Monte Nido & Affiliates Trauma Protocol

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Individuals struggling with the aftermath of a traumatic experience require an effective protocol ensuring long lasting results. It is important to specifically ask treatment centers to provide detailed descriptions of their trauma protocol and how they offer this important and sensitive support. At Monte Nido & Affiliates, we offer a clear methodology that will treat trauma patients with care, compassion and practices that work.

Cognitive Processing Therapy (CPT) is the chosen model we use at our locations because it has strong empirical research and outcomes. This type of therapy is manualized but still leaves room for flexibility based on the patient’s needs. Features of this treatment include targeting perceived cognitive distortions and challenging the patient through socratic questioning. This type of questioning allows patients to reach conclusions themselves and promotes inner reflection. Somatic experiences, such as mindfulness and yoga, are incorporated into the program as well, although it is not our direct method for treating trauma. The CPT process is also integrated with other modalities such as Dialectal Behavioral Therapy (DBT), Cognitive Behavioral Therapy (CBT) and Eye Movement Desensitization and Reprocessing (EMDR).

At every location that offers this programming, there is a trained staff member on call. These treatment plans are administered through certified therapists that have undergone extensive training by Dr. Patricia Resick. She has administered national two-day training programs at locations in Malibu, Miami and Briarcliff. Additionally, Dr. Resick continues to check in with supervision calls with the clinicians at our locations to ensure each patient is receiving the best care possible.

Knowing your loved one is struggling with the aftermath of a traumatic experience can be a devastating process and we are here to help ease your pain. If you are ready to take a step toward healing, please visit our admissions page here.

For more information about Clementine adolescent treatment programs, please call 855.900.2221, visit our websitesubscribe to our blog, and connect with us on Facebook, Twitter, and Instagram.


10 Things I’d Say to 15 Year Old Me

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Caralyn is the writer and speaker behind the blog, BeautyBeyondBones. She’s a twenty-something actress and writer in New York City. Having battled a severe case of anorexia herself, she now uses her story of total restoration to positively impact others, and offer hope and encouragement for those with eating disorders, and other forms of adversity. She is currently in the final revisions of an upcoming book, and has plans for another, shortly after! When she’s not writing and acting, she enjoys exploring the city with friends, singing, and living in the abundant freedom of a life, free from ED! Read on to hear some advice Caralyn would offer to her younger self…

You know what I love doing?

Looking back at old pictures from middle school/early high school.

I mean, the fashions, the hair styles, the flip phones, the boys I had crushes on. It is just a blast from the past.

And let’s be real, it wasn’t thaaat long ago. But given every twist and turn my life has taken thus far, it feels like a lot of life has been lived since then.

I developed anorexia when I was 16. And looking back and reflecting on those delicate and formative years, I can see traces of the disease creep in at various points in my adolescence.

I think we all have things on our hearts that -in hindsight- we wish we could say to our former selves. Nuggets of sage wisdom that could have been helpful.

So here’s 10 things I would say, given everything I know now. Things that recovered me would say to a budding young me, on the brink of succumbing to what would be a long battle with ED.

Dear Fifteen-Year-Old Me,

Freshman year can be a pretty scary time. New high school. Older boys. Drivers licenses. Changing bodies. Navigating it can be tough. So here’s a little help…

1. Relationships are important. Invest in the people who know who you really are, and love every quirk and imperfection. At a sleepover, if you can’t wear your retainer or walk around in sweats with them…reevaluate.

2. Mischa Barton from The OC is pretty awesome, but you don’t need a boy to rescue you. And while we’re at it: stop idolizing her body type. You’re not 5’10.” You never will be. And  being waif-thin is not something to gamble your life for.

3. Everyone’s bodies change at different paces. No, your body may not look like your voluptuous friend, but that doesn’t make you any less beautiful, or any less worthy of being loved. Just be patient. Bikinis aren’t everything. And being able to fill out a Victoria’s Secret bikini isn’t the “be all, end all.” Nor is having your ribs show.

4. Boys will say a lot of things. Good and bad. But never let that determine how you feel about yourself. Or how you dress. Or wear your hair. Or who you’re friends with.
5. Knowing the dance to High School Musical is great, but that’s not real life. High school is not idealistic, and boys won’t serenade you like Zac Efron. Don’t expect them to.

6. Don’t dismiss people because they belong to a certain “group.” People are people. And they can surprise you. But you have to give them a chance. And the “cool” table, is full of just people.

