Reflections is a hospital-based eating disorder treatment program in northern Virginia, right outside of Washington DC. They offer inpatient, partial hospitalization, and outpatient.
Any reviews? Please post in comments below. You can check out the FAQ and Guidelines for suggested questions. Thank you!
Update: I just called the Reflections intake coordinator and she told me that the program is not contracted with Medicare.
Anything recent? admitting here either tomorrow or wednesday, would love to hear anything about it!
I was here in 2021, and again in August 2023. I left a review of my 2021 stay that you can scroll down and read. I didn’t leave a review of my 2023 stay because I was only there for 1 day and then was transferred to their general psych unit because of an incident that occurred. They said I could come back to the ED unit if I wanted to after I spent a week in general psych, but I felt like it wasn’t a good fit for me at the time, so I signed myself out AMA. I did overall have a fairly good experience there in 2021, but I know it has a new director, is under new management, and has mostly new staff now. Dr F is still the psychiatrist though, and I loved him. He’s one of the best psychiatrists I’ve ever had. Are you an adolescent or adult? I think the program has much more groups and more programming for the adolescents, but they are treated significantly worse than the adults by the people who work there. I think Reflections is a better program for adults, though you do get very minimal groups as an adult. I think they are overly punitive towards the adolescents for minor misbehaviors. For example, when I was there in 2021, some of the adolescents were drawing on the furniture in the adolescent lounge with markers, so not only did they take their markers and crayons away, but they took all of the adolescents furniture away as punishment for drawing on it. They took away all their couches and chairs, and they just had to sit on the floor. I would often see them sleeping on the cold, hard hospital floor because they couldn’t nap on the couches… it felt like a really excessive punishment that didn’t seem to fit the crime. They could have just taken the markers and crayons away, but let them keep their furniture. It does have a new director now, and mostly new staff, so the adolescent side may be better now
Thank you so much for the reply! I will be on the adult side- admitting tomorrow afternoon. Random question- are you able to have comfort items ie stuffed animal/blanket?
No, unfortunately, you’re not
When you get out, if you’re comfortable with it, would you mind leaving a review? I’ve been thinking about going back here, but I know it’s under new management now and has a new director now, so it may be a completely different program than what I experienced
Hi, would you be willing to share your experience?
Please lmk if anyone has newer information. It’s 2024. How is the staff here? Do they care about patients? Helpful with self harm?
Does anyone have a more recent review of this place?
I would love one too! It seems like policies here have changed a few times over the years since they first opened, so I’m not sure what it is like now. It would be great to get a recent one for ED IP and a recent one for ED PHP.
Has anyone had a positive experience here?
I had a really positive experience here! I really liked it, and found it very helpful! I was inpatient from July-August 2021
*trigger warning: suicide
I have no idea if anyone will read this, but I’m begging you not to send your kids here. I was there for months and months, and I think it’s safe to say that this place is abusive. No one cares, not a single soul. I’d say you are treated like animals, but that’d be an insult to animals. I still get nightmares about this place, the only reason I held on and didn’t fail when I tried to take my life MULTIPLE times was because the other patients were going through just as much suffering and they would help. Please don’t go here, I’m begging you.
My daughter was here for almost two weeks in July 2022. It was a terrible experience. We never had a family session – we had one scheduled but when my husband and I arrived the therapist told us our daughter couldn’t join because it was breakfast time. (Then why schedule it for that time??) After about a week, she stopped eating, refused tube feeds and medications. Their approach was to monitor since “we don’t force them.” My 12-year old was allowed to starve herself for X days until we insisted on taking her to ER. The physicians at the hospital couldn’t believe they had let it go on for so long. My daughter was in bad shape and had lost X pounds. She is now in a different facility and the difference is like night and day. We have two family sessions a week, I met with the care team the day we admitted her (something that never happened at Reflections) and my daughter is doing so much better. It’s a longer drive but so worth it.
I’m so sorry about your family’s experience… it really sucks that this is one of the only options for those with Medicaid/Medicare Advantage in Virginia (and probably HMO plans as well). It seems like some people have experiences that are at least better then no treatment but then there are horror stories like your daughters… there needs to be more options in this state. It’s rough everywhere in this country but our mental healthcare/ED treatment system is particularly bad.
So sorry that was her experience but glad you found a place that was a better fit. What was the second place that was more helpful? It sounds like you’d recommend it for adolescents?
Can I ask what’s the name of the good facility.My daughter is doing bad at Dominion hospital and the doctor wants to kick her out . [*TW*]She completely stopped eating and drinking[*END TW*] but the doctor doesn’t care .
Any recent reviews??
I was there in July-August 2021, if that’s recent enough for you. I can do a review if you’d like me to!
Describe the average day:
Elizabeth, thank you so much for this! Would you be willing to do a review of your experience with the trauma program at River Oaks last summer? I’ve been interested in attending there as my ED is secondary to trauma, and would love to hear how it was for someone who was able to focus more on trauma than ED stabilization if possible. Thank you again <3
No problem! I can do a review of River Oaks trauma unit, but I’m not sure it will be very helpful, because I was only there for 7 days. It was last August (August 2021), and I don’t know if you remember or not, but there was a really really bad hurricane in New Orleans last August, since August is hurricane season for New Orleans, and the hurricane happened while I was there, so everyone was discharged early, and sent home. Anyone who was suicidal or was a danger to themselves, was transferred to a psychiatric hospital in Shreveport, LA which was about 6 hours away, so it was farther away from the hurricane, and was safer there. Everyone else was discharged, and went home early. I was suicidal, so I was transferred to the psych hospital in Shreveport, and was there for 4 days, and then was discharged and went back home to Virginia. River Oaks had said they would call me once their facility re opened after they fixed the damage to the building from the hurricane- they said once the building was repaired, they would call me to re admit me to the program, but they never did, and I never heard back from them, and I honestly hadn’t expected to hear back from them, because after even a couple days in the program, they were discussing administratively discharging me because they said my trauma was too severe for them (I have trauma induced psychosis), and they said they didn’t know when they accepted me into the program that I had trauma induced psychosis, and that they can’t accept patients who struggle with psychotic symptoms, and that if they had known, they never would have accepted me in their trauma program. However, I had told them that I struggled with trauma induced psychosis during the intake assessment, so I think there must have been some sort of lack of communication, and the message that I struggled with psychosis wasn’t relayed somehow, so if you struggle with psychosis at all, they will not accept you. I think they accept people with DID and C-PTSD without psychosis though, but I’m not sure. I have C-PTSD with psychotic features, as well as Anorexia. So I can do a review for you if you want. I’m just not sure how helpful it will be, since I was only there for 7 days, before being discharged due to the hurricane, and they were planning on discharging me anyways, because they weren’t equipped to deal with psychosis, so even if the hurricane hadn’t happened, I probably would have only been there for a few more days. I will say though- the trauma side of the unit is absolutely horrible at dealing with ED, even though their supposed to be good with ED’s, they aren’t. I didn’t eat anything at all for X amount of days while I was there (I don’t want to say the amount because I don’t want to trigger you), and I fainted, and when I told them I fainted they just said “Eat more!” And when I explained why it was hard for me to eat because you know, I’m Anorexic, they didn’t understand at all, and said I should just “Eat more”, and they didn’t understand why “I couldn’t just eat”. They also handled me fainting very poorly from a medical perspective as well. I asked to see a doctor, since I fainted, and they wouldn’t let me see a doctor. They didn’t take me to the emergency room, or a hospital. They wouldn’t even let me see a doctor. They didn’t even let me see the psychiatrist about it, and they didn’t even take my vitals after I came to, which they really should have. So, if you have an ED, and want to go to River Oaks, I’d recommend going to the ED side of the unit, and not the trauma side, because the trauma side is not equipped to deal with ED’s at all, and there is zero supervision of meals for the trauma patients, and bathrooms are not locked for the trauma patients, so it is very very easy to get away with behaviors on the trauma side of the unit, because meals are not supervised at all, and bathrooms are unlocked and you can use the bathroom absolutely whenever you want, so unless you are very very far along in the recovery process from ED, I wouldn’t recommend going to the trauma side of the unit at River Oaks, and I’d recommend going to the ED side of the unit. They do have some combined ED/Trauma groups that both sides of the units do together though
Thanks Elizabeth! Many of us will benefit from you sharing your experience at river oaks, but I am sorry that you had so many obstacles during your time there!
