Treatment Overview
The Johns Hopkins Eating Disorders Program provides a full continuum of care for eating disorders. Levels of care include outpatient consultations, an outpatient clinic for ongoing care, and a fully integrated inpatient and day hospital (partial hospitalization) programs.
If you are seeking an opinion regarding treatment it is usually best to start with a full evaluation in our Outpatient and Consultation Clinic.
We currently provide remote telemedicine video visits - for patients residing in Maryland only - which allow patients to connect face-to-face in real time with a clinician without leaving their home. Patients can use a smartphone, tablet or computer. Virtual connections are secure and HIPAA compliant.
Consultations include a full psychiatric and medical history as well as laboratory or imaging studies, when indicated. To provide the most thorough evaluation and opinion we request that you forward us any medical records or pediatric growth charts (for adolescent patients) ahead of time so the doctor can review these before meeting with you and your family. At the end of the consultation we will discuss a treatment plan and options with you.
If you are interested in Inpatient or Partial Hospital Program, you may wish to contact our admissions coordinator directly at the numbers listed below.
Contact Us
The Johns Hopkins Eating Disorders Program
Department of Psychiatry and Behavioral Science
600 North Wolfe Street, Meyer 101
Baltimore, Maryland 21287
For Inpatient and Day Hospital (partial hospitalization) information
Lisa Smith, Admissions Coordinator
Phone: 410-955-5114, Fax: 410-955-6155
E-mail: [email protected]
Eating Disorders Intake Referral Form
For Outpatient and Consultation services
Tracey Farrow, Outpatient Clinic Coordinator
Phone: 410-955-3863 Fax: 410-502-7907
E-mail: [email protected]
Directions
Inpatient Program
Director: Angela S. Guarda, M.D.
Assistant Director: Graham W. Redgrave M.D.
Nurse Manager: Devin Lowe, BSN, RN-BC
Clinical Nurse Specialist: Allisyn Pletch R.N.
Admissions Coordinator: Lisa Smith
The Inpatient Program is located on the fourth floor of the Meyer Building of the Johns Hopkins Hospital, which also houses the Adult and the Young Adult Mood Disorders Service. The Program draws on the multidisciplinary expertise of our dedicated Eating Disorders Treatment Team to provide comprehensive and individualized care. The team is staffed by physicians, nurses, social workers, occupational therapists, and nutritionists.
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- Severe eating disorder with associated medical complications
- Unsuccessful outpatient treatment
- Physician referral for admission and medical records
Learn more about the admissions process and contact information below
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If you adhere to your individualized treatment program during and after hospitalization, you can expect restored physical and psychological health. The program will assist you in mastering tools necessary to avoid relapse once you return home. You may feel ambivalent about admission and about pursuing treatment; these feelings are normal. Although treatment can feel difficult initially, recovery has huge rewards and is always possible. As you progress through the program your motivation to change your eating behavior is likely to increase -- even if you are ambivalent about changes at first. Most patients report a sense of mastery and increased confidence in the possibility of a full recovery as they progress through the program. You will use the program best if you bring to it a willingness to work hard and an openness to learn new ways of dealing with your emotions, and then apply principles learned in the program to your life at home. Read comments from patients and families treated in our program
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The expected length of stay on the inpatient unit is variable and depends both on your medical condition at admission and on how you progress with treatment. An average inpatient length of stay is two to four weeks but can be shorter or longer depending on individual factors. Once you are ready, you will transition to the Day Hospital (Partial Hospitalization), where the average length of stay is an additional two to three weeks but may be extended or reduced depending on your needs. We work together with you to formulate your treatment goals and to make your stay successful.
