Typical Daily Schedule
7:00-8:30 a.m. –Wake-up, shower, and clean-up room
8:30-9:30 a.m. –Supervised breakfast
9:30-10:00 a.m. –Free time and school work
10:00-11:00 a.m. –Recreational activity* and individual therapy**
11:00-11:20 a.m. –Clean-up for day, chores, meal plans for next day, and restroom
11:20 a.m. –Weight check
11:30-12:30 p.m. –Lunch preparation, supervised meal, and meal planning for next day
12:45 p.m. –Restroom break
1:00-2:30 p.m. –First therapy group (either psycho-educational or psychotherapy)
2:30-3:00 pm –Supervised snack
3:00 p.m. –Restroom break
3:15-4:45 p.m. –Second therapy group (either psycho-educational or psychotherapy)***
5:00-6:00 p.m. –Dinner preparation and supervised meal
6:00-8:00 p.m. –Education with teacher and tutors
8:00-9:00 p.m. –Recreational outing
9:00-1000 p.m. –Supervised snack
10:00-11:00 p.m. –Room activities
11:00- 11:30 p.m. –Restrooms and preparing for bed
11:30 p.m. –Lights out

* Examples of recreational activity include playing games, taking walks, working on art projects, watching TV, accessing the Internet, making phone calls, and visiting the library.

** Time for individual therapy, family therapy, and meetings with other staff members (such as psychiatrist, psychologist, social worker, nurse, and tutors) is interspersed throughout the day.

*** Only one therapy group meets in the afternoon on Saturdays, so adolescents devote more time to recreational activity. No therapy groups meet on Sundays, but each adolescent meets with a therapy staff member.

Initial Assessment
Before admission to ARP, River Centre Clinic conducts a comprehensive clinical assessment to gather information regarding the patient’s current symptom picture, history of eating problems, health history, family history, current and prior medications, and various questions about overall emotional and physical health. The clinic also obtains information forms and questionnaires completed by each patient. Patient information from both interviews and questionnaires is essential to ensure that we do not overlook important details of each patient’s current situation or history. Before admission to ARP, patients must receive a medical evaluation to determine their general health status. In most cases, patients receive the medical evaluation from their personal physician.

Individualized Treatment Plan
In the first week after admission to ARP, patients and their family receive an individualized treatment plan tailored to meet their unique needs, based on our ongoing assessment of problems and progress. This plan is developed based on the initial assessment, then applied within the framework of evidence-based treatment principles and protocols, and continually revised as changes occur during treatment. The treatment team works closely with each patient and their family to set realistic treatment goals, and staff members are available to patients and parents to explain the rationale behind various aspects of treatment. While in the program, patients learn how to address the main symptoms of their eating disorder. They also learn how to identify and start resolving the emotional issues that have contributed to the development and maintenance of symptoms. Patients and their families are encouraged to participate in the treatment plan’s development and evolution as changes occur throughout the treatment process.

Nutritional Rehabilitation
ARP treatment provides complete nutritional rehabilitation in a safe and structured environment. The goal of this aspect of treatment is to help patients achieve and maintain a healthy body weight, as well as to develop appropriate eating patterns that will lead to true control over the eating process. Since food and meal planning are key elements of nutritional rehabilitation, each patient has a food plan tailored to meet individual needs under a dietitian’s or physician’s supervision, and specially trained staff members supervise meal planning and meals. ARP provides all meals and snacks, seven days per week.

Medical and Medication Services
One aspect of the ARP treatment plan is evaluating and addressing each patient’s ongoing medical needs, and is provided by our staff psychiatrist and consulting physicians. River Centre Clinic’s medication/somatic service provide medical interventions including physical assessment, prescription, or supervision of medication(s). This service is aimed at educating patients who require medication so they may develop an understanding of their medication regimen and other health issues.

Psychological Therapies
The ARP treatment plan involves a mix of individual, group, and family therapy. The plan also encourages family visitation that is prearranged with clinical staff members.

Individual Therapy: Each ARP participant is assigned to one or two staff members for individual therapy meetings. One of the aims of individual therapy is to help these patients overcome some of the fears and inhibitions they might experience in a group setting.

Group Therapy: The ARP treatment plan places strong emphasis on group therapy because it provides an opportunity for patients to learn by interacting with other people who suffer from eating disorders. The group therapy format also plays a valuable role in recovery by providing hope, reassurance, and understanding. Nevertheless, our approach is very flexible. We recognize that some people take longer than others to feel comfortable in groups. We encourage patients to express any concerns that they have about our treatment format so that our staff members can explain the rationale behind various aspects of treatment.

Family Therapy: River Centre Clinic encourages each ARP participant’s family to be involved as part of treatment. We emphasize family therapy as one of the cornerstones of treatment and require it for nearly all patients who are under the age of 18 or who are living at home. From a practical perspective, parents or guardians are legally responsible for the patient’s well being, and parents can provide powerful directives that support therapeutic goals. From a theoretical perspective, the interaction between family members and the patient’s thinking, feeling, and behavior is usually so salient that it compels family involvement. We can schedule family meetings or therapy sessions regularly or periodically, according to the patient’s individual treatment plan. Each patient’s individual treatment plan may change over the course of treatment.

Educational Plan
If continued schooling is considered appropriate, given the nature and seriousness of the patient’s eating disorder, River Centre Clinic can provide individually tailored educational plans so the patient can continue to meet educational goals. This can be accomplished in several ways:

•The patient’s home school district can coordinate the curriculum and provide the patient with all materials required to maintain current classes or a partial course load.

•Patients can enroll in the local Sylvania school system, but payments for this service must be made by the patient’s home school district.

•Patients in grades 5 through 12 can earn credits through nationally accredited correspondence courses.

Visitation
River Centre Clinic encourages family and friends to visit ARP participants, but it is best if these visits are prearranged with clinical staff members. The aim is to provide maximum benefit for patients by considering all factors pertaining to their treatment goals and progress. Hotel accommodations for family and visitors are available nearby at:

Wingate by Wyndham –Sylvania/Toledo
5480 South Main Street
Sylvania, OH  43560
U.S.A.

Local Phone: 419-517-2000
Toll-Free Phone: 866-502-5381
Website: http://www.wingatesylvania.com/

Please ask for the River Centre Clinic corporate discount rate for rooms.

Discharge Planning and Aftercare
Discharge planning is an ongoing process that begins upon admission to the ARP. The ARP treatment team works closely with each patient and their family to set realistic treatment goals and develop an aftercare (continuing care) plan for applying the behavioral management, communication, and problem solving skills that have been effective in treatment. Aftercare involves a range of options, including weekly aftercare groups, relapse prevention therapy, or phone follow-up to provide safeguards against relapse. River Centre Clinic also assists patients and their families who need referrals for additional treatment or support in their home communities.