7. Getting good grades is important, but not at the expense of your mental health. Get a B. You will be okay.

8. Don’t do the beauty pageant. Just don’t do it. There’s more to you than your outer beauty. Being judged by how you look in a bikini is frankly stupid. You are so much more than that. Oh yeah – and stop going to the tanning bed. Like, immediately. Your skin will thank you later.

9. You are enough. Just as you are. You don’t have to be the lead in every school play. You don’t have to play varsity sports. You don’t have to sit at the “cool” table. You don’t have to get straight A’s. You don’t have to wear a size 0. You are enough. Just by being you. You don’t have to earn your worth.

10. Let people love you. The real you. You don’t have to put on the air of not caring what other people think. You have feelings and emotions, and that’s important. Honor them. Feel them. Share them. Your heart is a beautiful temple. Protect it, but don’t be afraid to show it.

High school is kinda like a big game of poker. Everybody has insecurities. Everybody’s in the same boat, a little bit over their head, just trying to figure it out. And everybody’s trying to put on their best poker face that they’ve got it all together. Spoiler alert: they don’t.
The sooner you realize that you are beautiful just as you are, and that your worth doesn’t come from any of these superficial things, the more abundantly you will live.

Respect and accept your body. Listen to your parents. Stop striving for perfection.

You are enough. Right now.

Love,

Your older and wiser self 😉

 

For more information about Clementine adolescent treatment programs, please call 855.900.2221, visit our websitesubscribe to our blog, and connect with us on Facebook, Twitter, and Instagram.

To learn more about our newest location, Clementine Briarcliff Manor, please reach out to a Clementine Admissions Specialist at 855.900.2221.


Article Spotlight

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Join us in reading inspirational and informative articles we have cultivated from across the web. If you have found an article you feel is inspirational, explores current research, or is a knowledgeable piece of literature and would like to share with us please send an e-mail here.

 

5 Ways to Self-Care During Difficult Times NEDA

Friends of Teens with Eating Disorders Unsure Where to Turn Psychology Today

6 Key Steps to Getting Back on Track after a Relapse in Recovery Angie Viets

Cultivating a Positive Relationship with Food MEDA

Disordered Eating Patterns to be Aware of Among Adolescents ED Hope

 

For more information about Clementine adolescent treatment programs, please call 855.900.2221, visit our websitesubscribe to our blog, and connect with us on Facebook, Twitter, and Instagram.

To visit or tour a Clementine locations with one of our clinical leaders, please reach out to a Clementine Admissions Specialist at 855.900.2221.


Our Clementine Family: Megan Hamann

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megan-hamann-20171Clementine Academic Liaison Megan Hamann has been working in the education field for over ten years. In her role, Megan ensures that the adolescents are able to stay on track with their school work while on their journey to full recovery. Learn more about Megan and her work at Clementine in this week’s “Our Clementine Family”…

What is your name and what are your credentials?

My name is Megan Hamann. I hold a Bachelor’s degree in Early Childhood Education from Asbury University in Wilmore, Kentucky and I also have my Master’s degree in Special Education from Florida Gulf Coast University, in Fort Myers, Florida. I am looking forward to beginning my Specialist degree in Education leadership in the Fall here in Miami.

Please give us a brief description of your background.

Surprisingly, teaching was something I never thought I would do! School definitely was not my favorite thing growing up. However, after a decade of being an educator, I wouldn’t have it any other way! I decided to pursue education, to make it a fun and enjoyable experience for my students.

I have had the privilege to teach in amazing schools, focusing on grades 1st – 6th. I hold certifications in ESOL, Elementary K-6, English 6-12, and Special Education. Having taught in Georgia, Naples, Florida, and Miami, I have had a wide experience in different public school systems, as well as Charter Schools. However, one of the best experiences was teaching at Ada Merritt in Miami – one of the top International Bachelorette schools in the country! I love all the experiences I have had, especially the wonderful students & administrators I have worked with, which has thoroughly helped in the position I hold today!

I began working for Oliver Pyatt Center in 2015 after I was looking to step back from the public school system to spend more time with my children. I started OPC as the English teacher and after a few months of working with the clients, I was asked to fulfill the role as the Educational Liaison. I love to work with the adolescents, parents, school counselors and principals on a daily basis to ensure the adolescents are able to stay on track with their education while they focus on their recovery.

What does a typical day look like for you at Clementine?