Thank you so much! I mean, I’m not saying River Oaks is bad or anything or that you shouldn’t go there. It’s just that I personally had a bad experience there, and they weren’t equipped to deal with the severity of my trauma or the severity of my ED. Unless you are very very far along in your ED recovery, I’d recommend going to the ED side of the unit and not the trauma side, because it’s very easy to get away with behaviors on the trauma side, and meals aren’t supervised at all. And I assume you could still work on your trauma in your individual therapy sessions even if you were on the ED side, and there are some combined ED/Trauma groups, so I assume you could still work on your trauma issues, even if you were on the ED side. Also, if you don’t want to go to River Oaks, I know Rogers has a trauma residential now, as well as their ED and OCD residentials, and Dominion Hospital has a trauma unit. Sheppard Pratt has a trauma unit as well
I’ve been here twice (both forced after being on inpatient psych unit) and it was horrible. They are much more like a psych ward and they treat you like a child. It’s a small locked unit and you aren’t allowed outside. Adolescents are mixed in with adults and that was terrible. They technically have their own lounge but they would always come into our adult lounge and staff didn’t care. It was cramped and I’d usually have to sit on the floor. It was very loud because the adolescents were always screaming and shrieking. You don’t get your personal electronics and phone time is very limited. Food is really simple hospital food. Groups are SUPER basic and not helpful unless maybe it was your first time in treatment and you knew nothing about eating disorders. They are very strict with things like strings and sharps because it is inpatient in a psych hospital. Overall, just avoid if you have absolutely any say.
Can I reach out to you and ask some questions
Ideas of things to answer:
When were you there? summer 2020. During COVID, so I don’t know what things are like outside of it.
How many patients on average? The unit has 10 rooms with 2 beds each, but there were only 6 inpatients when I was there.
Does it treat both males and females? If so, is treatment separate or combined? Yes. Combined.
How often do you see a medical doctor, psychiatrist, psychologist (therapist), nutritionist, etc? Every day
What is the staff ratio to patients? Not sure. It seemed good. And most of the staff are super nice.
What sort of therapies are used? (DBT, CBT, EMDR) etc? DBT, CBT
If applicable: How is the program responding to COVID? (Less patients, virtual programming, no visitors, masks, social distancing, etc) All visiting hours are virtual. Also they are keeping inpatient groups and PHPs groups separate and there isn’t interaction between IP and PHP.
Describe the average day:
– Monday, Wednesday, and Friday you get orthostatic vitals (laying down, sitting, and standing vitals) around 6:30, the remaining days you wake up around 7:00. Depending on if you have a roommate, you can set a shower schedule. You have to take a shower at least every other day, and you can only shower in the mornings.
– People mostly dress in comfy clothes. FYI no drawstrings are allowed.
– You have to be out of your room by 7:30am and then rooms are locked until it’s time to get ready for bed, around 8:30pm after snack. From then on until breakfast, you can do whatever, there are two lounge rooms where you can sit with the other patients.
– Breakfast is supposed to be at 8:00 but it can be a little late sometimes but it usually starts somewhere between 8:00-8:30.
– There are groups like DBT, Mindfulness, and Coping Skills groups in between meals and snacks that are about 30 mins–1hr, also groups like Art/Music Therapy which I liked. You might get pulled for nutrition/therapy/psych sessions too.
– First snack is at like 10:15 or 10:45. Some examples of snacks are cereal (lucky charms, frosted flakes, cheerios, etc), goldfish crackers, a fig newton bar, pretzels, string cheese, peanut butter, etc
– Then more groups/sessions, then Lunch is around 12:30-1:00. Same rules apply.
– After lunch is when you’re given the opportunity to work on school if you have it. If you are an adult, you can have a device during this time. When you don’t have groups or meals/snacks, you can use the unit computer/phone all you want. If you break the rules, like going on an anti recovery website, look up calories, etc, those privileges are taken away for 24 hours.
– At the end of the day, if the weather is nice, you can go outside with an RN to sit and watch the sunset.
– On weekdays, TV is only allowed once all the groups are done with. On weekends TV is allowed all day.
– On weekdays, you have to be in bed by 10:00 I think, but you can stay up a little later and read, draw, or whatever if you want. There’s no “bedtime” but if you’re up really late, like past midnight, they will tell you to go to bed and turn off your lights.
What were meals like? You all go in the dining room, there are several tables with a few chairs at each and you’re assigned a seat, unless you’re moved. On your first couple days, your meals are picked for you, but once you meet with your nutritionist, you get to pick all of your meals and snacks. You aren’t expected to complete all of the food on your first couple days, but you are expected to at least complete the supplement (see below). You get 30 minutes to finish all meals and 15 minutes for every snack. Everyone is also offered 5 extra minutes after meals and 2-3 minutes after snacks. Some RNs are nice enough to give you a couple extra minutes if you are close to finishing. If you finish your snack early, you can leave the dining room, but if you finish a meal early, you have to wait until the allotted time is up. Rules during mealtimes are basically no talk of food, calories, exercise, etc. The obvious things. If they see you using behaviors like cutting up your food in tiny pieces, shaking your leg, hiding food, etc. they aren’t afraid to call you out in front of everyone. So it’s better not to try to do those.
Did they supplement? How did that system work? How did that system work? If you don’t complete a meal or snack they give you Ensure. There is chocolate, vanilla, or strawberry. The portion the supplement according to how much you didn’t finish.
What is the policy of not complying with meals? Supplements. Tube as last resort. Please at least do the supplement. If you refuse it for a certain amount of time, they will tube you. I only saw one person get it and from what I’ve seen, you have it for awhile. It’s not worth it to refuse supplements.
Are you able to be a vegetarian? Yes.
What sort of groups do they have? DBT, Mindfulness, Coping Skills, Art Therapy, Music Therapy, Cooking Group. I think PHP does exposure therapy.
Would you recommend this program? Yes
What was the average length of stay? Varies of course. A lot depends on insurance, unfortunately. They might cut you off earlier than the doctors want. But usually between 2 weeks and 1.5 months. Sometimes less, sometimes more.
What was the average age range? 15-60
How do visits/phone calls work? I think right now it’s like, Tuesday and Thursday there is virtual visiting time from 7:00pm-8:00pm, and Saturday and Sunday virtual visiting is from 2:00-4:30 with a snack from 3:30 to 3:45.
What is the electronics policy? (ex: cell phones, iPods, Kindle, laptop, tablets) Unless it’s visitation or you’re doing school work, your own electronics aren’t allowed. There are like 4 computers and 2 phones you can use. One phone at the front desk and one in in the back computer room.
Are you able to go out on passes? I don’t know what it’s usually like, but there are no passes with COVID.
What kind of aftercare do they provide (Step-downs, PHP, IOP, Transitional Living, Alumni Groups)? PHP, IOP, alumni support groups. I HIGHLY recommend doing the partial program after inpatient, if your insurance lets you. It can be hard to go from 24/7 inpatient care straight to being at home with only outpatient appointments. PHP is 7am-7pm every day and is structured like inpatient, but you get to go home at night. Please do it!
Do they help you set up an outpatient treatment team? Yes
Any recent reviews? Trying to schedule an assessment here.
The people who commented on great this place is must be high. I was there in 2010 and 2012, so it may have changed, but this was the worst TX center I have EVER been in. And I have been in 6 or 7 separate programs. The site director is abusive. That’s not even an exaggerations. I would never suggest this place to anyone.
Change in staff. Incoming didn’t read the chart? Had no idea what our child had been doing, could do, was working on. I demanded that her supervisor sit in and she echoed saying she didn’t feel comfortable meeting without her supervisor. Strange because we arrived for our weekly meeting and there was no supervisor. Never had planned to include one so I got up and walked away. The records indicate that the mother was uncooperative. With incompetence, I’m uncooperative every time because reading the chart and knowing the patient’s triggers should be a given. “He should have told me being forced to face his triggers (in week two) was roo much.” MAYBE THE TEARS AND OTHER PHYSICAL REACTIONS FROM A CHILD OTHERWISE TOTALLY COMPLIANT SHOULD HAVE BEEN A CLUE? I would have pulled him but he liked the other patients and wanted to be with them as he learned to eat better. It was frustrating.
