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Partial Hospitalization

Please note: Eating disorders develop in men, women, girls, and boys. For ease in reading, we have used "she" and "her" in the text below.

Partial hospitalization, also called day treatment, is suitable for patients who do not require 24 hour care but are not ready for outpatient programs. Individuals entering this level of care may be quite absorbed in negative thoughts about calories or weight and need structure in their day in order to refrain from unhealthy behaviors. Partial hospitalization programs, which are often part of an inpatient or residential facility, consist of up to 8 hours of structured activities, including support and encouragement during meals and snacks. Individuals commute to treatment from home or perhaps from transitional housing units affiliated with a residential center. In recommending partial hospitalization, the physician considers how many days a week the patient needs to attend in order to derive optimal benefit.


For an individual to make good use of partial hospitalization, she needs to be able to participate in groups, which constitute a major part of the program. Led by mental health professionals, these group discussions focus on topics such as women’s/men’s issues, adjusting to change, relaxation methods, family or peer relationships, expressing feelings, managing free time, and body appreciation. Arts-based therapies and instruction in meal planning, cooking and grocery shopping may also be available. Participation in some groups is shared with individuals on the inpatient unit.


Patients who attend day treatment also have appointments with various members of their treatment team, which is likely to include an individual and/or family therapist, a primary care physician, and a nutrition counselor. Collaboration among treatment providers is essential. Time spent at the partial hospitalization level ranges from a week to a few months. Having made progress in day treatment, an individual is generally well enough for intensive outpatient or outpatient care.



References
Day hospital programmes for eating disorders: a review of the similarities, differences and goals
Abbate-Daga, G., Gramaglia, C., Preda, S., Comba, E., Brustolin, A., Fassino, S. Day hospital programmes for eating disorders: a review of the similarities, differences and goals. Eating and Weight Disorders. 2009; 14: e 31-41.

Practice guideline for the treatment of patients with eating disorders
American Psychiatric Association (APA). Practice guideline for the treatment of patients with eating disorders. 3rd ed. Washington (DC): American Psychiatric Association ; 2006 Jun. 128 p. [765 references].

Refining treatments for eating disorders
Crow, S., Peterson, C.B. Refining treatments for eating disorders. American Journal of Psychiatry. 2009; 166: 266-7.

Prevalence and correlates of exercise motivated by negative affect
De Young, K.P., Anderson, D.A. Prevalence and correlates of exercise motivated by negative affect. International Journal of Eating Disorders. 2010; 43: 50-8.

Effectiveness of day hospital treatment for anorexia nervosa and bulimia nervosa
Fittig, E., Jacobi, C., Backmund, H., Gerlinghoff, M., Wittchen, H.U. Effectiveness of day hospital treatment for anorexia nervosa and bulimia nervosa. European Eating Disorders Review. 2008; 16: 341-51.

Arts-based therapies in the treatment of eating disorders
Frisch, M.J., Franko, D.L., Herzog, D.B. Arts-based therapies in the treatment of eating disorders. Eating Disorders. 2006; 14: 131-42.

The effectiveness of a day program for the treatment of adolescent anorexia nervosa
Goldstein, M., Peters, L., Baillie, A., McVeagh, P., Minshall, G., Fitzjames, D. The effectiveness of a day program for the treatment of adolescent anorexia nervosa. International Journal of Eating Disorders. 2010. (In press).

Salient components of a comprehensive service for eating disorders
Halmi, K.A. Salient components of a comprehensive service for eating disorders. World Psychiatry. 2009; 8: 150-5.

Overview of treatment modalities in adolescent anorexia nervosa
Herpertz-Dahlmann, B., Salbach-Andrae, H. Overview of treatment modalities in adolescent anorexia nervosa. Child and Adolescent Psychiatric Clinics of North America. 2009; 18: 131-45.

How important are motivation and initial Body Mass Index for outcome in day therapy services for eating disorders?
Jones, A., Bamford, B., Ford, H., Schreiber-Kounine, C. How important are motivation and initial Body Mass Index for outcome in day therapy services for eating disorders? European Eating Disorders Review. 2007; 15: 283-9.

The slippery slope: prediction of successful weight maintenance in anorexia nervosa
Kaplan, A.S., Walsh, B.T., Olmsted, M., Attia, E., Carter, J.C., Devlin, M.J., Pike, K.M., Woodside, B., Rockert, W., Roberto, C.A., Parides, M. The slippery slope: prediction of successful weight maintenance in anorexia nervosa. Psychological Medicine. 2009; 39: 1037-45.

A Dutch day treatment program for anorexia and bulimia nervosa in comparison with internationally described programs
Lammers, M.W., Exterkate, C.C., De Jong, C.A. A Dutch day treatment program for anorexia and bulimia nervosa in comparison with internationally described programs. European Eating Disorders Review. 2007; 15: 98-111.

Bulimic symptoms in undergraduate men and women: Contributions of mindfulness and thought suppression
Lavender, J.M., Jardin, B.F., Anderson, D.A. Bulimic symptoms in undergraduate men and women: Contributions of mindfulness and thought suppression. Eating Behaviors. 2009; 10: 228-31.

Effectiveness of self-esteem and social skills group therapy in adolescent eating disorder patients attending a day hospital treatment programme
Lázaro, L., Font, E., Moreno, E., Calvo, R., Vila, M., Andrés-Perpiñá, S., Canalda, G., Martínez, E., Castro-Fornieles, J. Effectiveness of self-esteem and social skills group therapy in adolescent eating disorder patients attending a day hospital treatment programme. European Eating Disorders Review. 2010. (In press).

Excessive exercise in eating disorder patients and in healthy women
Mond, J.M., Calogero, R.M., Anderson, D.A. Excessive exercise in eating disorder patients and in healthy women. Australian and New Zealand Journal of Psychiatry. 2009; 43: 227-34.

Cognitive behavioral approaches in adolescent anorexia and bulimia nervosa
Schmidt, U. Cognitive behavioral approaches in adolescent anorexia and bulimia nervosa. Child and Adolescent Psychiatric Clinics of North America. 2009; 18: 147-58.

The road less traveled: Associations between externalizing behaviors and eating pathology
Slane, J.D., Burt, S.A., Klump, K.L. The road less traveled: Associations between externalizing behaviors and eating pathology. International Journal of Eating Disorders. 2010; 43: 149-60.

Treatment of anorexia nervosa in a specialty care continuum
Treat, T.A., McCabe, E.B., Gaskill, J.A., Marcus, M.D. Treatment of anorexia nervosa in a specialty care continuum. International Journal of Eating Disorders America. 2008; 41: 564-72.

An evaluation of the effectiveness and short-term stability of an innovative Australian day patient programme for eating disorders
Willinge, A.C., Touyz, S.W., Thornton, C. An evaluation of the effectiveness and short-term stability of an innovative Australian day patient programme for eating disorders. European Eating Disorders Review. 2010; 18: 220-33.

Inpatient versus day clinic treatment for bulimia nervosa: a randomized trial
Zeeck, A., Weber, S., Sandholz, A., Wetzler-Burmeister, E., Wirsching, M., Hartmann A. Inpatient versus day clinic treatment for bulimia nervosa: a randomized trial. Psychotherapy and Psychosomatics. 2009; 78: 152-60.



Photo Credits:
"TS 46" by Topeka and Shawnee County Public Library , Flickr.com Creative Commons
"TS 42" by Topeka and Shawnee County Public Library , Flickr.com Creative Commons


This page was last updated on November 23, 2010.