Typically, my day begins by checking my email to make sure I can connect the adolescents with the teachers or counselors who have emailed assignments or tasks. On the days I am in the classroom with the adolescents, I check in with them to see how their work load is. We aim to maintain a healthy balance of school work with their treatment. If adolescents are overwhelmed, we cut back, if they can handle more work, we add more. When adolescents first admit, we create a personal plan for each. We look at their work load, course requirement for graduation and the reality of what can be attained during our school hours at Clementine to find the best fit for each adolescent in treatment.

In your own words, please describe the philosophy of Clementine.

Education, as well as recovery, is something that effects the adolescents for the rest of their lives. While their recovery and focus on treatment is the number 1 priority, education is also an important part of their lives as well. Our goal is to maintain the appropriate balance to keep the adolescents on track for graduation, while they focus on recovery. However, this is different for each adolescent that comes in, which is why communication is a key factor in the success.

How does your team work together? How do your roles overlap and differ?

Teamwork is key at Clementine! Education is just a piece of the puzzle that we all bring to the table. Without that piece, there would be a big hole in the picture! As our team brings together information, it is amazing to see how certain parts of the Eating Disorder can affect school, learning capabilities and also social aspects as well. As an educator, I aim to bring my knowledge together with the doctors and therapists to help understand why the school situation is impacting the clients positively or negatively.

What is your favorite thing about Clementine?

My favorite aspect of Clementine has been working with schools and adolescents all over the country! I have learned a lot about the school systems and medical leaves, school & state requirements, and have met so many wonderful people who are also focused on wanting the best for our adolescents. Guidance Counselors and principals play a key role in helping the girls attain success as well, it has been such a joy to work with such caring people!

What are three facts about you that people do not know?

When I was in college, I was a nanny for a family who had four kids under the age of three in SoHo, NYC! That was an experience! I also backpacked Europe after I graduated college with only a couple hundred dollars! My biggest secret is – When I was in college I had a major intestinal surgery that took a year to fully recover from, I know that is odd to share here, but I have seen that it has helped me connect with the girls in a very intimate way. I had to take a semester off my college classes and felt it was the end of the world, however, to get better and recover was actually what I needed. I was able to continue to finish school, I finished just a little later than I first anticipated. However, that ended up being the best thing for me. I love to share this with the clients, so they know I completely understand how hard it is to stop their ‘plan’ for school and focus on the quality & health of their own life. I understand it is hard, but we will work together to get them to a place where they can be successful!

 

For more information about Clementine adolescent treatment programs, please call 855.900.2221, visit our websitesubscribe to our blog, and connect with us on FacebookTwitter, and Instagram.

To visit or tour a Clementine location with one of our clinical leaders, please reach out to a Clementine Admissions Specialist at 855.900.2221.


Article Spotlight

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article-spotlight-pic
Join us in reading inspirational and informative articles we have cultivated from across the web. If you have found an article you feel is inspirational, explores current research, or is a knowledgeable piece of literature and would like to share with us please send an e-mail here.

In Groundbreaking Victory for Eating Disorders Prevention & Treatment, Congress Passes Historic Mental Health Reform Legislation NEDA Blog

The Use of Meditation in Children with Mental Health Issues The Psychiatric Times

Transitioning Back to College after Winter Break while in Recovery Eating Disorder Hope

3 Reasons to Let Yourself Feel Your Emotions Psychology Today

Holidays & Hungry Hearts: Serving Soul Food with Jenni Schaefer & Robyn Cruze Angie Viets’ Blog

Wise Words from 10 Women in Recovery About What Empowers Them to Keep Going Chime Yoga Therapy Blog

 

For more information about Clementine adolescent treatment programs, please call 855.900.2221, visit our websitesubscribe to our blog, and connect with us on Facebook, Twitter, and Instagram.

To visit or tour a Clementine locations with one of our clinical leaders, please reach out to a Clementine Admissions Specialist at 855.900.2221.


Empowering the Healthy Self

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zanita
Clinical Director Zanita Zody, PhD and the Clementine Portland team help clients to empower the voice of their healthy self in order to challenge the eating disorder self voice. In her blog post, Dr. Zody gives insight into how to strengthen the healthy self voice and support client’s journey to full recovery.

Anyone who is intimately familiar with an eating disorder knows how damaging and destructive that voice can be. “You are disgusting,” “I can’t believe you ate that,” “If you don’t exercise every day you will get soft and gross.” This voice taunts and torments in a way that no one should have to endure. For those of you who have held on to hope and seen it first hand, you have also heard the voice of the healthy self; reminding you that there is more to life than the eating disorder. “I know how hard it is to nourish your body but it is worth it,” “your value is not determined by the size of your jeans,” “your friends like you for who you are, not how you look.” Differentiating between these two voices and empowering the healthy self (HS) can be an important part of recovery.