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Patient-Focused
If you have an eating disorder, you and possibly your loved ones are suffering as a result of your complicated relationship with food, weight, shape, and feelings. Our treatment goal is to assist you in normalizing your eating behavior, to help decrease your preoccupation with food and weight, and to aide you in restoring your weight if it is too low. We will also address any co-occurring medical or psychological conditions or complications of your eating disorder. An important strength of this program is that it is highly structured and will assist you in regaining control over your eating and your life.Treatment of Depression and Anxiety
The attending faculty member and team leader is a psychiatrist. Psychiatric symptoms such as depression and anxiety are often experienced by those with an eating disorder and their treatment is important for a full recovery. Group treatment of mood disorders may be recommended. In some cases, psychiatric medication may be helpful to relieve these symptoms. All medications you are currently taking will be reviewed by the attending physician once you are admitted. We may recommend a trial of a new medication or a change in medications after discussion with you. Standard psychological testing designed to help you understand your particular strengths and vulnerabilities when faced with the stresses of living may also be recommended.Restoration of Function
Eating disorders can consume much of an individual’s time and energy. This can lead to a decrease in social, academic, or occupational function. Patients often report feeling stuck or “derailed” by their eating disorder. You will have the opportunity to work with specially trained occupational therapists on creating appropriate goals, updating resumes, job-seeking and re-entrance into school. We believe that full recovery from your eating disorder is possible and this includes not having your eating disorder permanently affect the trajectory of your life.Group Therapy
Daily group therapy sessions with patients on the unit provide a forum to explore the challenges of coping with an eating disorder and its toll on relationships, work, and emotional life. These meetings provide the opportunity to learn from other patients and decrease the loneliness and isolation that often come with these conditions. We also offer more structured cognitive-behavioral therapy, family relations, discharge planning, body-image, and stretch and relaxation groups. In the Day Hospital (Partial Hospitalization Program) you will participate in daily meal preparation and social eating skills groups that include grocery shopping, ordering carry-out meals, and eating in restaurants.Family Involvement
Whenever possible, we actively engage loved ones of the affected individual and include them in the treatment team. With adolescent patients we use a Maudsley family therapy approach that includes intensive parent training. We help families assist their child to eat normally and to correct driven eating disorder behaviors. Maudsley therapy was originally developed at the Maudsley Hospital in London and is a family-based treatment shown to be effective for adolescents with eating disorders. A social worker and other team members will work with you and your family to assess the impact of your illness and to help your family support you in your recovery. Family members will be asked to attend a weekly special educational groups and family therapy meetings. Additional meetings will be recommended as part of your treatment as needed. Parent training is part of the treatment of all adolescent patients.
Inpatient Admissions
Admissions Coordinator
Admissions Coordinator, Lisa Smith
Eating Disorders Treatment Program
Johns Hopkins Department of Psychiatry and Behavioral Science
600 North Wolfe Steet, Meyer 143
Baltimore, Maryland 21287
Phone: 410-955-5114, Fax: 410-955-6155
Hours of Operation: Monday - Friday, 8:00 am - 4:30 pm
E-mail: [email protected]
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To arrange admission of a patient to one of our inpatient services, the person currently treating the patient, a member of the patient's family or the patient him/herself should contact The Johns Hopkins Hospital Admissions Office as soon as possible. There may be a waiting list for admission.
The Admissions Office will request that current clinical information about the patient's condition be faxed for review before admission arrangements are made. This information will help determine which service is most suitable for the patient. It is also essential for the Admissions Office to have clinical information in order to contact the patient's insurance company. The insurance company will then determine the extent to which the patient's policy covers the admission.
The patient and the patient's family are advised to discuss financial details with the Admissions Office in order to clarify the extent and nature of insurance coverage. Depending on the level of insurance coverage, a deposit may be required on the day of admission.
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Patients who are not being admitted through the Emergency Department should report to The Johns Hopkins Hospital Admissions Office in Meyer 143 at the arranged time. Planned admissions usually occur between 8:00 a.m. and 10:00 a.m.
The patient will sign admission papers and review other documents that will be explained by the admissions coordinator. The patient and family will then be escorted to the inpatient unit in the Meyer Building. There, a nurse will welcome them and provide a tour of the unit.
The attending psychiatrist and resident psychiatrist will take medical and psychiatric histories and examine the patient. It is important for the patient to tell the physicians about any medical problems, including allergies to medications. A nurse will do an assessment so that the nursing staff can plan for its part in the patient's care. A social worker may also meet with the patient's family to assess the patient's social supports.
