INTENSIVE OUTPATIENT PROGRAM (PAI)
The Intensive Outpatient Program (PAI for its name in Spanish) is a comprehensive treatment program for adolescents and young adults with eating disorders and other associated conditions, which includes the family in the therapeutic process. It is designed for people presenting the following conditions:
Patients continuing treatment after hospitalization.
Patients that are not facing life-threatening conditions who require an intensive and multimodal approach.
Patients with eating disorders symptoms resistant to outpatient treatments.
OBJECTIVES
- To restore healthy eating habits.
- To achieve and maintain a healthy weight.
- To recover the loss of nutrients, vitamins and minerals.
- To provide therapeutic tools for the identification and regulation of emotions.
- To restructure distorted beliefs and attitudes regarding food, weight and body image.
- To diagnose and provide treatment for other associated medical and psychiatric disorders.
- To train family members and caregivers in supportive strategies and skills.
- To prevent relapses.
ASSESSMENT AND TREATMENT PROCESS
DIAGNOSTIC ASSESSMENT
The diagnostic assessment is done by the therapeutic team and consists of four appointments of 1 hour each.
Psychiatry
The psychiatrist assesses the type of eating disorder faced by the patient, as well as any other existing illnesses or medical disorders. The type and intensity of the treatment are defined according to the severity of the symptoms. The psychiatrist also assesses the need for laboratory and other diagnostic tests.
Psychology
The psychologist identifies existing dysfunctional patterns of thought, behavior and emotional regulation in three main areas: eating, body image and interpersonal relations. The predominant symptoms are characterized in detail.
Nutrition
The registered dietitian makes a complete nutritional history emphasizing habits, quantities and quality of food consumed, and patterns of exercise and physical activity. A physical and anthropometric assessment is also made. With this information the nutritionist designs a nutritional guideline adjusted to the requirements of each patient.
Feedback with family members
During feedback sessions the information gathered is complemented, and both the diagnosis and the indicated management plan are presented. Family members are given initial indications for at-home management.
THERAPEUTIC GROUPS
Therapeutic groups are proposed as a complementary tool to individual psychotherapy. They seek to profit from the therapeutic properties of being in the presence of other people facing similar difficulties. Each group offers patients the possibility of having different experiences (“this is not just about my own issues, it’s about those of others as well”). These groups are always directed by a therapist from the program.
EDUCATION
Each group is both a therapeutic and an educational space where patients learn about diverse nutritional topics, as well as about the medical and psychological consequences of their illness. Working in groups expands the time available in individual therapy to delve into other personal aspects. Group members influence each other using their own experience to identify and solve problems.
UNIVERSALITY
Each group is both a therapeutic and an educational space where patients learn about diverse nutritional topics, as well as about the medical and psychological consequences of their illness. Working in groups expands the time available in individual therapy to delve into other personal aspects. Group members influence each other using their own experience to identify and solve problems.
SUPPORT AND ACCEPTANCE
Patients with an ED frequently feel rejected or misunderstood by their relatives or peers. The group offers a therapeutic space of acceptance while also supporting and encouraging the patient to strive for change. Through positive group experiences, patients can receive empathy from other group members and extend this empathy to themselves.
INTERPERSONAL RELATIONS
Patients have usually lost or not yet found the necessary confidence or abilities to engage in quality interpersonal relations. With the help of other group members, they can learn about their feelings and emotions, while also learning how to manage and communicate these. Patients can thus learn to share, trust and become close to others, among other things.
CONFRONTATION
Once an atmosphere of care and trust has been established, the therapist facilitates confrontation between group members, pointing out inconsistencies, ambivalences, denial and self-destructive behaviors. The task is to teach patients to challenge each other in a loving way, allowing them to learn it is possible to be angry, to cry, etc.
FRIENDSHIP
Even though the therapeutic group is not designed as a self-help group, activities and proposals of this kind may spontaneously emerge between patients, outside of the framework of the program, in a search to provide support and company. This is not encouraged, but neither is it prevented by the program.
PAI COMPONENTS
The program operates Monday through Friday in three sessions: Morning Session (7:30am – 12:30) – Afternoon Session (12:30pm – 5:30pm) – Extended Session (7:30am – 5:30pm). It integrates different types of individual and group psychotherapy, therapeutic lunches and snacks, and activities designed to facilitate patients’ exposure to food and other daily situations.
“VÍNCULO” PROGRAM – TRAINING PROGRAM FOR PARENTS AND CAREGIVERS OF A LOVED ONE WITH AN EATING DISORDER
It is a complementary treatment tool designed for relatives and other caregivers. It consists of 8 sessions of one hour and a half that seek to educate and train the family in skills for the at-home management of the problem. Sharing and listening to others allows family members to know that they are not alone in the suffering, feelings, emotions and experiences that come from having a relative with an Eating Disorder. Although the stories are individual and each patient and family are unique, a collective atmosphere of understanding and solidarity is created.
FAMILY THERAPEUTIC MEAL
This is a space that the therapeutic team offers for the patient’s family, where two therapists witness the family dynamic during one live meal, pointing out the observed interaction patterns and reinforcing those that favor the patient’s recovery.
PAI PLUS, PAI, SEMI PAI, OUTPATIENT TREATMENT
As therapeutic objectives are reached, the intensity of the program gradually decreases to three days a week (SEMI PAI), then one day a week (MINI PAI), until patients only receive outpatient treatment to follow-up on their case.
GROUP THERAPY
Therapeutic groups are proposed as a complementary tool to individual psychotherapy. These are always managed by a therapist. Groups seek to: *Offer education about the disorder. *Give support and encourage the drive for change. *Develop abilities to identify and express emotions. *Confront dysfunctional thoughts and behaviors that trigger symptoms or maintain them in time.
Calle 118 # 47A -12. Barrio Alhambra. Bogotá
+571 805 00 25 –+571 6122915–+571 320 8578794
Bogotá – Colombia –