It is widely accepted that Cognitive Behavior Therapy (CBT) is one of the treatments of choice for eating disorders. CBT challenges distorted and irrational thoughts that lead to maladaptive behavior. Reiff and Reiff (1998) found that individuals with a DSM-defined eating disorder think about food and weight between 70% and 110% of the day (dream time accounting for the additional 10%). The voice of the HS can be used to challenge those ED thoughts and behaviors. Initially, this voice may be difficult to identify so it can be helpful for the therapist to point it out. From there, the individual can start journaling dialogues between the HS and ED or engaging in them internally. However it is done, the HS should have the last word.

Fear and uncertainty often accompanies the reduction of eating disorder thoughts and behaviors and in their absence emptiness is often felt. Returning to the eating disorder or other self-destructive behaviors may fill this void. On the other hand, if the healthy self is simultaneously nurtured and strengthened, there will be no room left for the eating disorder. It is also important to honor and respect the eating disorder as it is part of the individual and has served an important function in his or her life. Discovering what that is and allowing the healthy self to take over those responsibilities in adaptive and supportive ways can help lead to lasting recovery.

Reiff, D. and Reiff, KKL, “Time Spent Thinking About Food.” Healthy Weight Journal 12(6) (November/December 1998): 84.

For more information about Clementine adolescent treatment programs, please call 855.900.2221, visit our websitesubscribe to our blog, and connect with us on Facebook, Twitter, and Instagram.

To visit or tour a Clementine locations with one of our clinical leaders, please reach out to a Clementine Admissions Specialist at 855.900.2221.

 

 


A Fine Line: The Intersection of Mental Health and Medicine in the Treatment of Eating Disorders

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Joel JahrausLaurenOzboltClementineBlogClementine’s Chief Medical Officer Joel Jahraus, MD, FAED, CEDS and Medical Director Lauren Ozbolt, MD, CEDS oversee the psychiatric care and attending psychiatrists at all Clementine adolescent treatment program locations. In their writing, they share the many challenges with eating disorder treatment and the broader implications for adolescents and young adults. They stress how accurate diagnosis and treatment necessitate the interaction of a multidisciplinary team including mental health, medical and nutrition.  

I have yet to see any problem, however complicated, which, when you looked at it the right way, didn’t become more complicated.” –Paul Anderson

To say eating disorders are multi-faceted illnesses would be a serious understatement, as any professional in the field would tell you. Not only do treatment teams have to find a balance between their different disciplines when addressing complicated medical and psychiatric issues, but they also face the added challenges of working with patients who are often unhappy about being in treatment, tend to have difficulty trusting treatment providers, may feel in denial of their condition or resistant to treatment, and on top of everything else may face legal or financial barriers to seeking proper treatment. All of these obstacles don’t even begin to cover the myriad of psychiatric and medical comorbidities that typically present in a patient with an eating disorder.

When unraveling an eating disorder medically, we are first encountered with the challenge of discerning whether or not symptoms such as dizziness, tremors, and heart palpitations are the result of malnutrition, dehydration, altered metabolism or from psychiatric manifestations such as anxiety.  Additionally, we also come across co-morbid medical conditions such as hypothyroidism, anemia, and atypical chest pain (just to name a few) that can in turn cause psychiatric symptoms. When psychotropic medications are introduced into the equation, it is important for the team to be vigilant as they themselves can have side effects that can manifest as medical or psychiatric complications. This constant presentation of symptoms that compete for both medical and psychiatric care calls for effective and cohesive clinical integration when treating clients with eating disorders. The underlying illness, whether psychiatric or medical may be challenging to diagnose and one should not immediately rule out the other when complications arise. People with mental health issues often get physically ill; they are not mutually exclusive.

It is clear that there are a multitude of considerations to make when first meeting a client and as promised, the problem is only more complicated when we hone in on any one aspect of the illness. When it comes to evaluation and treatment planning, once again, clinical integration is key. There are several general considerations that we recommend taking into account when first meeting a patient:

  1. Be suspicious- patients may make evaluation more difficult, either by being unwilling to give a full history, unable to give an accurate description of symptoms or too frightened to allow a full physical exam.
  2. Remember that patients with mental illness develop medical problems too.
  3. Be alert for presentations, which make medical illness more likely, but don’t stop considering a medical illness just because they don’t initially fit.
  4. Look for symptoms that make medical illness more likely.
  5. Do not assume a certain symptom “must” be of psychological origin.
  6. Be holistic- note the patient’s feelings and functioning within the current context as well as what happened in the past.

