Does treatment at Kartini Clinic work?
Yes. Kartini Clinic’s integrated treatment program, with its strong emphasis on prompt and adequate weight restoration followed by family-centered psychotherapy, incorporates the very latest in evidence-based eating disorder treatment.
What is Kartini Clinic’s “success rate”?
Most patients who do not receive appropriate treatment can expect a re-hospitalization rate of roughly 40%. At Kartini, for those patients who complete our treatment program, including tailored aftercare treatment, our rate is about 10% after one year. But rather than try to convince you with claims of success rates, our primary goal is to explain what we have found to work and why we think it does. In the case of anorexia, we do not want to paint an overly rosy picture of treatment success or “cures.” As anyone who has a loved one with anorexia or suffered from it themselves can tell you, treatment can often be a long and frustrating process. But this process is one that is emphatically not without hope for a return to a rewarding and fulfilling life.
What works (and what doesn’t)?
Successful eating disorder treatment involves a number of factors; some of the most important are listed below. Any treatment program that does not truly incorporate these factors is not – in our professional opinion – delivering the best evidence-based eating disorder treatment.
Recent clinical trials have shown family-centered eating disorder programs to be the best known method to secure lasting remission in children with severe eating disorders such as anorexia nervosa. We practice only family-centered treatment. Parents should not accept substitutes; many eating disorder treatment programs tout themselves as “Maudsley” programs, but to be a true family-centered program it should include weekly family therapy (with the patient) over the entire course of treatment, family-based meals and parent training in how to care for an eating disorder child. The occasional phone call to parents is NOT family-centered treatment.
Because Kartini provides medical stabilization (if needed) as a seamless part of our program, many of our patients get a level of coordinated care unavailable at most other treatment facilities. Most treatment facilities will not accept medically unstable patients; if they do they usually admit them to a psychiatric ward and later discharge them to a separate eating disorder program with an entirely different team of providers that your child must then learn to trust. We believe strongly that this is not the best standard of care for children with eating disorders. Children are not adults and should not be expected to respond like adults in treatment. They require specialized care that is sensitive to their needs. Our patients never leave our care, from the day they are admitted to day when they return to their primary care providers in their own communities.
Weight Restoration First
Without prompt and adequate weight restoration, no amount of psychotherapy will help to secure lasting remission. If your child is in a treatment program where weight gain is not mandatory (or is not occurring after two weeks of treatment, at most), you should find a different program immediately. Never “argue with the illness” Successful treatment, especially in children and young adults, ultimately does not depend on a patient’s “willingness” to be treated when they are in the depths of the illness. Anorexia is a brain disorder.
Eating disorders are brain disorders
Too often treatment programs spend countless hours “arguing with the illness,” that is, trying to convince someone with a brain disorder to behave rationally. This simply does not work.
Physiological and psychological remission is secured through the use of a multi-disciplinary treatment team. While our treatment program emphasizes the medical aspects of eating disorder treatment, this does not mean we fail to address the “whole person.” Our treatment team includes group, individual and family therapists, movement therapists, a hypno-therapist, and a licensed school teacher (for patients in our Partial Hospitilization program aka “day treatment”).
Eating disorder treatment is often required over a number of years; an important focus of treatment is therefore to reduce the level of treatment intensity over time. At Kartini Clinic our goal is to secure lasting results and to limit the most intensive (and expensive) forms of treatment such as hospitalization and 24-hour residential care. We achieve results by first addressing immediate symptoms of anorexia (e.g. weight loss, irrational fear of being fat, etc.) in the controlled environment of the Kartini Partial Hospitilization program (day treatment) while simultaneously teaching parents of young patients how to care for them at home as much as possible. For young adults the goal is to teach them techniques for independent living. Medical stabilization, family therapy and other forms of psycho-therapeutic treatments are designed to gain remission and prevent the need for (re)hospitalization and/or residential treatment. Treatment of eating disorders such as anorexia is complicated, time-consuming and often quite expensive. Kartini Clinic’s program is designed to be clear about the nature of the illness, the treatment steps that are necessary to secure lasting improvements in health, and to minimize the cost of treatment by preventing the most intensive forms of it.