FAQs

Admission

Do I need a referral from my doctor?

No, a doctor's referral is not necessary for admission to the River Centre Clinic, unless specifically requested by your insurance company. If you are transferring from another facility, we will need medical records and recent lab-work to review.

What are the steps in the admission process?

1.	Contact us by phone, or
2.	Complete the Initial Information Form.
3.	Our Intake Coordinator will contact you confidentially by phone or e-mail.
4.	Schedule an interview and complete medical testing and pre-admission forms.
5.	Schedule an admission date.

What is the Initial Information Form?

The Initial Information Form is a very brief form that provides us with important information about you, current symptoms, medical problems, treatment history and insurance information. The information on this form is confidential and allows our Intake Coordinator to discuss the most appropriate treatment alternatives with you. Filling out this form does not obligate you to participate in treatment in any way.

What will the Intake Coordinator speak to me about?

The Intake Coordinator will contact you confidentially by phone or e-mail to discuss details of our program and to answer any of your questions. Topics discussed include admission procedures, how quickly you could be admitted, the most appropriate level of care, living arrangements, insurance benefits, treatment costs, lengths of stay and any questions you might have about treatment. Once insurance benefits have been verified, the Intake Coordinator will be able to schedule a Clinical Assessment and will also request that you prepare for the assessment by filling out a more detailed set of online Assessment Forms on our website. The Intake Coordinator will give you the instructions about these forms as well as provide you with a personal username and password needed to complete the Assessment Forms.

What is the Clinical Assessment?

An Assessment is needed for one of our experienced clinicians to make a recommendation for the most appropriate and most beneficial level of care. Usually, these interviews are face-to-face but if this is not practical, we can conduct the interview over the telephone. As part of the clinical assessment process, we ask prospective program participants to complete more detailed assessment forms on our website. The information on these forms is extremely helpful in allowing us to provide you with recommendations regarding treatment goals and the duration of stay. As part of the clinical assessment, prospective participants and their family are given a tour of the facility.

What is covered in the Clinical Assessment?

In the clinical assessment, we gather information regarding the current symptom picture, the history of eating problems, health history, family history, current and past medications, and various questions about overall emotional and physical health. Because of the personal nature of the information gathered, we are particularly mindful of need for confidentiality. Information related to history and the current situation is also obtained from standardized forms and questionnaires completed on our website.

How quickly are applicants admitted?

Admission depends upon a number of factors, including a whether there is a waitlist, insurance considerations, and the medical condition of the potential program participant. However, applicants are usually admitted on the first Monday after the clinical assessment is completed. The clinician performing the assessment should be able to give you a general idea of an admission date after the assessment.

How long do participants usually attend the River Centre Clinic's programs?

There is no set length of stay for our programs since treatment is individualized to meet the needs of each program participant. However, the average length of stay ranges from a few weeks to a few months, depending on the personal treatment goals of the program participants as well as their progress.

Do you have a waiting list?

A waiting list depends upon the number of patients currently enrolled in the program. We want to make sure that there is adequate staffing for those who are in the program in order to provide optimal care. The waiting list is flexible and may change from time to time.

Is one ever able to fully recover from an eating disorder, or are they always "in recovery"? How do you know if you are recovered?

There are different opinions on this topic; however, the scientific literature is clear- complete recovery from an eating disorder can be attained. However, studies have also shown that the prospects for recovery are greatly reduced without proper treatment. Even though a person may have a sincere and determined desire to "do it on their own," the research just does not support this idea. For some people recovery remains elusive and they continue to have mild, moderate or severe symptoms. It is important to remain optimistic since we have seen people who have had chronic and debilitating eating disorders make a full recovery. However, it is important to be realistic about recovery since it is usually not an easy or quick process. But, with the right professional guidance and the proper level of care, it is definitely possible to learn to deal with life and all of its challenges without an eating disorder.

About the Treatment Program

Do you provide treatment for problems other than eating disorders?

