Why Therapy May Actually Not Be Working

If you haven’t yet, I would encourage you to read my post from last week, Is Therapy Even Working? This post will build upon that post and explore reasons that therapy may actually not be working.

I would suggest that there are 3 main reasons why your therapy may actually not be working. It is necessary for you to ask yourself the following questions:

• Are you doing the work? You may find that your answer is no. Unfortunately, a therapist can only do so much, and the real change must lie within you. Are you holding yourself accountable for your own recovery?
• Are you working with an Eating Disorder treatment specialist? I will include a link below to a post that will talk about the importance of seeking treatment from an Eating Disorder specialist. If your therapist does not specialize in that treatment, you may not be getting the treatment you need.

• Are you at the right level of care? There are different levels of care for Eating Disorders. The level that you need will depend on how severe your Eating Disorder is. I will include a guide to help you to determine what level of care may be right for you. However I would recommend you speak with your therapist or have a consultation with an Eating Disorder specialist to help you to determine what level would be most beneficial for you. This usually will take having a few sessions with the specialist to be able to assess you in order help to figure out what level is best.

Below is a crash guide of the different levels of care. It’s important to note that the proper process is to step-down through the levels of care when you are placed at a higher level. This is designed to help you acclimate to living on your own again with, hopefully, solely under the care of an outpatient therapist (that’s me!)

• Hospitalization: Of course, this is the place that you would go if you have imminent health risks. If you have been restricting your food intake, a hospitalization setting is where re-feeding will occur.
  
• Residential: This is the next level of care and where you would be if you are more medically stable, however you need 24/7 care with supervision to essentially make sure that you’re doing what you need to be doing to recover and to continue being medically stable.
  
• Partial Hospitalization Program (PHP): If you are medically stable, and may not necessarily need 24/7 supervision, this is the place for you. If you are still struggling and aren’t able to completely be on your own just yet (which no one would expect you to after residential), a PHP program can help you get used to having more freedom at home while still having intensive therapy, nutrition and meal supervision. No program looks exactly the same, but most typically you’ll find that a PHP program is an all-day program where you eat 2-3 of your daily meals under their supervision, while having individual and group therapy and nutrition sessions. The programs usually range from 5-7 days a week.
  
• Intensive Outpatient Program (IOP): This is slightly less intense than PHP and usually is when you are able to eat on your own more-so without needing extra support most of the time. Again, these programs vary, but often you will eat 1 meal a day along with group therapy and nutrition. The programs range usually from about 3-5 days a week.
  
• Outpatient: That’s me! I may be your first step and your last step. I can help you to determine whether you need a higher level or care. Outpatient is when you are able to maintain recovery for the most part on your own without the need for much meal supervision. You will see your therapist at least once every week. This level of care is more indefinite.
  

​​Once you have an outpatient therapist, they will work closely with the programs that you are in to help the transitions go smoothly. Anytime my clients have to go into a higher level of care, I collaborate closely with the treatment center they are in and make sure that my clients know that I am involved with the process and that they are not alone. I want them to be assured that their transition back to me will be as smooth as possible, as though I was seeing them all along!

I hope you find this post useful. Please share with anyone else who could find it helpful. If you have any questions, concerns or requests for future posts, please leave a comment or message me privately.
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I wish you a smooth journey on your way to finding your State of Balance!

Related posts you may find helpful:
Is Therapy Even Working?
What to Do When I Feel My Therapist Isn’t Helping Me?
Therapy: Debunking Expectations