He did outpatient and pick up time interrupted our family dinner time. I’m not sure how that could be solved although I have some ideas. No one ever thought about helping the families heal during meal times while their loved ones are in treatment, I guess. We are all tired of eating and struggling with food.
That was week two. All down hill from there. Sad face.
What happened?
Very happy. VERY happy to end up here. It’s a hard journey for all, you know? We are happy our son is here. Get your struggling family member here and go for it!
I cannot speak to others’ experiences, but I cannot put into words how grateful I am for Reflections. I spent six weeks there about a year and a half ago, and have been progressing in recovery ever since. I found the staff committed, thoughtful, and unfailingly professional. To be sure, not everyone will get along with everyone else, but I absolutely felt there was a team that cared about my wellbeing. Treatment is difficult, and there were certainly moments at Dominion when I was utterly miserable, but a year and a half out, going there was one of the best decisions of my life.
When were you there? I was admitted from March 8th-April 12th 2015. I was 18 at the time and I was an inpatient and a partial patient.
Describe the average day: best described by “Anonn” (Nov 4th, 2015) post above
What were meals like? The food, for “hospital”, was better than one would think. The menus repeated I think every 3 weeks, but there was a good selection. I actually had a favorite dish. They had vegetarian options too.
If you didn’t finish a meal, what happened: people who didn’t finish their meals were given an Ensure supplement drink. The amount depended on how much they didn’t eat. It is consistent and varies from person to person, depending on what each person needs.
What privileges are allowed? I was 18 and medically withdrew from my second semester of college. This was terrifying and extremely hard, but it was the best decision. My parents suggested that I wait until summer, but had I waited any longer, I wouldn’t have been able to stay in treatment for as long as I did (moral of that story- DO NOT WAIT to get help. Get it when you need it). Anyway, I actually decided to withdraw while I was at Dominion. However, before I withdrew from school, Dominion allowed me to use my laptop to get work done for my classes. Of course, I had to get that privilege approved beforehand. During the day, my laptop was kept behind the front desk in the unit. At 7, when partials left, I was able to use my computer for 45-55 mins or so, only for schoolwork, before our evening snack at 8 (I think that was the time)
You could also have visitors- my family traveled 2 hrs to get to the hospital. Due to them being farther away than a lot of the other patients’ families were, they could stay an extra 30-45 mins during visiting time. When visitors came, the staff unlocked different rooms on the unit so that you and your families/friends could have some alone time. This really helped me and I was grateful for the visitors I had.
What groups do they have? Music therapy, DBT, Yoga, Art therapy, “Adult Processing” (school aged patients went downstairs to use the computers there for their schoolwork while us adults stayed on the unit and had a group for 18+), Nutrition, CBT, post meal groups
What was your favorite group? Yoga. Also music therapy, which seemed a little childish at first, but if good songs get chosen, you normally would have a good time.
What did you like the most? I liked the staff’s outward willingness to help me get better. I could talk with them about most anything. These are trained professionals, some of whom have studied eating disorders and other mental disorders for years. They know what they’re talking about. My therapist helped me with issues that I didn’t think I would target during treatment. She literally sat with me when I made difficult phone calls to my parents during our therapy sessions and answered any questions my parents had to keep them in the loop since they weren’t in Falls Church with me.
Also, Dominion doesn’t just drop you when you transfer from inpatient to partial. Because my home was far away, my only option to stay in the partial program was to stay in the Ronald McDonald House of Greater Washington D.C. No joke, it literally smelled like apple juice and love in that house, and it was literally just a huge house for people like me who couldn’t afford hospital bills AND hotel stays. It was $15/day and it included a room for me and my mom with endless amounts of foods in the kitchen and other supplies for the families. I believe there were 7 families including me and my mom. But the RMH is another tangent…I just loved it. You don’t realize how thankful you are for these charities until you’re the one in need.
What did you like the least? I didn’t like how small the unit was. It was amazing that I hadn’t been off the unit, when I was inpatient, for weeks because the place was so small. I hope that they expand the unit. Toward the latter half of my stay, we had close to 20 girls in the program (both inpatient and partial) and the lounge was so full that sometimes there wasn’t enough chairs for everyone to chill in it at once.
What level of activity or exercise was allowed? Everyday, there was time devoted to going downstairs to the rec room or going outside if the weather permitted. There were 3 levels of activity, if I remember correctly, the first was light stretching that had to be on your bottom, the second was walking, then level three was basketball, but normally there was only one person at level 3.
Weekends: the schedule wasn’t as filled as the weekdays. Most of the time, we either watched TLC or a Disney movie and had 4 or so groups. It was nice. I felt kind of bad for the older woman who was in the program with us. I think she just tolerated the Disney movies, but she never outwardly said, “can we turn this off please?”
Do you get to know your weight? No, thank god.
What was the average age range? When I was there, it was a good mish-mosh of ages. Girls 14-18, we had a 12 yr old, and a good amount of adults 18+ (like 5 or 6)
Do they help you set up an OP treatment team? For me, they gave me suggestions about good people in my home area. from there it was up to me, so it was a little difficult to figure out who my insurance covered and who it didn’t while I was in the program. That’s where my parents help. Getting my team back at school for the Fall was on me, but that wasn’t difficult since I started seeing them before I left for Reflections.
How many IP beds? 8
How many patients in PHP or IOP? 9 or 10 when I was there
Would you recommend this program? Yes. Most definitely. I’ve gained friends that I would have never met without this program and we support each other after we’ve discharged, which is nice since we don’t live near one another. I am doing so much better now than I was at this time last year. I’m not saying that Dominion has cured me of my eating disorder. It takes time, but it took tears, tough conversations, strength, and perseverance to get to where I am today. I know that’s a little much for an 8 month time span, but hey, it’s true. Honestly, I treated my time in the program like it was the only chance I would get to receive that intensive of treatment because, well, it was. I probably won’t have another chance to go back to treatment. With that being said, the program was something that my family and I didn’t take for granted. Some girls took it for granted, and they might have been at a different point in their recovery than I was, but speaking for me, it’s what you make of it. I loved the program overall, amidst it’s minor flaws.
7:30 am -Partial patients (which was me) arrive, do assessments;weight check in and symptom check in
8:00- Breakfast, my favorite meal there (often started late bc set up takes a while)
8:30- Post mea; – we had to fill out a sheet with feelings/urges/symptoms/etc…it was effective for some people, I found it useless
9-10 – “Journaling time” which was very very rarely used to journal. I often had to go to the psych techs and ask them to make everyone calm down and take down the noise because it would make me super anxious….alot of us would work on the Washington Post crosswords which was fun.
10:15 – First group of the day..it was either recreation therapy (most awkward and useless), cognitive behavior therapy, or nutrition I believe.
10:45-11:00 – Snack Time (often running late)
11:00 – Group starts…usually art therapy or expressive therapy
12:00 – School age kids go downstairs to classroom with computers and such, adults have “adult processing group” every other day the other days is down time for them. (this ALWAYS ran late, school never happened on time because bathrooms would always happen before school and that took forever)
1:00 – Lunch – most on time meal of the day
1:30-2:15 – Free time
2:15 – Group, CBT, DBT, Nutrition
3:00-3:15 – (always late bc bathrooms) Rec time, go outside (where the fences are as high as a small tree and you feel like a prisoner) or down to the rec room (which we called the armpit) Most people hate rec because they can’t do anything
3:45-4:00- Snack time, again runs late bc not enough staff to set up
4:15-6:00- Free time, spend watching TV (after 5) talking, crafts, computers, puzzling.
6:00 – Dinner (again always late)
6:30-6:45 – Post meal processing (depending on who ran this group it was either really good or meh)
7:00- PHP leave
…The rest I do not know because I was not inpatient..
Weekends were Generally the same..minus that there was usually 1-2 groups(music/yoga/art) instead of 3-4 a day and alot more down time…it was nice if people brought in good movies…or if you had made friends there…not for the ADD people…one girl when I was there could never stop complaining about the down time, I preferred to be bored than in groups.
