatient Adolescent EDP is comprised of evidence-based treatments that work collectively to facilitate recovery for teens and young adults. This stream incorporates elements specifically for parents and caregivers in order to foster a home environment conducive to recovery. The program is tailored to the needs of the individual and treats the following Eating Disorders: Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder, Avoidant/Restrictive Food Intake Disorder (ARFID), Other Specified Feeding and Eating Disorder (OSFED), Orthorexia, and disordered eating.
EDP Treatment Components:
Comprehensive Intake Assessment
Treatment begins with a comprehensive multidisciplinary assessment with the following professionals extensively trained in Eating Disorder assessment and treatment:
- Pediatrician or Adolescent Medicine Physician (90 minutes)
- Psychology team member (60 minutes)
- Registered Dietitian (75 minutes)
This assessment allows us to collaboratively determine the severity of the youth’s symptoms, establish an accurate diagnosis, and create a personalized treatment plan. As part of the intake assessment, the adolescent will complete baseline measures to help track progress throughout treatment. Following the assessment, the youth and family will be referred to participate in the following treatments where appropriate:
Individualized Eating Disorder treatment meets the client at their current motivational stage and guides them toward achieving their therapeutic goals. It helps individuals understand the function of their disordered eating, reduces problematic eating behaviours such as restriction, bingeing, or purging, and guides them toward developing more adaptive coping strategies. An integral part of individual therapy for Eating Disorders includes the cessation of problematic behaviours, the management of body image concerns, and the development of increased body and self-acceptance. Treatment for traumatic stress, mood challenges or other comorbid concerns is easily integrated into individual therapy to best support client needs.
Dietetic support helps clients understand the impact of Eating Disorders on a physical level and supports them in gradually improving their relationship with food and their bodies. Fully customized to the individual’s needs, this service incorporates monitoring of eating, personalized meal plans for each stage of recovery, and exposure work for managing food rules and restrictions. Clients in the EDP are expected to participate in regular dietetic support, and the frequency of this is determined together with your treatment team, as there is no one-size-fits-all approach.
Caregiver Support Series
Caregivers are required to participate in our two-part workshop series in order to best support recovery within the home environment. These workshops address the primary concerns within the home domain that tend to most impact treatment.
Supporting a Loved One with an Eating Disorder: This workshop introduces emotion-focused family therapy strategies for meal support and symptom mitigation. It helps caregivers more confidently navigate meal times, manage difficult emotions, and reinforce recovery between treatment sessions.
Navigating Recovery Through Food and Nutrition: This workshop targets many of the nutritional roadblocks that often impede recovery, including how to speak appropriately about food within the home, challenging myths and unhelpful beliefs about what we eat, and modelling healthy eating as parents and caregivers.
Medical Monitoring via TPWG+MD
(If found to be medically necessary at intake assessment)
TPWG is the first and only private clinic in Ontario to offer OHIP-covered medical monitoring with a physician as part of a comprehensive Eating Disorder Program. This was born from a need to have consistent monitoring by a physician specifically trained in the assessment and management of Eating Disorders. With fewer individuals having a family doctor to turn to for regular monitoring, this service provides consistent care and access with minimal waits and limited barriers. Where desired, our physicians or nurse practitioner can provide regular monitoring, medical support, and medication management. Currently, this service is available to clients under 18 years of age and requires a physician referral and a valid OHIP card for access. Those over 18 are able to receive medical monitoring through our Nurse Practitioner within our Adult Eating Disorder Program.
Medication Consultations via TPWG+MD
TPWG offers in-house consultations with our Adolescent Medicine Physician or our Nurse Practitioner. These professionals are able to assess and make recommendations to optimize medications and can offer follow-up care until stabilization is achieved.
Recovery Review Reports
Clients in our EDP will receive personalized Recovery Reports every three months. These reports provide a summary of the client’s progress from all clinicians involved in their care and include objective assessment results so they can track their improvement across a variety of domains. These reports allow us to reinforce hard work, celebrate successes, and identify areas for continued growth.
Those caring for disordered eating are able to participate in their own individual sessions throughout the course of their loved one’s treatment wherever needed.
Clinicians working within our eating disorder program are extensively trained in the treatment of disordered eating through specialized continuing education and hospital training.
Adjunct Group Treatments
(offered where needed):
Our Outpatient Adolescent and Adult Eating Disorder Programming both offer specialized groups that may be added to a client’s care when needed in order to augment treatment and facilitate recovery. These include Dialectical Behaviour Therapy Skills Group, Radically Open DBT therapy, and Body Image Group. Read more about our groups here.
OUTPATIENT EDP FOR ADULTS:
This program consists of evidence-based treatment components that work collectively to facilitate recovery in adults. This stream involves flexible programming that can be tailored to the unique needs and motivational stage of participants. Treatment components include:
Individualized Eating Disorder treatment meets the client at their current motivational stage and guides them toward meeting their therapeutic goals. It helps clients understand the function of their disordered eating, reduces problematic eating behaviours such as restriction, bingeing or purging, and guides clients toward developing more adaptive coping strategies. An integral part of individual therapy for Eating Disorders includes the management of body image concerns and guidance toward increased body and self-acceptance. Treatment for traumatic stress, mood or other comorbid concerns is easily integrated into individual therapy to best support client needs.
Dietetic support for those struggling with disordered eating helps clients understand their symptoms on a physical level and supports them in gradually improving their relationship with food and their bodies. Fully customized to an individual’s needs, this service incorporates monitoring of eating, personalized meal plans for each stage of recovery, and exposure work for managing food rules and restrictions. Clients in the EDP are expected to attend regular dietetic sessions, and the frequency of this is determined collaboratively with the treatment team, as there is no one-size-fits-all approach.
