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Samira Zakkout, MA
- Admissions Clinician
- One-week Intensive Programs
- (858) 246-1825
Eating disorders are often chronic disorders with symptoms lasting many years or even a lifetime. When a child suffers from the devastating illness of an eating disorder, all members of the family and the relationships between them are profoundly affected. Some of the latest research in the eating disorders field points to potentially unprecedented levels of success when families become centrally involved in the treatment process.
The purpose of Intensive Family Treatment (IFT) is to provide parents with an understanding and the tools necessary to successfully interact and manage their child with an eating disorder at home. In addition, we teach adolescents how to understand the symptoms that they are having and develop more effective coping strategies. We also work closely with siblings and other family members to better understand the illness and find ways to support themselves as well as their loved one throughout treatment and recovery. Thus, IFT benefits all family members by providing a roadmap for how to continue to navigate recovery successfully within the family. Treatment includes psychoeducation, coping skills training, parent training, meal coaching, and novel neurobiological skills based on brain imaging research. We believe the UCSD Intensive Family Treatment Program will benefit not only the ill child, but the entire family, through improved understanding, communication, and capacity for growth.
Many families cannot find eating disorder experts in their local communities, nor can they afford long term out-of-pocket inpatient or residential care. In order to meet their needs we developed a five-day intensive treatment program for adolescents with eating disorders and their families. IFT takes place from Monday through Friday and involves approximately 35 hours of treatment over the course of the week. The program takes place monthly, with 3-6 families participating during each round. The treatment is conducted in a multi-family format, with families receiving treatment together. Studies conducted on multi-family therapy for adolescents with eating disorders suggest that family-to-family contact during treatment may increase the change of positive outcomes and provides significant benefits beyond separate family therapy. Throughout the course of the week, participants receive a psychiatric evaluation, family therapy, adolescent coping skills training, parent training, and psychoeducation. In the event that continued treatment is needed, adolescents have the opportunity to transition to our adolescent family-based day treatment program.
The majority of families who attend IFT do not live locally in San Diego. Families usually fly in on Sunday before the treatment week and stay at a nearby hotel. Our intake coordinators can answer questions about local accommodation options and assist with setting families up with lodging. For a list of hotels near our clinic, please visit this page and click on “Lodging Near UCSD Thornton Hospital & Per Ambulatory Care Center”.
“I'm surprised that the concept of training and involving parents in the treatment of their minor child has not been already well- established! It seems obvious that parents are the most influential and can control to a certain extent what their child eats and any consequences of not eating. Yet it took us 3 years of weekly therapy and nutritional consultation for my child's team to finally suggest a more intensive Family based therapy program. The 5-day intensive program is very effective- much more so than an ongoing one-hour per week outpatient therapy.”
“What an exceptional week! We are grateful to all at UCSD who helped us, especially Stephanie and Brittany.”
“We feel so much more confident in our abilities as parents to help our daughter through this troubled time, and preserve our family. It helped reaffirm that the information we have been receiving is correct, and the best possible way to help our daughter. We are not afraid to parent her through this terrible disorder. We have been shown that indeed there are glimmers of light at the end of this tunnel, and that we can and will make it through this, with even a stronger family than before. Thank you so much!”
“What a wonderful experience for our family. We learned some tremendously helpful information and feel empowered to help our daughter cope with this illness.”
Adolescents must receive medical clearance from our medical director prior to attending our program to ensure medical stability and program appropriateness. Families are required to set up appointments with a local physician to complete the necessary medical tests. Upon admission, UCSD provides medical forms that outline required tests. Most families are able to complete the medical requirements within the two weeks prior to attending the program.
What is your success rate?
Data collected from past participants of our program suggest that this program is effective in reducing eating disorder symptoms and restoring adolescents to a healthy weight. We followed up with 79 past participants of our IFT program and found that the majority of participants (87.8%) achieved a full or a partial remission (full remission: 60.8; partial remission: 27%) from their eating disorder. IFT was also found to reduce the risk of hospitalization and other higher levels of care. These results are impressive within the context of other studies that have reported on outcomes of their adolescent programs given the high rates of chronicity and relapse rates known to plague eating disorders.
Will insurance cover this program?
UCSD Eating Disorder Center is contracted with most major insurance companies. The IFT program is typically covered by insurance companies. Our billing office supports patients by providing an insurance screening which allows us to verify and interpret coverage for this program. We also provide a financial consultation to go over your financial responsibility for this program.