Above all, it is important to be aware of the limitations placed on a patient’s capacity for recovery when looking at a complex illness through a narrow lens. It is crucial that clinicians are acutely aware of the urgency of the patient’s needs, whether medical or psychiatric, and appropriately empathize with the individual to reassure them that you understand their concerns. They need to know that you will you will work to help them feel better whatever the cause.  Integration of the various disciplines involved in the care and treatment of eating disorders takes collaboration. With balance, careful consideration of contributing factors and regular communication, eating disorder providers can successfully help treat their patients in a holistic and effective way.

To learn more, join Dr. Jahraus and Dr. Ozbolt in Tarrytown, NY at the Westchester Marriott on September 15th. RSVP to Professional Relations Manager Jennifer Vargas (jennifervargas@montenido.com).

For more information about Clementine adolescent treatment programs, please call 855.900.2221, visit our websitesubscribe to our blog, and connect with us on Facebook, Twitter, and Instagram.

To visit or tour a Clementine locations with one of our clinical leaders please reach out to a Clementine Admissions Specialist at 855.900.2221.


The Intersection of Mental Health and Medical Treatment of Eating Disorders

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Joel Jahraus
Chief Medical Officer of Clementine adolescent treatment programs Joel Jahraus, MD, FAED, CEDS specializes in medical management of patients with eating disorders. He has been a board certified physician for over 30 years and is a recognized expert on diabetes and the medical complications of eating disorders. Dr. Jahraus shares his experience of treating patients with comorbid disorders. He explains how he uses a systematic approach in order to establish a strong rapport with the patient and then is able to assess and treat the complex case.

Over many years of treating medical complications of eating disorders I have watched an interesting trend of patients claiming to have more and more medical comorbid disorders. In fact it is not uncommon for me to see someone who says they struggle with food allergies, irritable bowel syndrome, lactose deficiency and gluten enteropathy. This creates a complexity that is challenging to say the least. It requires a well-coordinated effort between medical and mental health clinicians to truly evaluate the validity of the medical illness claims and their integration with anxiety, depression and other comorbid mental health disorders as well as the eating disorder itself.

Fortunately relatively definitive and objective guidelines are available to assess each of the comorbid illnesses. Yet too often patients come in either self-diagnosed or without a complete work up and have fully come to believe that they indeed have a food allergy or IBS. In addition there are often family issues related to medical disorders where the individual is told to even expect that they will have these disorders due to family history of the same. Given the typical challenges of refeeding with gastrointestinal symptoms and heightened anxiety this can easily throw the patient’s recovery off course. I have found that there are several caveats that will set the stage for a better-informed patient and family that often mitigates some of the challenges of refeeding. Education is power and food is medicine so I begin with that premise. Then I use a systematic approach to build trust with the patient as we progress through a workup:

1. I validate the patient’s concerns and reassure them that I will be sure to evaluate their physical concerns and help them understand physical versus emotional symptoms and how these symptoms are related to each other. I provide examples of emotional symptoms causing physical illness like stress and anxiety causing high blood pressure or stomach ulcers. I want them to understand that I am not dismissing their symptoms as “just emotional” but rather that finding their true cause will allow us to help them feel better whatever the cause.

2. I review the work up (or lack of one) regarding each condition and then outline what is needed to be complete and have an accurate diagnosis. I also tell them that even if they do have a physiologic medical illness it may well improve with achieving a healthy body weight and maintaining healthy nutrition and healthy eating habits while eliminating eating disorder symptoms.

3. I order appropriate consultations and testing as indicated and review the results with the individual outlining both medical and psychological treatments that will help them including the use of stress relaxation and medical and psychiatric medications whether prescription or over-the-counter meds including nutriceuticals and complimentary therapies.

4. I assure the individual that we will proceed through treatment with regularly scheduled appointments for follow up so they don’t need to worry that they are simply being dismissed.

With this approach I have had significant success in evaluating and treating these increasingly complex cases. We all know how rewarding it can be to have an individual so restricted by the complex medical and psychiatric illnesses associated with eating disorders to suddenly find new life and relief from the burdens of physical and emotional pain and worry!

 

For more information about Clementine adolescent treatment programs, please call 855.900.2221, visit our websitesubscribe to our blog, and connect with us on Facebook, Twitter, and Instagram.

To visit or tour a Clementine locations with one of our clinical leaders please reach out to a Clementine Admissions Specialist at 855.900.2221.