Eating disorders are our specialty and we generally do not provide treatment for people with other primary diagnoses. However, it is important to remember that those suffering from eating disorders typically meet the diagnostic criteria for other disorders such as depression, anxiety, obsessive compulsive disorder, post-traumatic stress disorder just to name a few.

What are the ages of the other patients?

The ages of program participants vary considerably. Participants in the adult Partial Hospitalization Program must be 18 years old or older. Although the most common age range of program participants is 18 to 22, we typically have individuals in the 30s, 40s and 50s in the program.

Do you see male patients?

Yes. We see both men and women in our programs. It is our experience that men feel quite comfortable and well-accepted in our programs.

Do you have to be thin or underweight to get help?

Absolutely not! Serious eating disorders occur with people at any shape or size. Our program participants represent a wide range of body shapes and sizes.

How do I know if I should be an outpatient or in the residential/partial hospitalization program? What if I only want outpatient therapy?

A clinical assessment needs to be conducted in order for an experienced clinician to determine the most appropriate level of care to address the problem. Our goal is to recommend the least intrusive and most economical mode of treatment; however, we do not want to recommend a level of care that has little prospect for success. We have found that the Partial Hospitalization and Adolescent Residential level of care are the most effective for most people who have serious eating disorders. Outpatient therapy is also appropriate for others. The aim of the Clinical Assessment is to recommend the most appropriate level of treatment and to help you understand the reasons for this recommendation.

Can I commute to your program?

It is possible for program participants who live close to the program to commute each day. The relevant clinical and logistical issues will be discussed in the Clinical Assessment. Some adult program participants who live locally find it useful to begin the program by staying in the residence and then transition to commuting daily from home. These individuals report that the positive effect of social support by peers after program hours is a significant factor in this decision.

What therapeutic approach do you use?

The River Centre Clinic uses a cognitive-behavioral therapy (CBT) model specifically designed for treating eating disorders. It enhances the basic CBT by integrating group and family therapy, applied in an individualized manner for each patient. This model helps patients to identify negative thought patterns and negative core beliefs that interfere with normal functioning, and to learn how to modify their thought patterns and behavior to bring about positive results. Family therapy is emphasized, especially for adolescents, because parents have the potential to provide powerful directives in support of therapeutic goals. Family involvement is a cornerstone of treatment since eating disorder symptoms typically affect everyone close to the person who is suffering with the eating disorder. Our approach to treatment has been the subject of numerous scientific publications and presentations over the past 25 years.

Will I have an individual therapist? How often will I have individual therapy? What is the mix of individual and group therapy?

An individual therapist will be meeting with you at scheduled points throughout each week of treatment. The amount of individual therapy will be determined at the time of your admission and may be adjusted over the course of your stay. The psychological therapy in the program involves a mix of individual and group therapy. It is tailored to meet the needs of each program participant based on our ongoing assessment of problems and progress. The mix of group and individual therapy is individually tailored to meet the needs of each program participant based on our ongoing assessment of problems and progress. The RCC staff spends 35 hours a week with you, so we get to know you quickly. This highly concentrated time with you in groups and at mealtimes allows us to be focused and goal directed in individual meetings. Even though you may feel reluctant at first to talk in groups, program participants have consistently reported that the group format is one of the most helpful aspects of the program.

Who do you have on staff? Do you have a doctor on staff?

Our treatment team staff consists of a multidisciplinary group of therapists, social workers and psychologists, a dietetic technician, kitchen support specialists, a registered nurse, and a medical director. Our medical director specializes in psychiatry and is on staff during program hours. A consulting physician visits the clinic every week to address general medical concerns and there is someone on call 24 hours a day to meet medical needs. For more information on the staff, please click the "staff" link on the menu to your left.

What will I do when I am not in program?

