Transitional Living: The Key to Lowering Relapse Rates in Recovery from Eating Disorders?

In a city with limited resources for eating disorder treatment, Thalia House is a hidden gem. Located in the heart of Kansas City, Thalia House is a transitional living facility for women with eating disorders. For those in recovery from an eating disorder who have been discharged from a higher level of care, transitional living is essential. Relapse is very common during the recovery process. The rate of relapse among those recovering from anorexia nervosa and bulimia nervosa are estimated to be between 35 and 60 percent. Furthermore, the highest risk of relapse is believed to be in the first several months after symptom reduction.1 Why is this so? One reason may be because the transition from higher to lower levels of care is too steep. Transitional living facilities, such as Thalia House, may be the answer.

 

Once an individual is released from a highly structured treatment program into “the real world” they often become paralyzed. For most, the degree of supervision & accountability is drastically lower, even if they enter an Intensive Outpatient Program and/or have access to an outpatient team consisting of a therapist and Registered Dietitian. Individuals must plan & prepare their own meals, do their own grocery shopping, hold themselves accountable to getting in all of the nutrients their bodies need to maintain their weight and resisting urges to restrict or purge calories. And they must face all of this amidst the stresses of living everyday life – attending high school or college, working, fulfilling family obligations, raising a family, etc. This is a tall order.

 

Transitional living facilities like Thalia House are the key. Thalia House is an in-between step. Instead of discharging from a higher level of care and being thrust back into “the real world” with minimal support, Thalia House allows their residents to slow down the transition to lower levels of care and work toward being able to live independently while in recovery. Group therapy is held each weekday morning, and the afternoons are left open for academic work, part-time jobs, volunteer opportunities, outpatient appointments, time with friends and family, etc. Thalia House encourages sovereign living while still living in a supportive, recovery-focused environment. All meals & snacks at Thalia House are supervised, and intake is documented, although in a non-intrusive way. More independence surrounding meals & snacks is given as residents progress through the program.

 

One thing that really stands out as a unique feature of Thalia House’s programming is the incorporation of family-style dinners. One resident is assigned to shop for, prepare, and serve one dinner meal per week for the other residents living at the house. Everyone, including a member of the Thalia House staff, sits down to enjoy the meal, which is served at the dining room table. For some, family-style meals is a foreign concept. And for most, family-style meals are met with resistance. The purpose of this component of the program is to challenge residents to tolerate relinquishing some control over food preparation and to learn how to bridge the gap between the food items & portions that are laid out in their meal plan and what they serve themselves. Family-style meals are also a chance for residents to try to develop a level of comfort and ease surrounding meals, which are often an anxiety-provoking experience. Thalia House staff strives to make meals relaxed, enjoyable, and focused on socialization and building relationships.  

 

Transitional living facilities are an essential component of a successful recovery model. Inclusion of these types of facilities in the course of one’s recovery, especially in the first few months after discharge form a higher level of care, may be the key to helping lower rates of relapse among those who suffer from eating disorders.

 

1 F.E.A.S.T.’s Eating Disorders Glossary: Relapse. Retrieved from http://glossary.feast-ed.org/5-psychology-and-therapies/relapse.

 

Celine Goblet

Student - Master of Science in Counseling Psychology, Avila University

Counseling Intern - Thalia House