Is Alsana St.Louis/Castlewood closing permanently? I heard this rumor from a peer I was in treatment there with, but haven’t found a public statement. Is Juneberry also closed? It looks like Juneberry was removed from the website all together.

does anyone have any recent reviews? what is their current electronic policy?

I’ve been talking with admissions at Alsana- Does Alsana still do behavior tracking/weekly BCA accountability groups?

I want to say that Alsana saved my life. The treatment team had high expectations as the LOS increased, but they will put you in a spot for ongoing success. I would give them five stars, and I would recommend their treatment to others asking for advice. If you are hesitant but willing to change, Alsana is the place for you.

Any recent reviews for Alsana in St. Louis for residential?
I’m looking for a program that won’t look at my BMI and reject me [for not being as “low”]. I’m very much restricting and exercise obsessed just doing my best to follow my dietitians meal plan but I need more support to stop behaviors. 7 years is long enough.
There aren’t programs in my area for day programs or anything.

Are there any recent reviews?

Could anyone tell me the days/hours of STL IOP?

I was at St Louis location – Hawthorne house for about 8 weeks. I had a good enough experience.

I’ll do a fuller review later but a few things that’s good to know given COVID.

As of Jan 2021- new admissions wear a mask first two week of programming. You can take them off during meals and in your room. It’s annoying but you get used to it. You wear a mask during groups. At meals there are these plexiglass dividers on the table.

You get to keep your phone overnight the first night. After that you turn in your phone at 10 pm and get it back after breakfast. If you don’t turn it in then you don’t get coffee. If you want to keep your phone overnight or get it earlier than you can speak to your team. I was able to have nursing get my phone at weights and vitals so I can speak to my son.

You could have laptops or other electronics. There are no visitors, no outings. They just started doing client creation my last month after stopping for a bit ( this is when clients are able to cook a meal together).

This is MY experience.
St louis, MO
~March 2020
Pros: really good therapy program, really good groups, teach and practice dbt skills, most of the DCs are amazing and understanding, taught me self compassion, no one is forcing you to give up behaviors, a lot of clients so you get to pick and choose those who are beneficial to your process.
Cons: A LOT of clients, understaffed and overwhelmed DCs, nursing was a mess, their refeeding meal plan protocol felt defeating, people were using behaviors at the table and in public areas which may be triggering, people disappearing and self harming, some DCs being unknowingly triggering with comments, I didn’t feel nurtured here but that may be a pro.

I was in PHP for three weeks in 2015 and I absolutely would NOT recommend Castlewood to anyone. On paper, it looks great, but I was traumatized by my stay there.

The good things: The location and facilities (C2 and PHP, I never visited C1) are beautiful, I personally find IFS helpful, I loved being able to keep my phone, laptop, etc., and the person in medical records is nice and very responsive. They also had a great drama therapist, but she left a few weeks after I did.

The bad things: First, my therapist and I both wanted me to go to res, and they would only allow me to come to PHP. They said I’d be more likely to be covered by insurance in PHP and it seems this is a common case. My current therapist recently told me that she had a client who also wanted to go to res and CW wouldn’t even do a review with insurance to see if they could get coverage. Personally, I have been to inpatient, res, and PHP before and after my stay at CW (with the same insurance) and never had problems getting coverage. But it turns out they messed up my insurance verification anyways. I had an HMO, meaning I couldn’t go out of state to MO, which I told them. They said I was covered and I asked them to check again. Again, they said I was covered. My mom (the policy holder) then did a three-way call with them and my insurance company, who said I was covered. After three weeks there, insurance denied coverage for any of my stay. Obviously my insurance company did mess up (I was eventually able to get them to pay for it 100%), but I have never had that issue with another center (I’ve tried to get coverage for out of state programs at least five other times, before and after CW, and was always told I wasn’t covered). I saw many people lose their coverage while there too, much more than I’ve seen anywhere else.

Second, my second meal there was completely by myself. I admitted the night before family week, which they did not tell me about ahead of time, and it was awful. Breakfasts were without staff supervisor and I was staying in one of their apartments without any roommates. People were constantly overlooked during family week- no one so much as asked if we ate breakfast. I walked back and forth between the PHP house and C2 for days because no one told me I wasn’t allowed to on exercise restriction and no one ever noticed that I was doing it (I was not the only one on exercise restriction that was doing it either). Morning vitals weren’t explained to new clients by staff (it’s alarming when people start coming out of their rooms in hospital gowns and start taking their own blood pressure when none of this has been explained). Another client was starting to have a panic attack- which no staff noticed- so she and I went outside and no one even noticed that we weren’t in group until we came back inside at least a half hour later.

