Research question (but I'm not a rando gawker! I just don't want to bug my friend!)
Long story short: My BFF/roommate is in recovery from severe, decade+ long AN, and I've been there with her through it. I'm a writer, so she encouraged me to write about EDs because so many of the narratives we get are awful (contribute to stigma, reinforce myths, etc. I'm tired of seeing characters presented like they're stubborn and misbehaving, then they faint and "learn their lesson" and hug it out and are cured. I also think ED stories focus more on the tedious pathologies of illness rather than the FRIKKEN DRAMA of interiority.)
And while I've been there with her through it, I still have a lot of random perfunctory questions -- because I want what I write to be perfectly accurate. Right now, she spends so much time in treatment I don't want to waste her limited leisure time taking notes on the minutiae of treatment -- that time is better spent watching Doctor Who together and talking about which sort of moth we would each be if we were both moths.
This is a fiction piece, and not intended to be educational or didactic. But fiction explores ideas, allows people to empathize with experiences they have never had, or identify with characters whose experiences they do relate to. My goal is to write something that 1) helps people [family, friends] who don't have EDs understand what treatment and recovery is actually like and the experiences of people going through it, 2) makes people who've experienced it think, "That's so accurate! Exactly!"
It would be impossible to tell a good, interesting, well-written story if I wasn't achieving both of the above. And I would be kinda lame if I didn't do ALL THE RESEARCH. Yeah, I know a whole lot. But I don't pretend to know everything, and I'd be lame if I did.
I know that this might be triggering or just exhausting for some people, so people absolutely have the right to not answer. But if anyone is interested in demystifying and generous enough to share, I would be so, so appreciative!!! I'm definitely sourcing my research from a lot of different places, but it would be a huge mistake not to ask a variety of people who can speak anonymously online.
Here are some things I want to make sure I get right:
What staff members are there in Residential? What are their duties? How often are they each around/how often do clients interact with them?
I've visited my friend and gotten to know staff during groups, and of course I know a lot from what she tells me, but I still want to make sure I thoroughly know what the treatment team looks like. Therapists, counselors, nutritionists, nurses. There are also people whose roles I don't know at all, but I know they unlock the bathroom for me.
-Who all is on the team? What are their job titles? What all do they do?
What does a "typical" Residential schedule look like? (Daily, weekly, monthly?)
I know this can vary wildly from Res to Res, but there do seem to be some consistencies (groups, one-on-one therapy, outings, medical stuff, art projects, etc)
-What does a typical day look like? Typical week? Typical month? What's the schedule?
What types of groups are there?
I know it's a whole lotta groups -- I know they can often be taking turns reading from a packet and then discussing that topic. I know groups can be themed to different topics.
-What are the different kinds of groups? What topics do they cover?
If you got this far even just reading, thank you!
I genuinely have so much respect and admiration for people battling EDs. For general health stuff, we think of "recovery" as "taking it easy" -- like when you break your ankle and stay in bed a while watching Netflix.
But with EDs, recovery is going to battle. It's sword-wielding, monster-slaying, epic quest shit. Recovery is courageous.
Anyway. If I were a moth, I would be a peppered moth.
What about you?
Posted Sep 12, 2019, 11:11 AM UTC
Alrighty, I'm going to do my best to answer all of these!
therapists --you were given your individual therapist and you interacted with them at least once a week but definitely more for the first week or two you were there. You also interacted with other therapists because they would run groups or have chats with everyone every now and then. If you needed to, you could request to see your therapist more than once a week after the initial week and if you didn't think you and your therapist were a good fit, you were able to request a different therapist.
Therapeutic Assistant (TAs)--these were the people you interacted with the most. They are basically "glorified babysitters" (they are psych/social work grad students) and are the people that are with you during groups, meals, free time, outings, etc. There are morning, afternoon/evening, and night TAs. You never see the night TAs unless you're up using the bathroom. They're typically wonderful but there's always a few bad ones in the mix. They don't last long.
Nurses--ahhh I loved the nurses. They're very sweet. You interact with them multiple times a day as well. You see them in the morning for weigh-ins/vitals. If you're new, you get your vitals checked multiple times a day. You'll see them for meds and if you need a place to calm down or talk. They'll come draw your blood randomly (that's always fun). They're typically really fun :)
Group Staff-- depending on the day, you'll have different groups and each group has a different staff member (unless it's being run by a therapist) so you'll only see these people once a week. There's DBT, CBT, interpersonal (my least favorite),Art Therapy, Dance Therapy, etc.
School Teacher-- this isn't in every residential place but there was one in mine. She just watched over us as we did our school work and would send in/receive our schoolwork from our respective schools. She would help us if necessary but she didn't do too much, honestly.
Kitchen staff--they make your meals so you see them quite often! You even get to do a few cooking classes with them which is a LOT of fun :)
-you wake up around 7am (I believe). You get your vitals and weigh-ins done then you go shower and get ready for the day (aka, get a shower, brush your teeth, put your sweat pants back on, and grab your blanket cuz it's cold)
-you have breakfast at 8 (you also receive your morning meds) then you come together after the meal and discuss how you feel about the meal and about your internal feelings
-if it's the weekend, you just chill until morning snack/lunch. If it's a week day, you typically have a group or two, and then lunch or morning snack (you only have morning snack for the first couple of weeks, most people opt out cuz it's really hard to eat THAT much in such a short period of time)
-you have lunch around 12 and get your afternoon meds and do the same thing you did at breakfast: talk about your feelings.