Medical Monitoring via TPWG+MD
TPWG offers in-house medical monitoring with our Nurse Practitioner (NP) for adult EDP clients. This was born from a need to have consistent monitoring by a healthcare professional specifically trained in the assessment and management of Eating Disorders in order to provide consistent care with minimal waits and barriers. Where desired, our NP can provide regular monitoring, medical support, and medication management.
Medication Consultations via TPWG+MD
Our NP is able to assess and make recommendations to optimize medications and can offer follow-up care as needed.
Adjunct Group Treatments
(offered where needed):
Our Outpatient Adolescent and Adult EDPs offer specialized groups that may be added to a client’s care when needed in order to augment treatment and facilitate recovery.
DBT Skills Group
Dialectical Behavior Therapy (DBT) is an evidence-based treatment for disordered eating. Our DBT Skills Group helps individuals better regulate their emotions and develop adaptive strategies for challenging problematic behaviours like restriction, bingeing, and purging. This group also addresses the underlying emotion dysregulation at the core of Eating Disorders and guides clients in better understanding and managing their emotional constellation of symptoms. Our DBT groups are specifically adapted to support individuals with eating-related concerns.
Radically Open DBT Skills Group
Designed for individuals struggling with over-regulation of their emotions, perfectionism, and rigidity, participants will learn specific strategies to improve cognitive flexibility, openness, and social connectivity in their lives in order to achieve greater balance.
Motivational Enhancement Therapy for Eating Disorders
This six-session group will provide clients with an opportunity to gain a better understanding of their eating disorder, identify tensions or inconsistencies between the way life is going now and how they wish for it to be, and then make informed choices about how they wish to proceed with their recovery. Based on the principles of Motivational Interviewing, this group is designed to produce quick and meaningful internally motivated change.
This six-session group will explore thoughts and behaviours that may keep the client locked into body distress. It will provide practical strategies and a framework for moving away from harsh self-criticism and toward body acceptance and compassion. The content of this group includes principles and techniques from Cognitive Behavioural Therapy (CBT), Self-Compassion, and Acceptance and Commitment Therapy (ACT).
EDP Frequently Asked Questions
Who is the Adolescent EDP intended and designed to support?
The treatment within our EDP is customized to the client’s needs. It’s intended for the following presentations: Those new to Eating Disorder treatment; those who have received some form of treatment in the past; those who have been recently discharged from more intensive treatment (inpatient/day program); OR who are on a waitlist for OHIP-covered eating disorder treatment and require symptom interruption or preventative work.
How long does the program take?
The program length is completely dependent on the severity of symptoms, the client’s willingness to participate in treatment, and parent/caregiver’s ability to implement recommendations within the home. Treatment typically takes between 6 months to 1 year, though more severe presentations may take longer.
How do you measure success in this program?
Success in our adolescent ED program is measured using our Recovery Review every 3 months, which incorporates a physician and therapist assessment and evidence-based assessment measures that look at specific domains of psychological and behavioural functioning.
I don’t think we need to see a dietitian, can we just skip that?
A dietetic assessment and treatment is a requirement for anyone in the EDP. This allows your treatment team to properly assess your intake, daily needs, healthy weight range, and establish proper goals for refeeding or balancing your intake. We cannot adequately treat an Eating Disorder without this. Ongoing dietetic support is generally necessary for successful long term outcomes. Those with consistent dietetic support typically recover more quickly.
I don’t think I need a Comprehensive Intake Assessment, can we just skip that?
Comprehensive intake assessments allow us to gather all the medical, psychological, and dietetic information relevant to establish the right treatment plan for each client. This is part of what makes TPWG’s EDP unique, as we do not believe in a one-size-fits-all approach. That being said, if clients have been given recent diagnoses, have a physician already managing their care, are currently involved in dietetic treatment, or have recently been discharged from a hospital program, we can adapt this intake process to meet individual needs where warranted.
Why are parents required to attend the caregiver workshops?
Parental involvement is significantly related to therapy outcomes. Parents must create an environment within the home that is conducive to recovery and not reinforcing the ED. With the right skills, parents can expedite treatment and reduce their child’s distress during recovery. We deeply believe in parents’ ability to help their teens heal, and we want to ensure you are armed with the right tools to facilitate this.
What other supports are available for my teen?
Additional group supports are available at the clinic, including DBT Skills Group and RO-DBT Skills Group, both of which are evidence-based for the treatment of Eating Disorders. Other groups at TPWG occur regularly and are shared on our website and social media. Snack and/or meal support is also available with our dietitians and can be helpful for working parents who may not be able to monitor meals.
Medical support is also available at the clinic. While teens will meet with a physician where applicable as part of our comprehensive intake assessment, ongoing medical monitoring is also available. Consultations with our Adolescent Medicine physician and NP are both available, as well. These professionals are able to address concerns pertaining to psychiatric medication and provide medication optimization assessments and follow-up care as needed.
How do you ensure medical stabilization?
TPWG‘s unique multidisciplinary program allows us to collaborate closely and consistently with medical providers to assess physical stability throughout treatment. Our physicians and NP are specifically trained in the assessment and management of Eating Disorders, having worked in this field for many years. They can consult with your family physician in your care or can oversee medical monitoring for you at the clinic.
How do I know if we need Family Based Treatment or a different approach?
The Comprehensive Intake Assessment allows our team to determine the appropriate course of treatment for the youth. Engagement in any particular approach is dependent on a number of factors, including past treatment, symptom severity, and your teen’s level of independence. It is important to us to create a treatment plan that aligns with your family’s unique needs. Our Recovery Review process allows us to monitor the client’s progress and make modifications where needed. This process also naturally establishes ‘check-in points’ within treatment to ensure an individual progresses as planned.