Third, this neglect was not limited to just family week. I had a panic attack one day and hid in one of the bathrooms (that do not lock). It took them two and a half hours to find me. Another client even texted me to ask where I was and I told her I was in the house, but it was still another hour before they found me (my panic attack left me terrified of people, hence the reason I was hiding). It is lucky I was only hiding and hadn’t done something to harm myself.

Fourth, Dr.X (name removed) is easily the worst psychiatrist I have ever worked with. We discussed increasing the dose of my medication and she then proceeded to write me a script for the same dose I was already on (and had over a month’s worth left of). I only discovered this a week and a half later after they failed to be able to fill my script and gave it to me to get filled (which meant another client with a car would have to take me to a pharmacy since I didn’t have a car there and staff couldn’t get it together enough to take me). We were supposed to meet with her weekly but I never even saw her one week because she changed my appointment time (there’s a big white board with everyone’s appointments) while I was in group. I left group to go to my appointment and found out she’d already left. She did it to another client too. It would have been easy to pull us from group, but she didn’t bother. I don’t know a single person that liked her or thought she was good at her job.

Fifth, not only do they let people use food rituals during meals, but I saw a staff member doing one once (that involved not eating 100% of her meal). When I told her I was upset by this, she told me staff only has to eat 75% of their meal and ignored that I was upset about the ritual itself. It was also frustrating that they could eat less since people with EDs tend to compare themselves with others constantly. And speaking of food, they weren’t actually feeding me enough. While I was happy about this from an ED standpoint, it was frustrating since I was there to recover, not continue to restrict. I’m also surprised at the amount of exercise they let people do there.

Sixth, the fit with my therapist was not good. After two weeks of painful sessions (for me and surely for her too), I decided to leave because it. It was only then that my dietitian mentioned switching therapists. You’d think my therapist would have mentioned this, but no, it was my dietitian. I did like my dietitian, although she kept focusing on things that I didn’t actually struggle with. Almost three years later and I am still struggle with believing certain things are normal and healthy because of comments she made. It is my understanding that she left CW a few weeks after I did. I, and others, also definitely should have been working with the OCD specialist, but staff just ignored our symptoms. One night a few of us reorganized the kitchen, in front of staff, and they just thought it was great that we were bonding and the kitchen was cleaner. It was sort of a joke to ask people why they weren’t seeing the OCD therapist.

Seventh, the support from staff is inadequate. They constantly told us we shouldn’t caretake each other, but we often did because the staff wouldn’t. For example, I ran out after I meal during posting (talking about the meal right after it) and the only person to follow me was another client. Another time, also during posting, another client (another person they wouldn’t let into res) ran to her room, clearly upset and this time I was the one that followed her. No staff member checked in with her until later, after she went to them because she had self harmed. She wound up leaving CW shortly after because they basically told her to “shape up or leave.” One day I was too depressed to get out of bed (I felt like I couldn’t even move), and all staff did was threaten to take privileges away from me. It wasn’t until after I had missed vitals and two meals that any staff member actually talked to me. I have received must more support in day programs than I did at CW.

Eighth, the nurse that was there was awful. She was sweet, but useless. When I found out I had no insurance coverage, they started processing my discharge within hours. Considering I lived half way across the country and had no further treatment set up, I started panicking. She was the first person I met with and when she asked if I was having suicidal thoughts, I said yes. She asked if I had a plan, and I said yes. She asked what my plan was and I told her. I clearly did not have the means to follow out my plan and she never asked if I had any intent to kill myself (I didn’t; I’ve struggled with suicidal thoughts since I was a kid as a sort of “escape fantasy” when I feel overwhelmed, which could’ve easily been confirmed by my OP therapist). Instead, she wrote an affidavit with direct quotes of things I never actually said. After that, no one would even talk to me about it or listen to what I, and my OP therapist (who I called), they just called an ambulance and the police. I was transferred to a specific hospital because Dr. X (name removed)worked there. Dr. X (name removed) never even saw me there, she just admitted me to a psychiatric ward based on the (incorrect) affidavit. I know for a fact that what happened to me prevented other people from talking about their suicidal thoughts and it left me traumatized. They also wouldn’t give me my medications when I left and the hospital wouldn’t give me any medications when I discharged, so I was left without meds. Thankfully CW did overnight my meds, which meant I only went a day and a half without my medications. I know someone else who wasn’t given her meds when she left CW and they didn’t overnight them, leaving her without meds (including her anti-seizure medication) for days. Apparently this nurse left very suddenly days after my discharge, but she was only one piece of the wrongdoing in my case. The only follow up I ever received from CW was to ask for payment a month later (even though they hadn’t even mailed me a bill…).