Adult patients sometimes schedule outings with their peers, such as going to area stores or community events. Patients will need to review their before/after program hour plans with their individual therapist. Patients are expected to arrange transportation with each other or independently. There is no set curfew for adult patients; however, it is helpful for patients to be able to come back to their residence in order to have adequate rest for the next day. In the mornings, patients are expected to fulfill their breakfast requirement as specified in their personal meal plans. Adolescent patients participate with residential staff on group outings on a regular basis. Commuting patients usually do not come into the clinic on the weekends, although they are permitted in the residence for social engagement. Some commuting patients may come in for supervised meals on the weekends. Adult patients in residence who do not receive meal supervision on the weekends are expected to follow their individualized meal plans on the weekends and to stay in residence unless they have arranged otherwise through their therapists.

Can I leave on the weekends?

Yes. This is generally arranged ahead of time through patients' therapists, depending on each patient's individual progress. New patients are encouraged to stay in the residence the first couple of weekends in order to fully adjust to the program, receive supervision during meal times, and to build peer relationships and receive peer support. Each patient is expected to follow through with his or her individualized meal planning if leaving the clinic during a weekend.

Can I have visitors?

Yes. Family members and friends are encouraged to visit with patients after program hours and during the weekend. Please make arrangements with your therapist ahead of time. Patients have the choice of whom they want to visit with while in treatment.

Can I receive mail?

Absolutely! Family members and friends may send cards, flowers, and gifts; however, they cannot send food.

What type of clothes do most patients wear?

We encourage program participants to dress comfortably in casual clothing. It is helpful for you to refrain from wearing attire that will draw inappropriate attention to the body, such as tight, skimpy, or revealing clothing that may intensify body image issues. As the indoor temperature may vary, it is recommended that patients dress in layers. Comfortable shoes are also recommended while staying at the clinic.

Do you have Internet access?

The River Centre Clinic has free wireless internet available throughout the building and we encourage program participants to bring personal laptops to stay connected to friends and family. However, adolescents must have permission from their parent or guardian to access the internet, and staff members monitor their usage.

What will I do on my first day?

On the new participants' first day, we introduce them to many of the staff. We complete the medical evaluation and needs assessment. The Primary Therapist meets with the participant and addresses questions and concerns. Next, we introduce the person to other program participants and their roommate. The program participant and family members are familiarized with the program and the River Centre Clinic policies and procedures. A detailed meal plan is worked out with the program participant and s/he is assisted in completing meals and snacks.

What is a typical day like?

The activities that you will be involved in vary depending on the level of treatment. Components of your treatment will include: goal setting group, written assignments and journal, social work processing and specialty education groups, experiential and art therapy groups, school/homework.

Living Arrangements

Where will I live during treatment?

The Adult Partial Hospitalization Program (PHP) includes, at no charge, participant's overnight stay in nicely furnished dormitory style rooms in the main facility during the week and weekend. This innovative independent living option bridges the gap between typical partial hospitalization level of care and inpatient treatment allowing this patient population to be treated safely and economically. It allows the PHP to be available to patients who live too far away to commute to treatment but is recommended even for those who live locally since it is part of a therapeutic social milieu that seems to be very important to achieving positive outcomes. The independent living area has a high level of patient acceptance when combined with partial hospitalization because it provides sufficient structure and the opportunity for peer support without the disadvantages of a highly restrictive hospital environment. It also allows program participants to practice "real world" activities such as shopping, meal planning, eating on weekends and socializing with others.

The adolescent residential unit is also dorm-style and comparable to the adult residence. There is also a common dining area in the unit. As the Adolescent Residential Program is staffed continuously, a staff office is located within the unit for 24-hour convenience.

What is the adult residence like?

The Adult Residence provides independent-living dormitory-style accommodations for women who participate in the Partial Hospitalization Program. The adult residence has a spacious sitting area, high ceilings, and several bedrooms. Each bedroom has enough space for at least 2 people, and each room has its own private bathroom. There is also a kitchen and dining area within the residence for meal preparation during mornings and weekends. Each residence also contains a television, computer with high-speed Internet, and a washer and dryer for convenience.

