Specialist Treatment for Eating Disorders at The London Centre

Intensive Outpatient Treatment (IOT)

Traditionally outpatient treatment involves a single clinician offering a single therapy session per week.  Occasionally therapy might be offered twice per week, or another clinician such as a dietitian may become involved in order to offer further support, but generally in order for outpatient therapy to be successful, a huge amount of work must be done by a client between sessions.  This means that clients suitable for outpatient therapy have to be motivated to recover, need to have the skills required in order to be able to make changes, and have to be able to cope with a fair amount of anxiety or distress in isolation.   As a team we recognise there is a huge gap between this form of outpatient support, and the next step up to day patient treatment, which may involve up to 5 full days of treatment per week.  There are many reasons why people may be reluctant to engage in day patient treatment, including regular work or family commitments, anxiety about or reluctance to engage in group therapies or anxiety about the impact of being around others with eating disorders.  Whilst we know that day treatments can be extremely helpful, and at times essential, there can be very valid reasons why a person may prefer not to opt for this level of treatment.  That said, for people who are really struggling with change, a single therapy session per week may also not be sufficient to help people make the changes they need to.  For this reason we have started to offer a more intensive form of outpatient treatment - an intensive outpatient treatment program, which aims to offer multiple sessions per week including psychological support, dietetic support and occupational therapy support.  This can include some supported meal or snack times as well as therapeutic input.

The IOT package will be determined in collaboration with an individual client at the point of assessment.  The options for treatment can include any or all of the following treatment components:

• Individual Psychology or Psychotherapy Sessions

• Individual Dietetic Sessions

• Individual Occupational Therapy Support

• Supported meals or snacks (a maximum of 2 per week)

• Family Education or Support Sessions.

• Family Therapy

All clients on an intensive outpatient program will also have medical and psychiatric oversight by a consultant psychiatrist specialising in eating disorders.  As a therapy team we do not have consultant psychiatrists within the team but work very closely with a number of external highly specialist Consultants.

The IOT is generally recommended for people for whom a single therapy session is unlikely to be sufficient to support meaningful change.  This may be because of the severity of their illness, the length of time that they have been unwell, or how stuck they feel they are.  It is likely that those individuals who may require an intensive form of treatment may be more physically or medically unwell than others, therefore it is a requirement that any individual being supported with multiple sessions per week is under a specialist eating disorder Consultant Psychiatrist prior to starting this form of treatment.  Initially an individual interested in intensive outpatient support will have an initial assessment to determine suitability.  From there, an individualised treatment program will be developed and agreed on, depending on what support is likely to be needed to promote change.  This is not a package of care, it is an individual tailored treatment plan and as such the specific details of the program (which clinicians are involved and how often a client will meet with each clinician) will be tailored to each individual.