Ninth, their system of sharing in groups means you probably won’t share anything for weeks. There is a whiteboard where you write your name on a list and then you have to wait until it is your turn to share. This would be fine in a community of 8 or so, but we had around 17 people. The amount of people also made the community very cliquish.

As I said, on paper, I still think CW looks great, but I would never go there again and would never recommend someone go there. Perhaps it’s different if you’re actually placed in the right level of care as I do know some people who did well in, and after, their program. If you struggle with feeling like you are “missed,” “unseen,” “invisible,” etc., CW is definitely not the place to go, which is ironic considering they say they work on healing attachment injuries.

Location: Missouri (Ballwin)

This is for Castlewood 2 in Ballwin.

When were you there:
May – June 2016

Describe the average day:
Wake up whenever you feel like it, just make sure you are up and weighed by 7:30 or you’ll get a noncompliance. Breakfast at 7:30, group, group, AM snack, group, lunch, group, PM snack, group, dinner, and then free time aside from HS snack at 8:30. You’re supposed to go to your room at 10:30 but they’re super chill and don’t really start pushing you until 11. No bedtime but the night staff will tell you off if she thinks you’re up too late haha.

What were meals like?
Everyone sits together at 3 different tables in the dining room. 2 tables have at least one staff member sitting at the end but the other table is for people who are transitioning to PHP and they eat independently. Everyone eats the same thing but in different amounts. You could be plated at 50%, 75%, or 100%. Most people were at 75% though, you only got one of the others if you had a significant amount to gain or lose. There’s normally an entree, a starch side, a fruit or veggie, a fat, and sometimes a dairy. A few times a week they also plate dessert, though sometimes it’s optional. You get exactly 30 minutes to eat and then you have to drop everything when they call time so you can do what they call Posting, which involves going around the table and saying how you felt before, after, and during the meal and if you need any support. Snacks are way more casual, everyone eats their own thing and can come in or leave whenever they want during that time including if they don’t have a snack scheduled. People sit at one table with a staff and the conversation is way more lighthearted than at meals. 10/10 loved snacks way more than meals for that reason.

What sorts of food were available or served?
The food was prepared by a professional chef so it was really high quality, it just got repetitive and boring after a while. Menus run on a 2 week seasonal schedule so you were always eating the same thing. Most meals were very balanced and rather light, there was a lot of chicken, salad, wraps, etc. Sometimes they tried way too hard to be gourmet and ended up majorly blowing it. Do NOT eat the heart of palm, it was the only meal I ever had there where literally every single client just took a supplement for something. Breakfasts were my favorite (I just really love breakfast food). It was always stuff like muffins, cereal, eggs, and such. Once a week you had a buffet lunch where you had to plate your own stuff with guidance from a staff member and that could be anything. The most challenging buffets happened during Family Week because they would serve typical barbecue food like ribs, potatoes, and pie. One night a week was Family Style which meant you’d have something like tuna casserole and scoop it yourself after a staff showed you how to portion. Another night was Client’s Creation, so 3 clients would create a menu, shop for the ingredients as well as that week’s Challenge Snack, help the chef make it, and plate and serve it to everyone. Then a week later those same 3 clients went with the dietitian and therapist out to a restaurant like California Pizza Kitchen or Buffalo Wild Wings. Almost everyone ended up doing that. Snacks could be fruit, Mighty Shakes, crackers, ice cream, peanut butter, etc depending on your meal plan. Challenge Snack was once a week in the afternoon. Everyone got the same thing and it would almost always be a baked good of some sort.