-you have more groups between lunch and afternoon snack (likely school and DBT) and then between afternoon snack and dinner, you have something like Interpersonal/Dance/Art therapy.
-You also have something called "sleep hygiene" RIGHT after lunch. It's basically nap time but you can use that time to journal or just chill. You can't leave your room, though.
-throughout the day, you might meet your individual therapist and there's also some moments of free time, especially when groups are cancelled.
-dinner has the same routine as breakfast and lunch.
-after dinner, you finally get your phones!!! You have an hour or two to mess around on your phones, call family and friends, flip through social media, etc. You can't have your phone any other time so phone time is the BEST.
-after phone time, you have dessert/night time meds and then you go to sleep just to wake up and do it all over again :)
-on the weekends, if you're on a certain level, you're able to go on outings which is fun! You go to craft stores (cuz we're all whores for craft supplies, especially yarn and knitting needles), Target, Walmart, bookstores, things like that. They'll even take you out for a fancy meal (think Cheesecake Factory) if you're a high enough level. It's fun but I'm a homebody so I didn't exactly enjoy the outings.
So I sort of described the groups up there. Interpersonal was my least favorite because our residential group was very cliquey (we were all adolescents, I'm 23 now and was there at 16/17). One group always picked a fight with the other group and it was VERY awkward. I also hate confrontation so I typically ended up in the nurses station with a couple of Ativan in my system lol
I hope this helped!♥️
Oh and I was there from January 2013-April 2013, I had my 17th birthday 4 days after I got there :)
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So we could focus on ourselves and our recovery :) we were still allowed to FaceTime and take pics and things like that, so it wasn't really anything to do with privacy unlike the rehab place I was at.
Omg this was soooooo helpful, thank you!!!
You're welcome!! If you have any other questions, I'm an open book :)
Thank you! Are you up for follow ups?For a Res of like 5-10 clients, how many of each position would be employed? And what sorts of hours do they each keep? I'm imagining the TAs have roughly 8 hour shifts since there seem to be 3 shifts. What about the other positions?
Is there someone in a position of top seniority, like a lead therapist or clinical director?
For the nurses, do they have a dedicated nurse office? This is the one part of Res I've never seen, but I imagine it would be somewhat different than a typical doctor's office.
Are outings to stores and things every weekend? Outings to restaurants?
Thank you again sososo much!
Of course, love! Anything to help!
For 5-10 clients, I believe the staff would be cut in half. Each therapist has 2-3 clients at a time, sometimes clients have outside therapists or adjunct therapists come in (I don't know why this happens, it just does) so let's see... The kitchen staff would remain the same since it's already small (I think 2 members). There are about 3-5 nurses on rotation and a head nurse but I believe they would remain the same. There are typically 5-6 TAs at a time (if I remember correctly) so. I'm awful at math 😂
As for the hours, the therapists are in like a normal 8-5 job, 4-5 days a week, depending on whether or not that therapist has an outside office. Nurses' shifts are generally longer, 6-5 but there is always a nurse or two in the building. Night nurses are only there for emergencies or severe cases. I think you're right about TAs but their shifts could be longer or shorter. I know the night shift ends at 6 and that's when the morning shift comes in but the morning shift can last until the next night shift begins. Kitchen staff comes in at 5 and leaves right after dinner. However, if I remember correctly, there are a couple of days where the kitchen staff is gone which is when we learn to make our own meals based on our meal plans. As for the activity runners, they're only around a couple hours on the days they run their activities. Except for the teacher, she's there every day during the week for about 3-4 hours.
So yes, there are superior positions but I might mess up the actual terms. There is a head nurse (Carrie was the one at Veritas, I believe). There is a head nutritionist (I also forgot that there's a nutritionist because I'm a ding bat). I'm not entirely sure if there's a "head therapist" as they all kinda run their own show but I was always under the impression that there was one therapist that was above the others. And then there's the owners of the whole place (Stacey and Chase) who come in every once in a while to talk and meet everyone but in the four months I was there, I met Stacey twice and I think I MAYBE saw Chase one time.
There is a dedicated nurses office! There's the nurses station at the front and then there's a door behind it where you go in to get blood drawn and your blood pressure done and other things like EKGs and whatnot. I believe we all got weighed in the hallway next to the nurses station. And it's much smaller than a doctor's office. It looks like the little room you get a check up in or a nurses office at a school but with more technology.
There's also a separate room where people are held if they're a danger to themselves and others but I never saw the inside of that room lol.
The outings were most weekends! Sometimes they were shopping (never clothes, only things like books or makeup or craft supplies. No food, gum, or candy), sometimes they were shopping and a meal, sometimes it was just a meal. You could only go on these outings once you reached a certain level which you typically reach after about a month or so but there were always special cases where you could go earlier or much later. It took me about a month and a half. You can also get day passes to go out with family or friends but you couldn't go out for meals with them unless it was a special occasion and approved or you were a super high level. And right before you went on PHP (partial hospitalization program), you would have a night pass where you spend the night with your family and then a weekend pass to spend the weekend with your family, to see if you're ready.
I hope these answers helped!!
Any other questions?? :) I love answering questions. It's making me nostalgic for treatment lol
Oh! I'd like to add that when you first get there, and for a while, you're not allowed to use the restroom without the door being open and having a TA check the contents. I didn't get off that level for TWO AND A HALF MONTHS.