What is the adolescent residential unit like?

The adolescent residential unit has a capacity for 7 program participants. It is spacious and comfortable with 3 bedrooms, each colorfully decorated and with a bathroom. There is also a separate common sitting area with a television, computer and room for playing games. The kitchen / dining area is equipped with several microwaves and refrigerators to accommodate the meal preparations of each program participant on a daily basis. The Adolescent Residential Program is staffed 24-hour a day.

Is the residence supervised?

The adult residence, house, and apartment for adults are independent living accommodations and therefore are not directly supervised by staff; however, staff is on call 24-hours a day in case of emergencies. Our Adolescent Residential Program is supervised at all times.

Can I have a private room?

River Centre Clinic does not provide private bedrooms. Generally, two people reside in each bedroom in the adult residences. In the adolescent residential unit, three patients generally reside together. At times during the course of treatment, patients rotate bedrooms to become acquainted with other patients and to develop a sense of community while in treatment.

Cost of Treatment / Insurance

How do I pay for treatment?

The River Centre Clinic charges a flat daily rate for our services. For the vast majority of program participants, insurance pays for all or most of treatment. Once you fill out the Initial Information Form on our website, our staff will contact your insurance company to see whether your insurance will be accepted. For those without health insurance or with exhausted benefits, we will try to work out a plan for self-payment.

We have contracts with the following insurance companies:

Aetna
Anthem
Blue Care Network
Cigna
FrontPath
Health Alliance Plan (HAP)
Healthlink
Health Plan Ohio
Humana - Corp Health/Life Synch
Medical Mutual of Ohio
Medical Mutual – DaimlerChrysler
MultiPlan
Priority Health
Three Rivers
Value Options

We have obtained reimbursement coverage through many other insurance companies in Ohio, Michigan, Indiana, Illinois, Kentucky, West Virginia, and other states around the country. We have seen patients all across the United States and from as far away as Egypt, Poland, and Mexico.

Do you accept Medicaid/Medicare?

Unfortunately, at this time, the River Centre Clinic does not accept Medicaid or Medicare.

What is the cost of the program?

The flat daily rate for the adult Partial Hospitalization Program is $525 and this includes the cost of the independent living residence. This rate also includes the physician costs and the cost of 2 meals and a snack during the treatment week (5-days a week). The flat daily rate for the Adolescent Residential Program is $735 and includes physician fees as well as all food and outings in the evenings and weekends.

Are there any weekend costs?

For adults, there is no cost to stay in the independent living residence. Adults who require food from our kitchen on the weekend (usually the first week or so of treatment) there is a $25 charge per day that includes all meals and snacks as well as supervision if necessary. Adolescents in the residential program do not pay for meals on the weekends.

What forms of payment do you accept?

We accept cash, checks and credit card (VISA and MasterCard) payments.

Can I set up a payment plan?

Payment plans for the private pay option are set up on an individual basis. You may speak with our Chief Financial Officer to work out a payment plan.

Do you offer scholarships or discounts?

Unfortunately, the River Centre Clinic is not able to offer scholarships as it is a private, free standing clinic. A discount may be provided if you submit a fee reduction form to our finance committee for review.

Family & Friends

Can I talk to my daughter or son while they are in treatment?

We strive to keep an open communication with parents. Your daughter's or son's therapist or another designated staff member will provide information regarding progress on a consistent basis and will be available as needed.

If you have concerns or additional information you think could improve our treatment services, please share that directly with your primary therapist. Customer Feedback Forms are available if you would prefer to express yourself in writing. Your suggestions will help us continuously improve the treatment for our participants and their families.

My child is over 18 and needs help.