Did they supplement? How did that system work?
Supplements are looked down upon there. If you have to take one for non completion you have to fill out a form explaining why you made that choice and what you’re going to do next time you’re in that situation. You get 10 minutes after everyone clears to finish and if you don’t you get a non-compliance, which is really bad because if you get 3 during your entire residential stay they will consider kicking you out or sending you to inpatient in Chicago. They will do the same thing if you are consistently supplementing even if you drink it because they think anything except solid food is disordered and avoidant. Castlewood does take people directly from Denver ACUTE however so they routinely get some pretty ill people with a substantial amount of weight restoration to be done. If you need to gain a lot, if your insurance is turning up the heat, or if you go hypermetabolic they will tell you that you can either have 3 Mighty Shakes (which are banana, peanut butter, and ice cream) a day and be plated at 100% or they will insert a nasogastric feeding tube (most people go with the tube). They just put the pump and feed in a backpack and run it during the day. Usually you only have it for a few weeks and the staff are really kind about reassuring you that it isn’t a punishment.

What privileges are allowed?
They give you a LOT of privileges here. You can have your phone and laptop with you at all times as long as you don’t use them during meals or groups. You are allowed to go outside on the balcony whenever you want during free time. You are allowed 2 cups of coffee and 2 sodas (including diet) each day. Once you’re off bathroom monitoring you can sit in the art room without a staff during free times as well. You can smoke on the back patio, and at a certain percent of your IBW they start letting you go for 30 minute walks with a buddy. You can get passes to go to the city with other clients and you go on 2 outings every weekend to the movies, Barnes and Noble, the mall, Starbucks, etc. Every other weekend you have to pay for one of them (but admission is usually free), the rest of the time they give you $15 towards whatever they’re doing.

Does it work on a level system?
They mark levels using bathroom monitoring. You’re on 18 hour when you first get there (so pretty much always), and then bump down to overnights. Most people get to a point where they only have 1 to 2 hours of monitoring after meals. There is a level where you can use the bathroom unsupervised whenever you like but very few people get there. If you do, they also start to expose you to tests of willpower and motivation (a common one is giving you a binge food to keep under your bed and leaving your private bathroom unlocked. It can make or break how fast you get to step down.) As you can tell, C2 gives you a lot of trust and independence.

What sort of groups do they have? Core Group (basically reading miscellaneous assignments), Internal Family Systems, Menu Planning, Psychodrama, Improv Therapy, Meditation/Yoga/Dance (you must be medically cleared), Art Therapy, all kinds of various groups about relationships and self exploration that I can’t be bothered to remember right now, Substance Abuse, Trauma, ED, Nutrition…there was a lot.

What was your favorite group?
Psychodrama. It was so intense but super cathartic and always brought the house closer together.

What did you like the most?
I loved how they treated you like a person and not a patient and really looked beyond the food to see the real problems lurking underneath.

What did you like the least?
The pushiness to be rude and stupid to other patients in the name of “therapeutic feedback.”

Would you recommend this program?
Only if you are extremely motivated to recover, have a lot of money, and have sexual trauma. You will be judged severely if you don’t, which is one of my chief complaints with Castlewood. There’s a very uncomfortable hierarchy of suffering in which patients with DID and PTSD are at the top, and overly detailed war stories of abuse will be recounted. That was one of my biggest problems with Castlewood and ultimately why I decided to sign out AMA. I felt like there was a lot of attention seeking and clique behavior. I would also caution anyone who is LGBT or male to think twice about going here; nearly everyone else, clients and staff, are straight cisgender females and you may be made to feel uncomfortable by patients with trauma.

What level of activity or exercise was allowed?
At a certain %IBW you were allowed to go on walks, do yoga, and take dance classes. A few people who are very underweight (and also people who get the flu or whatever) are put on couch rest and aren’t allowed to move unless they’re going to a meal, group, appointment, or the bathroom.

What did people do on weekends?
Go on pass or an outing, visit friends and family, catch up on homework, therapeutic assignments, sit outside, watch Netflix, etc.

Do you get to know your weight?
Sometimes your team would tell you. People with ARFID were usually the only ones who found out though, if you had any hangups about numbers they would only tell you trends and approximately how much you had to gain.

How fast is the weight gain process?
1-2 pounds a week for most people, a little more if you’re plated at 100% or on the tube.

What was the average length of stay?
Probably 6-8 weeks, though some people only stayed for a month and others nearly a year.

What was the average age range?
From 15 to 60, but most were late teens or early twenties.

What kind of aftercare do they provide? Do they help you set up an OP treatment team?
Most people go to PHP at the house just up the hill, but some go to Birmingham or a program back home.

How many IP beds?
C2 has room for 16 clients at a time. If I recall C1 had 10.

