Eating Disorder Intensive Outpatient Program

Currently Accepting Referrals for IOP Assessment
Treatment Hours
Monday through Friday
8am to Noon

Electronic Referral Form

Portland DBT Institute is continuing to provide intensive outpatient eating disorders services during these challenging times. We are open and are conducting new client referrals and intakes via HIPAA-compliant Zoom telehealth video conferencing. To ensure the safety of our whole community, all ED-IOP services are now provided via telehealth using Zoom video conferencing, including our groups, weekly individual therapy meetings, meal support, RD nutrition services, and as-needed medication management services, as well as ongoing monitoring of vitals and weight.

PROGRAM DESCRIPTION

Our Intensive Outpatient program is intended to provide a higher level of care treatment option for adults struggling with an eating disorder who also need more support than a typical weekly outpatient therapy service or are ready to ‘step-down’ from a residential or PHP program.  Our program is built firmly on a Dialectical Behavior Therapy (DBT) foundation and is provided in a DBT-adherent setting by DBT trained clinicians. Our providers help plan for the week and the coming weekend and work to understand what is getting the way of the changes clients need to make to follow the path to recovery.

Treatment hours: During treatment hours clients will attend groups focused on acquisition and practice of DBT skills with a focus on eating disorders and will eat 2 meals daily with group members.  Weekly individual therapy will occur during or outside program hours, and meetings with our Psychiatric Mental Health Nurse Practitioner (PMHNP) and Nutritionist will be scheduled during or outside of group hours.  Clients attending the IOP will typically spend 20-22 hours a week at PDBTI.
 

Typical EDIOP Day: The treatment day will be 4 hours, starting at 8am.  When clients arrive, everyone will gather to eat breakfast. Following breakfast, clients participate in about 2 hours of programming. This programming will include:

  • DBT SKILLS GROUP: Teaching group where clients learn the DBT skills
  • TARGET GROUP: Goal setting and implementation group
  • WEEKEND PLANNING/REVIEW: Planning and answering questions such as “What are your goals for the weekend? Which skills and strategies will you use? How did the weekend go in terms of meeting your goals?”
  • MINDFULNESS and SKILLS ACQUISITION GROUP: Offered once per week, this group focuses on a more in-depth study of skills taught during the week and teaching specifically on mindfulness practice
  • NUTRITION GROUP: Psychoeducation group provided by one of our dietitians
  • BEHAVIOR CHAIN ANALYSIS: Group members take turns presenting their own behavior chains to the group. Clients then have the opportunity to participate in problem and solution identification together.
  • DAILY MINDFULNESS: Mindfulness is the foundation of DBT—it is what allows us to be present and skillful in moments of internal distress and pain. Mindfulness is practiced daily after breakfast
  • INDIVIDUAL THERAPY: Clients meet with their individual therapist once per week
  • MEDICATION MANAGEMENT: One appointment weekly or biweekly with a PMHNP
  • NUTRITION THERAPY: One appointment weekly with a dietician
  • 24 HOUR PHONE COACHING: Access to phone coaching anytime with the individual therapist between sessions

Treatment Duration: Typical treatment length is dependent on what the treatment goals are and how effective clients are in using skills and strategies to meet these goals.  Most clients will be in treatment somewhere between 3 and 12 weeks. Our curriculum is designed to complete a full rotation of skills material in 12 weeks.  If the PDBTI IOP is not helping well, we work with clients to find more effective treatment.

Program Graduation and Step-Down: Clients who are ready to graduate from the ED-IOP program at PDBTI will typically demonstrate:

  • Achievement of behavioral goals, usually including reduction or extinction of eating disorder and other identified problematic behaviors
  • Acquisition and practice of DBT skills and principles both during and outside of treatment hours

Upon graduation, clients are invited to attend ongoing step-down programming at PDBTI. This program is designed to support graduated IOP clients in continuing to build their DBT skills mastery and behavioral change trajectory.  Clients engaged in the stepdown program may have the option continue with their established PDBTI individual therapist, or may choose to return to their outpatient community therapist for ongoing clinical work, while engaging in the following:

  1. Group: 1x weekly 120 minute DBT skills group and 1x weekly 90 minute goal setting group.
  2. Medication Management: if clinically indicated, client will continue attending medication management. Session frequency will be determined between client and the nurse practitioner.
  3. Nutrition Therapy: if clinically indicated, client will continue attending individual nutrition therapy sessions. Session frequency will be determined between client and the nutritionist.