Ground rules – no phones/computers..no behaviors (you would think this is obvious but we had some major food hiding issues/purging situations/secret exercising), no numbers & food talk
To explain the food more…
Reflections uses the Exchange system, also used for diabetics (which was helpful for my friend who was diabetic there) Exchanges are pretty easy to figure out. 1 Starch exchange is 1/2 cup of mashed potatoes for example or 1/2 cup pasta..likewise 1 piece of bread is 1 starch. Snack starch options are all 1 starch so you would need to get popcorn and pretzels if you have 2 starches for a.m. snack. Proteins were similar but a little more tricky, 1 ounce = 1 protein..when it came to things like yogurt, 1/4 cup cheese = 1 protein 1 yogurt = 1 protein, 1 egg = 1 protein etc., but like bacon was 3 slices = 1 protein (never asked why) The protein servings you get for lunch and dinner (bc it was often baked fish/chicken/some kind of meat were sketchy, sometimes two orders supposed to be the exact same amount were different. With breakfast and dinner too entrees were usually 2 and 2 meaning 2 starches/2 proteins making it easier to count. So cheese ravioli was 2 and 2…or lasagne 2 and 2. Fats were also an exchange category(they all came pre packaged)..1tsp butter = 1 fat..1tbs peanut butter or cream cheese = 1 fat..1 tbs salad dressing = 1 fat..2% milk = 1 fat and 1 milk…oh yeah milk was an exchange and then veggies and fruits, but those were standard and often forgotten about because most people didn’t mind eating those.
Snacks were standard (granola,pretzels,smart-popcorn,fig newtons,cereal..yogurt, cheese, milk…pear, apple) the same choices for each, but you had to choose different options (based on your exchanges)for the morn/afternoon and you chose them in the morning and could not change them again.
Breakfast was always my favorite options changed up usually- omlet (just egg, you can add a protein by asking for cheese which is what i always did), hard boiled egg, sunny side up egg (microwaved not very good), bacon, yogurt (greek or yoplait), pancakes (like once a week and I loved them), bagels & english muffins (offered everyday), waffles, cereal, french toast sticks, oatmeal (you could ask for brown sugar/cinnamon), grits, cottage cheese (rare)…I
Meals for lunch and dinner rotated so lunches were very dinner like in my opinion, as if you went out to a restaurant for lunch kinda. I didn’t mind it..I actually kind of miss it at home when my only options are sandwhiches. Typical options were pasta w/chicken, lasagna, chicken (baked/fried depends on day), burger (garden veggie burger always offered), steak and cheese, turkey, stuffed chicken/fish..starches included potatoes, fries, rice (which was always hard to finish) rolls (worth 2 starches..never understood this)
They did supplement. There was a system. They would always write down what you didn’t eat and what portion was something eaten (like if i finished a couple bites of a burger, 2/3 burger leftover). Then they did some calculation (which I believe to be inaccurate) to give a person ensure plus. Supplements of mighty shakes, ensure plus, ensure clear plus?, and parfaits were used during refeeding as extra onto meals, which was often hard. Imagine eating a full dinner, plus milk, plus 8 oz ensure…it was rough. They did not tube people. There was a girl who came in from the hospital with a tube, but she didn’t have it for long.
You met with a therapist 3 times a week, twice w/family for adolescents (unless given permission otherwise) and once individually..Everyday you see your psychiatrist, which I found absurd considering the second time I was there I wasn’t on medication and did not want to be put on any, wasted time and money. Dietician..depends on how many menus they give you, usually twice a week they would meet with you to go over menu choices for the next few days and talk about increases or decreases (rarely).
Outings are also rare and reserved only to partial patients..the three options are restaurant/grocery store/clothes shopping..You do not choose if and where you go, the team decides (though you can mention to therapist/psychiatrist that you want to go)…Usually 3-4 people go with a therapist and dietician…at the grocery store you choose a fear food to eat for afternoon snack. The other two are what they sound like.
I went through the Reflections program twice. The first time I stayed for 8 weeks. I was severely underweight when I went in..gained 2-3lb a week. The goal weight for me (which I only knew because my mother told me) was highly argued about b/w my therapist/psychiatrist/dietician. My psychiatrist (the only one with a medical degree) agreed with my mom in that the weight was WAY too high. I am 5’2″ and they wanted me up to a point that was almost overweight. Alot of this contributed to problems in my recovery once I left, I was very uncomfortable with my weight in a non-ed way. I think this was a major factor in my relapse only 5 months later…My therapist also forgot about me alot while I was there and hardly had anything good to say..The therapists in general were either hit or miss. some were great some were meh. The psych techs and nurses actually provided better “therapy” to me than my therapist. When I left I felt like I was pushed out. I was not ready at all, but they wanted more space to bring more people in (more $). I discharged on the same day as 3 other people…felt like they were just kicking me out.
The second time I went I was only there for 4 weeks because I had to go back to school. I was very defiant this time around, showing up late every day ( with zero repercussions), not talking in groups, never filling out my morning/night sheets, but I did finish all my meals. The therapist I got the second time was wonderful (my outside team requested her through the program director) and really wanted me to succeed, but she could tell my mind wasn’t in the right place. The weight disagreement happened again b/w my team and my psychiatrist fought for the lower number because she didn’t believe the dietician was really considering my height when calculating. An agreement was set on my weight, but they still overshot me and had me drinking 2 ensure plusses a day when I left (usually they are able to take off supplements when you leave)…The weight issue and still having to drink supplements really messed me up when I discharged.
I did not get pushed out like the previous time (probably bc I explicit mentioned how much that upset me in sessions), but I definitely did not feel ready. Unfortunately like any treatment facility, you are kind of in a bubble away from the real world. I cried both times I left, mainly because I was scared, felt unprepared, and didn’t want to leave the friends I made there.
Overall I really do think the program is good at supporting people. They have a staff (well most of them) that really cares and wants to help. If you put aside the fact that yes you are eating hospital food, meals are pretty good/rules are fair. Unfortunately the groups do get repetitive and I think that is where a lot of people’s progress stagnates…after going to the same group 4 times, how much more can you work on it. A lot of my problems there came from lack of self motivation to get better, and I have actually considered going back a third time despite my eh experiences. I think that anything is possible there with the right mindset…the most successful people I met there were the ones who really wanted to change their lives. If anything else, the program director really knows what she’s doing, the execution is just sometimes a little less than perfect.
THIS IS A TERRIBLE TREATMENT CENTER! It’s basically a hospital and they don’t consider your opinions or preferences. They will make you stay as long as possible. The staff is uneducated and useless. It didn’t help me one bit. I learned more tricks there. I relapsed quickly and it’s just plain bad. Don’t send your kids here! The nurses are very forceful and strict. I was lied to a lot. You don’t do anything. The groups are pointless and boring. You do get to go to restaurants but that’s only like once a month and not everyone. It’s mixed with teens and adult which is not the best (there were a lot of conflicts). They only care about the money! WORST PLACE TO SEND YOUR CHILD!!! THEY ONLY CARE ABOUT WEIGHT GAIN! I gained about 4-5lbs a week!
Do you have any other specifics about what groups they offered? Types of meals/food they offered? Were you allowed phone calls or computer privileges?
Thanks for offering info!
POSTED ANONYMOUSLY:
When were you there?
March-April 2015.
Describe the average day?
General Schedule Monday-Friday:
6:00~ Inpatient vitals/weights (Inpatients can go back to sleep, shower, do whatever until PHP arrives)
7:30 ~PHP arrives/PHP weights/ Rooms closed for inpatients
8:00~ Breakfast
8:30 ~ AM Community Group/Post Meal
9:00- 10:00 ~ “Journal†time aka free time
10:00 ~ CBT, DBT, Emotional Intelligence, or Expressive Therapy
10:45 ~ Snack
11:00 ~ Expressive Therapy, CBT, or DBT
12:00 ~ Adolescents go to school, adults stay on the unit for adult processing (Mon, Wed, Fri) or “self-reflection†aka free time (Tues, Thurs)
1:00 ~ Lunch, occasionally post meal afterward when they remember
2:15 ~ Nutrition (Mon, Wed, Fri), Processing (Thurs) which basically means open floor discuss anything that’s bothering you or the group, or CBT (Tues)
3:00 ~ Recreation time (used to be called Fitness time until somebody complained) based on level system
3:45 ~ Snack
4:15 ~ CBT, DBT, Nursing (usually some type of game or art activity that is just a way to kill time), or Music therapy
5:45~ Dinner
6:30~ Wrap Up Group/Post Meal
7:00~ PHP leaves
8:00~ Inpatient night snack
10:00~ Inpatient lights out
Weekend Schedule
Note: Weekends are AWFUL- it’s basically sit around doing nothing but eat all day
6:00~ Inpatient vitals/weights
8:00 ~PHP arrives/PHP weights/ Rooms closed for inpatients
8:30~ Breakfast
9:00 ~ AM Community Group/Post Meal
9:30- 10:00 ~ “Journal†time aka free time
10:00 ~ Social Work Group (Sat)
10:45~ Snack
11:15~ Yoga (extremely gentle, mostly seated, only on Sat) or Social Work (Sun)
12:00~ Free time
1:00~ Lunch, sometimes post meal
1:30~ Music therapy (Sat) or art therapy (Sun)
2:15~ Free time
3:00~ Recreation time
3:45~ Snack
4:00~ Free time
5:45~ Dinner
6:30~ Wrap Up Group/Post Meal
7:00~ PHP leave
8:00~ Inpatient night snack
11:00~ Inpatient lights out
What were meals like?
