Case Study: One Young Adult’s Medical Leave of Absence for IOP Eating Disorder Treatment

Case Study: One Young Adult’s Medical Leave of Absence for IOP Eating Disorder Treatment

Est. reading time: 4 mins
Posted Under: Treatment Insights

Clinically Reviewed by: Amanda Fialk, PhD, LCSW, LICSW

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College life can be demanding and for many students the pressure can manifest in new mental health challenges or resurface issues that have been dormant for years.

In the case of Callie*, a former client at The Dorm who took a medical leave of absence from college, what initially presented as a panic disorder was masking a deeper-rooted issue hiding in plain sight: an unresolved eating disorder.

In this clinical case study, we’ll explore how our program’s unique approach to young adult mental health treatment played such a pivotal role in identifying and then addressing the underlying causes of Callie’s struggles, and how proactive adjustments in treatment planning allowed for her gradual return to a fulfilling collegiate life. 

*Callie is a pseudonym used to protect the individual’s privacy.

Background: Choosing a Medical Leave of Absence

When she first admitted to our intensive outpatient treatment program, it was Callie’s crippling panic disorder that had precipitated the leave, a condition that had her struggling to cope with class coursework and day-to-day life. 

It was clear she needed a high level of scaffolding and support right from the start. At admission, she joined us at our highest clinical tier of care (30 hours/week of support) to facilitate stabilization, offer strong structure and the maximum benefit of wrap-around services.

The Assessment Process: Flagging a Co-Occurring Eating Disorder Concern

At The Dorm, we know that how a client presents with us on day 1 often looks different at day 15, 20 and 30. In the first month, our interdisciplinary assessment process is an important time for teams to identify possible underlying and correlated causes of an individual’s symptoms, and to flag potential issues that merit closer observation. 

It was during this very assessment process, that significant insights first emerged regarding Callie’s diagnosis and symptoms.

  • A past history of eating disordered behavior and treatment was noted by the clinical team. 
  • In the health and wellness assessment, our dietetic team noticed Callie’s very regimented language and perspectives on food, eating and snacking, flagging them as worthy of follow-up and observation. 

Adjusting The Treatment Plan 

While Callie’s initial treatment schedule focused on addressing the episodes of panic that brought her to The Dorm, it was the alignment of her therapist, clinical coach and dietetic team that facilitated a necessary shift in the treatment plan. 

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In groups, therapy sessions and in her supported living environment, it became clear that there were patterns and signs of purging and restricting behaviors that had been popping back up as old coping mechanisms from High School. The client had addressed her restrictive behaviors about 2 years prior and did not deem her current behaviors to be “worthy” given the fact that she “was eating” and not “purging on purpose; therefore it must just all be due to anxiety.” 

Working together, her team realized that her symptoms of panic and generalized anxiety were actually being enmeshed with those of a primary eating disorder.

IOP Eating Disorder Treatment: A Wrap-around Approach

With agility and speed, Callie’s treatment team was able to pivot to better meet her needs, alerting outside providers and creating a new plan:

Individual Psychotherapy and Clinical Coaching

In individual therapy and clinical coaching sessions, Callie’s treatment team began to focus more on addressing her underlying eating disorder beliefs, behaviors and habits that were undermining her sense of self-worth, confidence and ability to thrive as an emerging adult. By addressing long-held issues and belief systems at the root, her episodes of panic and anxiety began to dissipate. 

Group Therapy Work

Callie’s new weekly group therapy schedule was adjusted to incorporate sessions such as weekly Body Image Processing and Radically Open Dialectical Behavioral Therapy (RO DBT)

In the Body Image Processing group, she was able to make productive strides to address her relationship with food and set goals in a supportive peer setting that could help hold her accountable. And in RO DBT, she began to work on addressing issues of rigidity that are common in over control (OC) disorders like anorexia nervosa. 

Dietetic and Nutritional Meal Support 

Working hand-in-hand with the entire team, our full-time registered dietitians begin to offer Callie dedicated nutritional counseling sessions and meal support. Spanning meal planning, grocery shopping and meal prep, this level of support also created space for processing difficult emotions that arose during snacks and after-hours meals. 

Because Callie was also in a supported living environment, the team’s accountability measures and wraparound support could be consistent in the evenings and over weekends. 

The Community Milieu 

One of the greatest hurdles for Callie was overcoming her fear of eventually returning to campus social life after her medical leave. Regular exposure to our Dorm community in safe and supported settings like social groups and our Community Clubhouse helped her practice newfound skills and gain confidence. As time went on, Callie began to “go beyond the four walls” of The Dorm, embarking on field trips with peers and fostering new friendships with individuals met through volunteer work.  

The Return to College after a Medical Leave of Absence

Callie’s journey back to full-time school was a gradual and progressive one. To ensure her success, she initially transitioned by taking virtual classes online, allowing her to ease into academic work while tiering down in our program.

From full-time affirming recovery housing at dWELL, an affiliate of The Dorm, she progressed to a transitional living studio and eventually moved into a college apartment where she could practice skills in place before returning to a full class schedule. 

Finally, to maintain gains in her eating disorder treatment, the treatment team coordinated with her on-campus counseling teams and a local IOP specializing in eating disorder treatment in case she needed more structure locally. 

Thriving Independence 

Today, Callie’s story of success is not just that her symptoms have dissipated, or that she is back in college full-time (though each is milestone is momentous in its own right), but that she has rejoined hobbies and activities that she once loved and is enjoying time with friends with a newfound ease and joy.  Her journey stands as a testament to her own resilience and determination in treatment, and to the transformative power of a dedicated team willing to go beyond the surface to support Callie when she needed it most.

Learn more about The Dorm’s Eating Disorder IOP Treatment Approach, Programming and Research Outcomes.

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