Since your child is 18 years old, s/he would be eligible for the Partial Hospitalization Program. S/he should contact the River Centre Clinic to begin the process for admission since s/he is an adult; however, even if a program participant is over 18, we consider some form of family involvement to be vital except in a small minority of cases. An eating disorder affects everyone in the family and research has shown that those who recover consider family involvement and changes in family relationships to be important factors in recovery. This being said, it is important to emphasize that we place a premium on confidentiality and family members are contacted only with permission of program participants.

What can I do if someone I care about does not want help, does not recognize there is a problem and is an adult?

It is a common problem that a person with an eating disorder will fail to recognize that there is a problem and resist recommendations for help. On one level, those with an eating disorder understand that symptoms are destructive but, on another level, there is often panic about the implications of recovery. The motivations in favor and against recovery are usually complex. Try to follow the recommendations below and take a gentle but firm approach to getting help.

How do I talk to a friend or family member who has an eating disorder?

Seeing someone engage in destructive eating patterns is frightening, frustrating and hard to understand. It is common to experience anger, fear, confusion and guilt. Regardless of how much you want to help, it is important to keep in mind that, if the person is an adult, they must make the decision to get professional help. If you are distressed about the situation and do not know what to do, you can seek help from a professional who specializes in eating disorders. You may want to seek advice from a support group like the Eating Disorders Support Network that is a professionally facilitated support group that meets the first Thursday of every month at the River Centre Clinic.

What are the general points I should consider in supporting a person with an eating disorder?

1.	Encourage the person to get professional help. Start with asking them to simply go to a professional who specialized in eating disorders only for an assessment, without making a commitment to treatment.
2.	If the person with an eating disorder is a minor, and you are the parent or guardian. You should insist that the person with an eating disorder get a professional opinion since you are the person responsible for ensuring their safety and welfare.
3.	Do not blame the person with an eating disorder. A person with an eating disorder is trying to solve a predicament or conflict with their symptoms in the best way that they know how. They need understanding, not blame.
4.	Do not comment on weight or appearance. People with eating disorders usually have heard comments about weight or appearance many times before and your comment will either be ineffective, irritating or will lead to a battle.
5.	Do not comment on weight or appearance. People with eating disorders usually have heard comments about weight or appearance many times before and your comment will either be ineffective, irritating or will lead to a battle.
6.	If the person is in extreme danger of death because they are very underweight or they are bingeing and vomiting many times a day. In these cases, you may have to step in and take control by asking a doctor to force hospitalization. However, this rarely is a satisfactory long-term solution since it may further alienate the person with the eating disorder.
7.	Be patient. Recovery from an eating disorder takes time. However, recovery is possible with proper treatment (see section on recovery).
8.	Assure the person that they are not alone and that you love or really care about them and this is the reason for your concern.

How can friends or family members get support from others?

Once a month, the River Centre Clinic provides an excellent opportunity, throught the Eating Disorders Support Netwok, for friends and family members to speak with others loved ones who have gone through the treatment process. The EDSN is a support and educational group that meets at the River Centre Clinic on the first Thursday of every month (except on Holiday or long-weekends, when it is rescheduled) at 6:30 pm to 8:00 pm. to provide parents and other family members the opportunity to gain information about eating disorders and to share experiences with others who need support.

Do family members participate in family therapy?

We enourage family involvement in the treatment. The type and level of family involvement varies depending on the age of the program participant and their family circumstances. Family therapy is one of the cornerstones of treatment for nearly all program participants under the age of 18 or those who are older and living at home. From a practical perspective, parents or guardians are legally responsible for the their children who are less than 18 years old and we work with parents to assist in meeting therapeutic goals.

For program participants who are 18 years or older, we strongly encourage family involvement that may vary in intensity from simply providing information to more intensive family therapy meetings. A key point to our perspective is that neither parents nor the person suffering from the eating disorder should not be blamed. We see eating disorders in families that are otherwise extremely healthy and functional. We also see them appear in families that have other problems. Regardless, blame is counterproductive. 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.