You had 30 minutes to complete your meal plus 5 extra minutes of overtime if you needed it- though if you used it too much then they would take away that “privilege†from you. No food talk, not even positive food talk such as liking the taste of something. There were a lot of rules, too: No peeling the whites off your orange, no mixing of anything (no milk or peanut butter in your oatmeal, nothing dipped in your yogurt, etc.), no peeling off the skin of anything (chicken skin, fish skin, and potato skin included). Meal plans were based on the exchange system and everyone’s meal plan was different- if you were on weight gain most likely you got a supplement with your meal or snack, although some people chose to have all the requirements in food which always ended up with them having truly enormous meals and snacks. You were allowed to be vegetarian. Food truly sucked- it was hospital food, and crappy hospital food at that. Breakfast had your standard options (English muffins, bagels, bakery muffins, croissants, biscuits, Danish, donuts, oatmeal, grits, cream of wheat, cold cereals, peanut butter, eggs, yogurt, bacon, sausage patties and links, veggie sausage patties, assorted fruits, milk). Lunch and dinner were assorted entrees that rotated on a 3 week basis which meant that every 3 weeks like clockwork you’d be having the same menus all over again. Some entrees were beef empanadas, stuffed chicken, veggie burgers, veggie and meat lasagna, ravioli, pizza, tacos, deli sandwiches, baked (rare) and fried (very common) fish, baked chicken with whatever sauce they decided to stick on it, etc. Lunch and dinner starches could include dinner rolls, wheat bread, mac and cheese, mashed potatoes, rice, couscous, taco shells, chips, potato salad, French fries etc. Fair warning to all: almost everything is fried and/or cooked in tons of oil, even the stuff that says “baked†on the menu- even the cooked vegetables they serve are served in a soup of grease and frankly it’s revolting. The baked chicken is a good example- it’s always super oily and if you deal with reflux or heartburn you’d better stock up on Tums before you get here.
Did they supplement? How did that system work?
They supplement based on the percentage of what you did not complete, For example, if someone ate 50% of their entrée they would calculate the calories missed and give the appropriate amount of Ensure Plus to replace it, rounded up to the nearest ounce. It’s a fair system usually except that the smallest amount of Ensure Plus given is 1 ounce, which you can get if you don’t complete (for example) 1 slice of an apple, or a bite of bread, which is completely inequivalent. If you were on weight gain most likely you’d have a supplement, which could be a yogurt parfait, Ensure Plus (vanilla or chocolate), a Mighty Shake, Carnation Instant Breakfast, Ensure Clear, or Ensure pudding, with amounts varying based on your individual meal plan.
What privileges are allowed?
Basically nothing. Inpatients get to have visitors some nights, use the computer and phone occasionally. There’s a lot of favoritism.
Does it work on a level system?
No. Everyone does the same thing as everyone else.
What sort of groups do they have?
It’s all the same. The groups are extremely repetitive, especially if you’ve been in the program for over 3 weeks (which is extremely likely unless you have insurance issues).
What was your favorite group?
None. They were all useless and were basically used as time killers. If I had to choose, it would be processing because it was an open floor group and everyone offered support and suggestions to one another which was really productive and positive.
What did you like the most?
I hated this place. The program always has one patient that the whole staff picks on, and that patient was me. It got to the point where I was under so many rules and restrictions that the other patients actually began to stick up for me and complain about me being treated unfairly compared to how the other patients were treated. It was awful and I got out of there ASAP.
What did you like the least?
They seriously think that everything is about food and weight. They set all goals by weight and they are extremely inflexible about everything. If the kitchen is out of the snack that you picked you were given anything that they chose, no substitutions. I was once given Raisin Bran when I have despised raisins since I was a baby because they were out of what I’d asked for, and they supplemented me rather than let me eat a different cereal. They honestly don’t care about what your struggle is, they just want to do things THEIR way without regard to your privacy or preferences, and if you don’t want treatment THEIR way, then you can leave- which I gladly did.
What level of activity or exercise was allowed?
Very rarely there was yoga, but most of the time it didn’t occur. You have to be seated 24/7 and if you are caught standing you get a strike- 3 strikes and you lost recreation time. Recreation time was on a level system: level 1 is seated stretching, no getting off your butt. Level 2 is slow walking, and level 3 (which is very rare) is playing basketball/shooting hoops.
What did people do on weekends?
Sat around and did nothing.
Do you get to know your weight?
No
What was the average age range?
It varies constantly but when I left most people were either 14-18 or 22+.
Do they help you set up an OP treatment team?
It seems they do this with the adolescents who have parents who are pushing the doctors to give them referrals. For adults like me, we mostly just got sent out to figure it out for ourselves.
How many IP beds?
8
How many patients in PHP or IOP?
They say the max is 7 but that’s a big fat lie. At one point there were 17 PHP, 8 inpatients, and absolutely no place to breathe. We were literally crushed together everywhere and half of us had to eat in the kitchen because the dining room was too full. On average there are about 12 PHP.
Would you recommend this program?
NO WAY. Not if my life depended on it. That place was a nightmare and I would never wish anyone to be subjected to such an unproductive, punitive environment that focuses entirely too much on food and weight and entirely too little on how to actually stop using your eating disorder as a way to cope. I was in a constant state of misery and boredom and I will never again return to that torture. Evidence for why this program doesn’t work? The majority of patients there are “repeat offendersâ€; that is, they completed the program and then relapsed in a relatively short period of time (within 2-3 years) and then returned to the program, rinse and repeat. If that doesn’t convince you not to come here, I don’t know what will.
Very mediocre program, I just discharged from there and am definitely not even close to being “cured” from my eating disorder. What specific questions do you have?
Could you answer the standard review questions, especially talking about schedule (timings, groups, meals, etc), how often do you meet with you team, foods available, passes/freedom/outings, are you allowed to have laptop/cell phone, have time for classes even if you are in college and not high school, and any other offerings (massage, yoga, walks, etc.)?
Thank you!
PS Are you allowed to leave when you feel ready/ feel like the program isn’t helping or are they going to try to force you to stay or tube you or something?
-Typical Monday-Friday Schedule for Partial Patient
7:30-7:45am: Weights/Vitals
8:00: Breakfast/Post Meal After (everybody agrees, pretty useless)
9-9:30: Journal (Nobody actually does, this is free time)
10:15: Social Work Group
10:45: Snack
11:15: Expressive Therapy
12:15: School for Kids, Nothing for adults
1:15: Lunch/Post Meal After
2:00: Nutrition, DBT, or Social Work
3:00: Fitness (diff levels, 1 only stretching, 2 light walking, 3 basketball)
3:45: Snack
4:15: Expressive, Nursing, or DBT
5:45: Dinner/Post Meal After
7:00: Leave
Blood work once per week. No passes if you are inpatient. If you are partial and showing progress, they do give half days and days off
-You meet with a psychiatrist every day for like 5-10 minutes, and a social worker 2 times per week for therapy. For the social worker sessions, one of those days will be family therapy, the other day individual therapy. Group are VERY basic and repetitive, like previous posters stated, those not new to the eating disorder world will be bored and not learn any new coping or self-help skills. Most people fall asleep in groups. I saw Reflections as a bubble to escape my symptoms; I wish that I learned something earth-shattering about myself and my disorder, but they did not challenge me, just contain me.