What is the difference between castlewood 1 and 2 and how do they decide where you go I haven’t heard the best things about cw1 but cw2 I hear is great. I have looked for some info on it but haven’t found much so if anyone knows anything I would appreciate it!

When were you there: 2014-2015

How many patients on average? Like others have said Castlewood 1 takes 11 and Castlewood 2 I think roughly 16.

Does it treat both males and females? If so, is treatment separate or combined. Yes and treatment is combined

How often do you see a medical doctor, psychiatrist, psychologist (therapist), nutritionist, etc? You see your psychiatrist 1x week, dietician officially 1x week but they are always around and in groups so you can always grab them if you need them and you see your therapist 4x week

What is the staff ratio to patients? I cant speak for C2 but at C1 it was roughly 5:1, however that is just official staff then you add all the therapists and dieticians that are there throughout the day

What sort of therapies are used? (DBT, CBT, EMDR) etc? They primarily use IFS but some therapists also use EMDR and other therapies. They also do a lot of attachment therapy which I found to be incredibly helpful

Describe the average day: weights and vitals, breakfast, group, snack, group, lunch, group, free time or therapy sessions, dinner, free time, bed

What were meals like? They were decent. They have chefs on the premises that cook all the meals

What sorts of food were available or served? They did a variety. Chicken was served a lot but they also offer bagels, cereal, muffins for breakfast, sandwiches, wraps, salads, sometimes steak etc

Did they supplement? How did that system work? Yes they supplement. If you don’t finish your meal they will supplement you the percentage that you didn’t finish. They use ensure or if you cant do ensure the dieticians will work with you. I’ve seen some people supplemented nuts because they couldn’t do ensure.

What is the policy of not complying with meals? They are patient with you at first but after a point they cant have you just sitting there refusing to eat so if you do it too much they will transfer you to a higher level of care. But other than that every time you don’t comply with a meal you get a non-compliance, 3 non-comps mean you cant go on the weekend outing.

Are you able to be a vegetarian? Yes

What privelages are allowed? Heaps, cellphones, laptops, gum, tablets, coffee

Does it work on a level system? yes, you will start off on level 1 which means you cant go on outings and you will be on 18 hour observations which means you have to be in staff sight during waking hours. However that usually gets reduced to 2 hours after a couple of days and then they will slowly reduce it more and more.

How do you earn priveleges? Complying with the program.

What sort of groups do they have? All sorts – art, expressive, relationships, core, ed, process, life skills

What was your favorite group? expressive group – the expressive therapist is AMAZING. I also really enjoyed core group and ed group and got a lot out of both. Actually I think I got a lot out of almost every group they offered.

What did you like the most? The staff was amazing. They really invest in you and care about you and go above and beyond for every single client. I also really liked the other clients – castlewood really encourages a very supportive community amongst their clients. And I loved the therapy and groups – don’t get me wrong, they were hard as hell but so so worth it.

What did you like the least? The stabilization program.

Would you recommend this program? YES YES YES

What level of activity or exercise was allowed? It depends on each individual. Some girls had half hour exercise privledges, others were on couch rest. Its something you and your dietician will work out together

What did people do on weekends? They still have a lot of programming on the weekends then afterwards people would sleep or watch tv or write things for their therapists or go on outings if they were on level 2.

Do you get to know your weight? NO

How fast is the weight gain process? Each dietician is different but I would guess between 1-2 pounds a week

What was the average length of stay? 3 months ish

What was the average age range? 16+ and honestly I saw all ages. What I did find though was that age really didn’t matter. Castlewood is exceptionally good at helping you to relate to people no matter their age, life experience, race etc

How do visits/phone calls work? You can have your cell phone so whenever you are not in programming you can make calls. As for visits you have to fill out a visitors pass but they are pretty good with allowing visitors to come whenever programming isn’t on. I did see a couple of visitors passes denied but that was because the client was following the program.

Are you able to go out on passes? Yes, once you get to level 2

What kind of aftercare do they provide? Do they help you set up an OP treatment team? They have a great level system so you don’t just go to residential and then home. They have day treatment, step down (like a modified days) and IOP. Before you discharge the discharge coordinator will work with you to make sure you have your team back home set up. They also have an alumni relations coordinator who will follow up with you monthly. Sometimes too, depending on your relationship of course, but your therapist will also check in with you from time to time. Like I said – they really do care.

Basically I would recommend Castlewood to anyone struggling with any type of eating disorder. They will save your life!!!