Note: This is a general description of what transpires on the day of a planned psychiatric admission; it may vary somewhat by service. Please contact the Admissions Office if more detailed information is required.
Day Hospital (Partial Hospitalization) Program
During your inpatient stay, the team will begin to plan for your transition to the Eating Disorder Day Hospital. The partial hospitalization program is a step-down service from the inpatient program with a focus on relapse-prevention and successful transition to home and outpatient follow-up care. The Day Hospital is fully integrated with the Inpatient Program and is located on the same unit and staffed by the inpatient treatment team.
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The Day Hospital runs from 8am to 8pm, seven days a week. As you progress through the program you will start to have days off to practice independent eating in a less supervised setting. You will learn relapse-prevention skills and develop a discharge plan for your return to home life, and will work closely with medical, nursing, occupational therapy and dietician staff providing meal support. You will gradually spend increasing time outside the hospital living at the Jefferson House (or with your family if you are an adolescent patient) and will have daily opportunities to practice your new healthy eating skills and to troubleshoot problems before leaving the structured hospital environment to return home.
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By discharge most patients are attending the Day Hospital three days a week; are preparing meals daily at the Jefferson House; are ordering carry-out meals; and are eating in social settings including at restaurants and cafeteria. Participation in the Day Hospital helps shorten the length of your inpatient stay, gets you ready to leave the structure and support of the treatment program and helps you independently practice the new skills you have learned in a real world environment.
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- increase patients' functional ability to the highest possible level
- decrease the length of inpatient hospitalization
- provide a smooth transition from inpatient to outpatient treatment
- facilitate reestablishing relationships with family, work and community
- provide additional education and support for patients and families
- provide practice in daily activities that improve and normalize social eating skills and nutritional intake. These activities include eating family-style and cafeteria meals, preparing and cooking meals, grocery shopping, and restaurant outings.
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Patients 18 years of age and older are accommodated at the Jefferson House for a low-cost fee. The Jefferson House is located two blocks from the hospital and is dedicated to the Johns Hopkins Eating Disorders Program. While in the Partial Hospital, adolescent patients stay with their families. If they are from out of town, staff will assist families in obtaining low-cost accommodation in the Baltimore area.
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8:00-9:00am
Breakfast – Grocery shopping outing (with occupational therapist) and breakfast at a coffee shop9:00-10:00am
Activity group and individual rounds meeting with the psychiatrist-led team
School for adolescent patients (9:30-11:00a)10:00-11:00am
Coping skills group (led by social worker) or cognitive-behavior therapy group (led by nurse)11:00am-1:00pm
Lunch - meal planning, preparation and performance group – this includes either selecting foods in the cafeteria, eating in a restaurant, having a family-style meal on the unit or cooking a meal (led by nurses).1:30-2:30pm
Psychotherapy Group (led by psychiatrist or social worker)3:00-4:00pm
Psychotherapy Group (led by social worker)4:00-4:30pm
Daily walk with staff or supervised gym time if appropriate (with nurse)5:00-6:00pm
Dinner6:00-8:00pm
Visiting Hours9:00-9:30pm
Stretch and Relaxation group (led by nurse or occupational therapist)
Outpatient and Consultation Clinic
The Outpatient and Consultation Clinic provides comprehensive evaluations for patients referred by their physicians, families, or themselves.
Consults are performed by a psychiatrist and include review of outside medical records and a comprehensive psychiatric and medical history to clarify the diagnosis. Laboratory studies or other medical tests may be ordered. At the end of the consult the psychiatrist will provide comprehensive recommendations for modifying ongoing outpatient treatment or may recommend more intensive hospital-based treatment in the Inpatient or Partial Hospital programs for medical stabilization and treatment of an eating disorder.
We currently provide remote telemedicine video visits - for patients residing in Maryland only - which allow patients to connect face-to-face in real time with a clinician without leaving their home. Patients can use a smartphone, tablet or computer. Virtual connections are secure and HIPAA compliant.
For more information or to schedule a consultation, contact Tracey Farrow at 410-955-3863, fax 410-502-7907 or email [email protected]