-This is NOT a nurturing place; if you cry, you are separated from the group and told to stop. I never did, but witnessed several people being emotional, as treatment is, and being chastised. Also, you are not allowed to hug other patients, hugging is prohibited and you WILL 200% be yelled at by nurses if you hug another patient. If you break rules because your eating disorder is severe, be prepared to be kicked-out, they show no sympathy in symptom use even if you are obviously miserable and begging for help.
-As far as ages go, it cycles, but is mostly adolescents. There were a couple of middle-aged folks there, but mostly 12-14 year old being forced in by their parents.
-Food. It’s typical hospital food. Not horrible, not the best. Stay away from red meat there, it looks like dog food. You do have a lot of flexibility in choosing what you want to eat, which is nice. Meals include gardenburgers, lasagna, sloppy joes, quiche, pretty much “normal” food. Dessert one or more times per week.You have 30 minutes to complete your meals, crumbs included, and 5 extra minutes if you need it. Whatever you do not complete will be supplemented with Ensure. They were consistent and fair with that.
-Bathrooms ARE locked and you are not allowed to flush, no exceptions. Staff checks the toilet every.single.time. Even if you have never purged in your life, you adhere to this rule. Quite demeaning, but you get used to it.
-No tubing. They shove you out if you are not following rules, no goodbyes, just pack your bags, you are on your own. I certainly feel that they would allow discharge if there is not progress.
Like I said, overall this is a very mediocre program. Some staff are dedicated and kind; a couple of “higher up” staff members are quite obviously more concerned with their image and the image of the program versus the actual patient and WILL treat you in a condescending manner, despite your age, education level, etc. I have an outpatient team of top providers in the DC area and they were not impressed with what I’ve told them, thus far. One actually told me not to waste my time at Reflections before I was admitted, and unfortunately now I agree with that opinion.
Can anyone provide a recent review? Thanks so much.
The last two reviewers must have REALLY been trying to find a silver lining in this place. It is the worst place ever (except Hopkins and SP).
When were you there?
Just left.
Describe the average day?
The whole schedule focused on food. Every time we ate, we had a group after…where everyone talked about food and nothing else. Sometimes the schedule didn’t even get followed if certain people were on staff that day. WAAAY TOO MUCH DOWN TIME!!!
What were meals like?
Sucked. Hospital food. You get to pick from a menu, but people’s meal orders get messed up a lot. You have to eat the food you get even if it isn’t what you ordered. They told one girl who was a vegetarian that she had to eat meat even though they told her at first that she could be a vegetarian. Sometimes they bring in random foods like Mexican and Italian and you have to eat it even if you don’t like it.
Did they supplement? How did that system work?
This isn’t consistent. Sometimes I saw a patient getting a whole can of ensure after she didn’t eat one of her sides, but another time a girl refused her whole meal and only got like half a can.
What privileges are allowed?
Basically nothing. You get to have visitors some nights and maybe use the computer some nights if the staff like you. There’s a lot of favoritism.
Does it work on a level system?
No. Everyone does the same thing as everyone else.
What sort of groups do they have?
It’s all the same. Everyone talks about the food they just ate, and nothing else. Sometimes we had nutrition and the dietician showed us how to make a meal, but it would usually be something that everyone already knows how to do like boil spaghetti and throw some sauce on it.
What was your favorite group?
Nothing. They were all useless and just talked about food.
What did you like the most?
I hated this place with everything in me.
What did you like the least?
They seriously think that everything is about food and weight. Even if you’ve never been underweight and don’t want to lose weight they think you do. They set all goals by weight and when they do the discharge planning they tell you, “You need to get treatment if your weight drops below X.” They saw no connection that I needed treatment for reasons not related to weight, and that I’ll probably never be down to X.
What level of activity or exercise was allowed?
Very rarely there was yoga, but most of the time it didn’t occur.
What did people do on weekends?
Sat around and did nothing.
Do you get to know your weight?
No
What was the average age range?
It’s mostly high school girls 14-18. Not too many adults.
Do they help you set up an OP treatment team?
It seems they do this with the adolescents who have parents who are pushing the doctors to give them referrals. For adults like me, we mostly just got sent out to figure it out for ourselves.
How many IP beds?
8
How many patients in PHP or IOP?
7
Would you recommend this program?
Like the others said, it beats Hopkins and SP all to pieces. If you have to get treatment and are local, this is the lesser of the evils. Wouldn’t say I’d recommend it though.
The last reviewer laid things out very well, but I’d like to add a few things since I was there just last month:
1. They have solved some of the problem with too much free time. I think they got a lot of feedback on that from past patients. But all the groups are still mostly the same over and over again, and that is especially hard because everyone is in the lounge all day for nearly every group and also during free time. The only exceptions to this are meals, expressive therapy (in the art room), nutrition (sometimes held in the kitchen), and meals (in the dining room). Or if you’re still in school and need to use the quiet room for school work.
2. When I was there, there were more adults than adolescents. I’m sure the patient population is always changing, but when I was there the community was exactly the opposite of the reviewer’s experience. Just over half the patients were 21 and over. But I know other people who have been there when it was all adolescents.
3. About the staff being caring, it really depends on who you get. Some of the nurses don’t know a whole lot about eating disorders. The therapists are really good and so are the dieticians. I second what the reviewer has to say about the therapy being simple though. I don’t think most of them know how to deal with someone who isn’t “new” to the eating disorder world.
4. Since the reviewer didn’t know much about the supplementing, I’ll add my experience. If you refuse the entire meal, you have to drink 12 oz. of Ensure Plus. If you eat some but not all, you get a smaller portion of that. I think it’s 6-8 oz. if you refuse the main part of your meal and less if you refuse side dishes. You have the option to order dessert but it’s not required. But if you order it and then decide you don’t want it, you will be supplemented for it.
Other than that, I agree with everything the last reviewer said.
Sure thing. Here’s my full review. Some of the aspects I didn’t pay attention to as fully as others while I was there. Sorry for the lack of info in those parts.
When were you there?
I don’t want to say specifically because I really want to remain anonymous, but I will say that I was there within 3 months of this post.
Describe the average day?
Wakeup and vitals, sometimes a community group, meal planning, breakfast, group, morning snack, personal time, lunch, group, sometimes another group or two but usually personal time (and homework time for adolescents), afternoon snack, sometimes yoga, dinner, group, personal time, evening snack, personal time. You also have individual meetings with therapist, physician, psychiatrist, dietitian, and/or social worker. I have heard that the schedule has changed slightly since I was there, but I don’t know how specifically. Hopefully it now has less downtime.
What were meals like?
In the dining room with staff. Small tables, 4-5 people. The food isn’t that great, but it’s not horrible either. It’s middle-of-the-road, hospital fare. While I was there, I ate a variety of foods: sandwiches, wraps, pasta, salads, stir fry, etc. All meal plans are individualized, and each day you do have a few choices in what you eat. It’s based on exchanges. The dietitians take personal food preferences and dislikes into account. If you’re ready for it, you can choose all your own foods. They accommodate vegetarianism, but not veganism.
Did they supplement? How did that system work?
This is one of the parts I’m unsure about because I never received supplement. I know they use ensure plus, but I’m not sure what the proportion is with regard to how much food you don’t eat. I also know that if you refuse supplement continuously (probably 3-4 consecutive meals), you will be asked to leave the program.
What privileges are allowed?
Not much. Visitation from family and friends twice a week in the evening, phone and computer privileges in the evening if your therapist approves. That’s about it until you get to partial and are going home at night.
Does it work on a level system?
Not really. They’re making an effort to make the program more individualized since it’s so small, so there aren’t levels. You and your treatment team determine your needs in terms of food and other forms of support, so many things are different from person to person.
What sort of groups do they have?
Nutrition, process, community, social work, art therapy, yoga. Process, community, and social work all end up being the same thing over and over again though. Very basic. As I mentioned in my last post, it’s hard to have a meaningful conversation here in the groups if you’ve already been through a lot of treatment and know your issues fairly well. Things tend to stay on a really simplistic level. Sometimes yoga doesn’t even happen. Nutrition also ends up getting boring pretty quickly.