WHO SHOULD ATTEND?
The IOP program at PDBTI has been developed to serve members of our community who can benefit from more support than our Standard DBT Program.  It is open to adults of all genders and all eating disorder diagnoses.  Clients under the age of 18/equivalent of high school graduate will be considered on an individual basis.

If you answer ‘yes’ to any of the following, this may be a great fit for you:

  1. Have you been referred to our DBT ED-IOP program by your treatment team?
  2. Do you need extra support to consistently eat meals without engaging in eating disordered behavior?
  3. Are you committed to recovery AND still struggle with stopping your disordered eating behaviors?
  4. Do you struggle with other problematic behaviors which are both separate from and yet connected to eating disorder behavior? For example: substance abuse, suicide, self-harming behavior, or PTSD.

Importantly, please be aware that clients who attend the ED-IOP, will be asked to put outside therapy relationships with psychotherapists and nutritionists on hold for the duration of treatment. Also, clients who seek admission to the ED-IOP program must be willing and able to attend full program hours: Monday-Friday, 8am – noon.

Clients who admit to our program will be required to have regular and frequent monitoring by a physician who knows you are involved in an eating disorder treatment program and who is willing to commit to caring for you for the duration of your time in the program. If you or your physician have questions about what it means to medically treat an individual with an eating disorder, please see the Academy of Eating Disorder’s Guide to Medical Care.

For more information please read our ED IOP frequently asked questions.
ED IOP FAQ 

MEDICAL REQUIREMENTS

We want to make sure that everyone attending our IOP is as safe as possible, so the following are very important indicators that this IOP may not provide enough support:

  1. Medical instability requiring extensive medical monitoring and intervention such as (though not limited to) IV fluids, NG tube feedings, heart rate below 40 beats per minute, very low blood pressure (below 90/60 mm Hg), and electrolyte imbalances.
  2. Poor motivation to recover.
  3. Unable or unwilling to participate in treatment.  Examples of this might be not working to avoid eating disorder behaviors and not attending treatment sessions with consistency.
  4. All meals require supervision during and after to avoid engaging in eating disorder behaviors (such as purging, restriction, over-exercise).

Unfortunately, we are unable to accept clients who are extremely underweight, unless medically monitored weight restoration has already safely begun and close medical supervision continues. We are unable to accept clients who are medically unstable and require hospitalization because of electrophysiological abnormalities, electrolyte imbalances, or other potentially dangerous conditions.

Following admission to the EDIOP program, we require new patients to undergo a medication assessment with our onsite PMHNP.

INSURANCE AND BILLING
At this time, our ED IOP is contracted with the following insurance carriers

  • Aetna
  • Cigna
  • Blue Cross Blue Shield
  • Moda Health
  • Kaiser Permanente
  • Pacific Source
    • Commercial plans
    • Pacific Source Community Solutions (Medicaid)
  • Oregon Health Plan through Care Oregon
    • Multnomah County
    • Clackamas County
    • Washington County

We are actively working to develop contracts with more insurance companies to increase access for our clients.  If your insurance company is not currently contracted with us, you may choose to pay out of pocket for treatment in the IOP and apply to your insurance company for reimbursement at the out-of-network provider rate.  Please call your insurance company to get more information on this option.

The first step in getting started is filling out our electronic referral form.

Electronic Referral Form

For general information about the program, please contact
Charlotte Thomas, LCSW, Path to Mindful Eating program manager.
cthomas@pdbti.org or (503) 290-3277

For registration, insurance, and billing questions, please contact our Intake Team
referral@pdbti.org or (503) 290-3291