What causes an eating disorder?
The treatment of eating disorders often involves lengthy hospital or residential stays, during which time patients may gain weight. However, many patients tend to relapse after they leave the structured setting of the hospital or residential program. Consequently for many, eating disorders become chronic disorders with symptoms lasting many years or even a lifetime and can include significant medical complications. The popular notion is that eating disorders are caused by cultural or societal factors. However, recent studies have shown that eating disorders are highly heritable because they are transmitted by genes. The influence of these genes is first seen in childhood, years before the onset of an eating disorder. People who go on to develop eating disorders tend to have certain vulnerabilities that start in childhood before the onset of the illness that made them susceptible to developing an eating disorder. These vulnerabilities may include anxiety, obsessionality, and perfectionism. Considerable evidence suggests that these behaviors are due to alteration of genes that affect the brain pathways that modulate feeding, mood, impulse control, and decision making. For example, people with eating disorders have biological disturbances of appetite regulatory centers in the brain. Even though they are often malnourished, their brains do not seem to provide an accurate signal that they should be hungry and need to eat. It is important to emphasize that just getting people with an eating disorder to a normal body weight is not enough to “cure” this disorder. That is because such behaviors (e.g. anxious obsessional focus on weight loss) persist after weight restoration, and because the family often struggles to manage their adolescent at home. The persistence of such behaviors after weight gain contributes to the high rate of relapse. Clearly, we need to develop treatment programs with a different focus. That is, not just weight gain, but better means of helping people with eating disorders, and their families, deal with the anxiety, perfectionism, body image distortions, obsessionality, and disturbed appetite that contributes to this chronic illness.
What can we get in just 5 days?
This week is a powerful intervention, but it is not intended to be a stand- alone treatment . Rather, it is an important, previously underutilized part of a comprehensive treatment plan. Simply put, the focus of IFT is to teach parents how to manage their child or adolescent with an eating disorderat home. IFT is an immersive form of family-based treatment (FBT), the only eating disorder treatment to date that has been shown to be effective for adolescents with eating disorders. FBT has been shown to provide parents with the knowledge and tools needed to manage their adolescents with eating disorders at home. IFT is rooted in principles of FBT and is focused on teaching parents appropriate ways to restore their adolescents’ mental and physical health. In addition to FBT, IFT also includes other novel treatment components that help to teach skills to both parents and adolescents in order to better manage the illness. The primary treatment components involved in IFT include: multi-family therapy, parent training, adolescent coping skills training, neurobiological psychoeducation, and behavioral contracting. Over the course of the week, these skills are taught and practiced with therapist-assistance so that families are equipped upon returning home. Moreover, therapists will provide meal-coaching assistance and guidance on how to effectively handle meal time behaviors, with the opportunity to practice newly acquired skills during the ten meals and ten snacks scheduled throughout the week. Additionally, each family leaves with a detailed, tailored behavioral plan constructed conjointly by the family and the treatment team which outlines the guidelines for continuing on the path to recovery.
In summary, treatment of eating disorders often is long, difficult and extremely expensive. While in some cases costly inpatient or residential stays cannot be avoided, in other situations, a family can be guided through the process of providing care at home. Our intensive, 5-day program is designed to help families determine whether outpatient, family-based care may be a viable treatment option in their unique situation.
Does my entire family need to come?
Entire families are highly encouraged to participate in the Intensive Family Treatment week. When a child suffers from the devastating illness of an eating disorder all members of the family, and the relationships between them, are profoundly affected. Unprecedented levels of success are reported when families and siblings become centrally involved in the treatment process. Siblings are provided with a safe space to discuss fears, struggles that he/she may be experiencing, and changes in the sibling dynamics. IFT benefits the whole family with improved understanding, open dialogue, and facilitates the capacity for growth. Having the entire family attend the IFT week will empower families as the effects of eating disorders impact the whole family unit.
Are my child’s siblings too young to join?
All siblings are encouraged to participate in the Intensive Family Treatment. Therapeutic activities will be tailored to the unique needs of the families. Developmentally appropriate activities will be offered to encourage communication and foster support and understanding.
What happens after IFT?
Clinicians provide you and your family with a behavioral contract and a detailed treatment plan. The contract is developed with the input of the family and child with an eating disorder. The contract is used to increase the likelihood of positive behaviors while decreasing negative behaviors as it’s related to the eating disorder. We make every attempt to communicate with your home town therapist and/or assist to help you find an outpatient team to continue treatment at home.