What was your favorite group?
Art therapy. I’ve been to much better art therapy groups before at other treatment centers, but at least this group was different from the norm and gave us the chance to be creative.
What did you like the most?
The caring staff. They’re very understanding, but they also don’t mollycoddle.
What did you like the least?
This program ends up drawing a lot of teenagers and a lot of people who are entering treatment for the first time. I felt as though I was the only one giving feedback in some groups, and I really didn’t get that much meaningful feedback from anyone else. I was able to use the time in treatment to focus on being physically well, but because of the place I was at personally when I entered Reflections, I felt the need for something deeper. I ended up feeling like most of my time there was devoted to supporting others in their recovery–my needs weren’t always met. Having that said, this is a great program for someone who is receiving treatment for the first time.
What level of activity or exercise was allowed?
Yoga and maybe a walk or stretching if approved by your treatment team.
What did people do on weekends?
A TON of downtime. I drove myself crazy on the weekends. One or two groups, meals and snacks, the usual in that respect. Sometimes we watched movies.
Do you get to know your weight?
They don’t like to tell people their weights. Depending upon your dietitian, it’s more likely that you will get the option to know your weight if you are not on weight gain and knowing that number is not triggering to you. I’ve always been around the same weight, I came in knowing that weight, and my weight is normal. In my case, they told me if I asked. But I know this isn’t the case for everyone.
What was the average age range?
Young. Probably 13-18. There are some adults, but never many. I’m in my late twenties, and this was so difficult for me. I found it very hard to relate to the high school aged patients. At one point, I was the only person over 18 in the entire program.
Do they help you set up an OP treatment team?
Yes. They’re great with referrals, and my therapist went the extra mile to help me find outpatient resources. They also offer a free support group on Wednesday nights. There are a few people who come from the local community, but most people who attend the group are former patients.
How many IP beds?
Eight
How many patients in PHP or IOP?
Seven. This can vary slightly if there are fewer in IP at the time. The maximum capacity for the program altogether is 15. There is no IOP.
Would you recommend this program?
It depends entirely upon your needs and what you are looking for. I wouldn’t go back to Reflections because I don’t think my needs can be met there, but I would definitely recommend it for others. I would recommend it specifically for people in the following circumstances: 1) Teen girls, 2) Anyone who has never received IP or residential treatment before and needs a good basic foundation for recovery, 3) Anyone living in DC/NOVA/MD who wants a more comfortable, nurturing, and supportive alternative to Sheppard Pratt and Hopkins. As I mentioned in my last post, I have hope for this program’s continuing improvement. I saw some aspects of it improve even while I was there.
Just a few quick questions:
1. Can you bring your own laptop and how much time can you spend on it each day?
2. What are the timings of the meals and snacks? Would they accommodate fewer snacks if you meet your exchanges elsewhere and would they accommodate a later evening snack if you have gastroparesis? Finally, are you allowed to add supplements/ denser foods to your Meal plan in order to not have to eat as much volume?
3. How do they deal with purging/ locked bathrooms?
4. Do they ever threaten certification/ tube feeding/ etc? Can you always sign yourself out?
5. What is the average weight gain per week and length of stay?
6. Are you allowed to go on passes? Are there outings?
7. Can you bring your cell phone? How much privacy is there?
8. Is there a “bedtime” or can you choose?
Thank you!
1. No laptops or cell phones allowed. They have a computer and phones on the unit that you can use at night.
2. Meals and snacks are really close together. I don’t remember the exact times, but there’s only about an hour and a half, if that, between snack and meal sometimes. And sometimes meals run late, which makes snacks even closer. At the time I was there, pretty much everyone has three meals and three snacks, and I don’t remember anyone questioning it. If it’s an issue for you, I would guess (though I don’t know for sure) that they would work with you because they are trying to make everything individualized–within reason, of course. Same with the later evening snack: I can’t say for sure that they would work with you on it, but I’m guessing they would. They assess your dietetic needs at your intake and you can mention that. I’m also not sure if they would let you add supplement to your meal to decrease the food volume. While I was there, the only reason patients drank supplement was when they didn’t finish their food. That may have just been the group of patients at that time though. The supplementation issue is something I never really paid much attention to while I was there because I did not supplement–sorry I can’t be of more help on that one!
3. Each room has a bathroom, but they can lock it if you need. I always liked the fact that they only lock it if you need it rather than forcing you to keep it locked. You’re expected to report it to staff if you have an urge to purge, or if you purge while there.
4. I never saw anyone get tubed, so I don’t think they do it. I did see two patients get kicked out of the program for refusing supplement. I also saw another patient being asked to leave the program and go to a more intensive one like Hopkins. So I can’t guarantee that they never threaten certification, but my guess is that if a person is too ill to thrive in the program they just insist that they find one with greater supervision.
5. I think the girls who were on weight gain had to gain 1-2 lbs. per week, but again, this is individualized. Average length of stay is pretty low because so many people end up getting cut off by insurance after about two weeks. However, I did know one girl who was there for two months. They want to keep you for as long as you need them to, but as with most places, not much can be done if insurance will not pay.
6. We did not have an outing the entire time I was there, and I was never offered a pass. Part of the reason for my not being offered a pass was probably that I have no family, and most of my friends aren’t local, so there was nobody for me to go on a pass with. Some of the younger girls who still live with their parents would go on occasional meal outings with them near the end of their stay, or near the time of their transition to partial.
7. No cell phones, and there is little privacy. The unit isn’t too big. There’s a lounge area, a study room, a kitchen, a dining room, and the individual bedrooms–that’s it, for 8 inpatients and 7 partials. Rooms are double occupancy (and actually very pretty and comfortable), so you may or may not have a roommate if the IP spots aren’t all full at the time.
8. Technically, there is a “bedtime.” They like everyone to be sort of settled in at some point between 10-11pm, but this varies and isn’t enforced very strongly (at least for the adults).
Can you give a full rundown review with the questions suggested? Specifically food options, weight info, etc?
Also, did you see any 30+ patients or was it mainly a younger crowd?
I am not sure if they take my insurance (medicare due to anorexia disability) so I am looking into that but having been traumatized by Hopkins and S Pratt it would be great to have a local alternative now that I need treatment again!
Thanks (:
This program is now much, much better than how people from a year or more ago are describing it. I would have been horrified to go there if it was like people were describing in previous times. For the sake of anonymity, I’ll not say when I was there specifically, but it was within the past three months. They have real dietitians and therapists now, so things are more individualized and the food is NOT just a bunch of low-cal stuff. Positives about the program: the staff is really caring and helpful in working with you to get an outpatient treatment plan set up, even if your insurance cuts you off on short notice. There’s a nice sense of safety and friendliness among the patients even though there’s a wide variety in ages and in patient commitment to getting well. They accommodate vegetarianism, but not veganism. Negatives about the program: there’s a lot of downtime. There’s a group after each meal, but after the group ends there is way too much free time until the next meal or snack. There’s not much variation in the groups. Except art therapy, they all seem kind of the same. The groups are all very basic too. It seems that many of the people in treatment at Reflections are in treatment for the first time, so it can be hard to have a deep discussion since many patients are still in the stage of beginning to discover their underlying issues. This can make it hard on a person who has been through lots of treatment before and has a good sense of those basic issues already. I felt that a lot of the time I was there, I gave much more than I got back. All the patients are local–everyone is from the greater DC/NOVA/MD area. No one ever comes to Reflections from outside the DC area or Virginia in general. Maybe this doesn’t mean anything, but I began to get the impression that even though Reflections is improving, it still isn’t “great” enough to draw people from outside the local geographic area. I do have hope for this program. I know I listed a lot more positives than negatives, but it is getting better–and it’s nothing like what was described before. And also, to the person who was asking about Rock Recovery (which isn’t affiliated with Reflections and should probably have a separate page), that program is definitely good for people who need low levels of support. I’ve done that program too.
Could you add a page for Rock Recovery in the DC area? It’s a small, nonprofit, outpatient program. I can’t find any information on it other than what’s on their website. I’m looking for a very hands-off, non-intensive program to supplement therapy after having been recovered from behaviors for a while, and I thought it might be worth a look…but I would like to see a review first, if anyone has used that program.
I don’t understand– how come they serve diet food?
Has that changed at all and do they make people who need to gain weight eat higher caloric food?
Do they allow visitors?
I’ve been to Sheppard Pratt twice and St. Joseph’s once (before the program moved to Pratt) and they’re program was not for me. There were too many patients and the atmosphere was like a prison with very triggering staff and nutritionists.I still go to Pratt for outpatient therapy, though, which I highly recommend. I must admit, despite the negative reviews, this place sounds wayyy better than Pratt.
How long is the average inpatient stay?
I was there for 3 months June – August 2010 only PHP, and I’m pretty sure that I knew both the other reviewers.
I actually found the group therapy there very helpful especially art therapy (but I’m just an artsy person). The staff has probably changed by now, but the therapist I had I did not get along with at all! and individual and family therapy was a complete waste of time! My therapist hated me and was so rude to me!!! it was so bad! Hopefully they’ve fired her and have a new therapist. There were 2 other therapist who worked with some of the patients who I liked much better, but they wouldn’t let me switch. I wasn’t on weight gain while I was there so I can’t really offer advise on that but they wouldn’t tell you your weight or goal weight and the weight gain process was very slow. The nurses were not strict at all during meals and you could get away with everything! There were 2 different nutritionists there during my time. One of them was very good and the other knew nothing about eating disorders and was EVIL!!!! She was a total bitch! I hated her! you got to choose from a menu for your meal plan. The first day they just give you a standard meal which is whatever is on the menu that day (entree, vegetable, fruit, starch, caloric drink) desserts were not required. there were certain meals which the kitchen always had and you could write in one of those to have instead of what was on the menu. The first nutritionist wouldn’t let you do that often but the 2nd one was clueless.. eventually they made a rule that you could on order off-the-menu for one meal a day (which is still pretty relaxed). basically… as far as helping with food goes, it was awful! It was very poor quality, I hope they have improved since I went there! But the group therapy i found very helpful and most of the nurses were quite nice. So, basically, this is a good fit if you are: in the beginning of your ED/caught it early/not extremely severe; or are very far in recovery; not in need of serious strict observation; just looking for some helpful therapy.
Wow, that last review paints a very bad picture of the program.
The meal plan sounds like something a diet program would offer.
Yikes.
When were you there?
august 2010
Describe the average day?
we really just sat around and did nothing all day. at most there would be like 2 groups, both really stupid…like “art therapy” (here’s a peice of paper and some crayons, draw how you feel) or social work group (what’s everyone’s favorite color of nail polish? how often do you wash your hair?) i don’t think we ever actually talked about ANYTHING remotely related to why we were there. it was really just meals, snacks, and sitting around staring at the wall.
What were meals like?
not bad at all. definitely the safest/easiest of any treatment center i’ve ever been to. you really get to come up with all of your own menus, they just give you exchanges to follow. we ate in a small dining room…there are three tables, each with 3-4 girls, and there are 2 staff members. it was pretty relaxed, they have the radio on/played table games etc. if you aren’t eating you get sent to the isolation room, so everyone in the dining room is actually eating.
What sorts of food were available or served?
the foods were all really healthy, and you had quite a bit of choice in what you wanted. here’s a sample day of meals from one of my menus:
breakfast-
3/4 c. special k cereal
8 oz. skim milk
1 c. honey dew melon
1/2 c. fat-free, sugar-free yogurt
snack-
pear
lunch-
peanut butter sandwich on whole-wheat bread
1/2 c. lite applesauce
1/2 c. baby carrots
8 oz. skim milk
snack-
pear
dinner-
veggie burger on whole-wheat bun
1/2 c. lite applesauce
1/2 c. green beans
8 oz. skim milk
they offered a lot of like, “diet foods” like, everything was “lite”, the bread, the hamburger buns, the yogurt, everything. if you got milk it was always skim, if you got canned fruit it was always the kind sweetened with splenda. we had a cooking group and we learned how to make “guilt-free” pumpkin bread, using applesauce instead of oil and splenda instead of sugar…it just seemed very odd for an eating disorder treatment facility.
Did they supplement? How did that system work?
yeah, and if you refuse supplement more than 3 times you get kicked out.
if you eat nothing, you get 12 oz. of ensure plus.
if you eat everything else, but not the entree, you get 8 oz. of ensure plus.
any other sides are 4 oz. of ensure plus, except for vegetables, which are just 2 oz.
What privileges are allowed?
none. they don’t even have phones that you can use. you really just sit there ALL. DAY. LONG.
Does it work on a level system?
nope.
What sort of groups do they have?
nothing helpful. the social worker who led the groups was horrible as well. we would just sit around and she’d talk about incredibly innapropriate topics. my first group we sat around in a circle and she told us all about how she was raped as a teenager (in great detail) and asked everyone else to tell stories about their trauma. she then proceeded to tell the girls that shared that they all could have prevented their traumas from taking place and that whatever happened to any of us was our own fault and we needed to take responsibility for it and stop “blaming other people”. or she’d tell us how stupid we all were to have eating disorders and how we were in total control of it and we were all doing this to ourselves and it was all our fault we had our EDs and were in the hospital. it was really ridiculous.
What was your favorite group?
there was nothing good about any of the groups.
What did you like the most?
there was nothing i liked about the program.
What did you like the least?
no one there even knew what they were doing! i was there for a week and never once did they even draw labs, the “dietician” is actually just a nutritionist who went to community college for 2 years who knows NOTHING about eating disorders, there is only one social worker who leads all of the groups and she is HORRIBLE, and the whole program is like, so claustrophobic…you really are locked in one room for 12 hours, doing nothing. it was horrible.
What level of activity or exercise was allowed?
none. we sat on the couch all day.
What did people do on weekends?
same as the week. nothing.
Do you get to know your weight?
no. they won’t even tell you your goal weight.
How fast is the weight gain process?
not very fast…i was there for a week and i gained like, 2 pounds.
What was the average length of stay?
3-6 weeks.
What was the average age range?
12-15. there was one girl who was 28, and then there was me (18) but everyone else was a lot younger.
What kind of aftercare do they provide?
none.
Do they help you set up an OP treatment team?
no.
How many IP beds?
8, but there was only 1 girl inpatient while i was there. it’s mainly a partial program.
How many patients in PHP or IOP?
8 is the maximum limit, i think there were 6 when i was there.
Would you recommend this program?
NO. i really think it’s the worst program out there.
I was never told my goal weight and it wasnt really talked about, which i found very odd. I was never told my weight but you could ask your doctor, and its under their discretion whether or not to tell you. They aim for 1-2 lbs per week. You don’t have to reach a percent, in fact a lot of the time girls are
Discharged for insurance reasons. They really just go on whether or not they think you are ready to Be on your own.
You have to be medically stabalized before you can go. If you are on weight gain, then it is very weight gain focused. They do have therapy to focus on other partsnof your ED, but I found it WAY too food and weight oriented.
They only have one therapist, and I didn’t like her. She was nice, but seemed ingenuine and distrustful of all of us.
Almost every single rule was broken multiple times throughout the day. Meals went much longer than 30 min for some, and there was no punishment, like there was for one woman who was there when it opened. I received an extra starch at dinner and tried to explain to the nurses I didn’t need it… They didn’t care and i was punished for not eating it. The next day, the exact same thing (even the exact same food item) happened and the nurses did not punish her for not eating it. Patients do tons of food rituals, and it is way too east to hide food.
The staff is friendly and somewhat supportive, but totally ignorant on eating disorders, I believe. Some are worse than others, though.
I haven’t been to any other treatment places, but I’ve heard that dominion is way more lax in rules and stuff than any other place. Granted, you still have to eat every last crumb ( I remember a nurse ordering me to eat my last 3 peas), but it’s a lot more lax than other places. I’ve heard about Hopkins and there is no comparing to that place. Dominion has a lot safer food and you get to pick it. Plus it’s not as strict.
I’ve been to dominion and it didn’t help at all. The good thing is you get to pick the food you want to eat after the dietician gives you your meal plan. They use exchanges, so you’d have a certain number of fats, starches, fruits, veggies, and protein at each meal. The food optins are relatively healthy. You order off a menu. There are prepared dishes you can order or you can always order something off the menu like a sandwich or something.
There are tons of therapy sessions, which is just talking really, they’re all the same except for art therapy. They dont give you really any helpful advice. We’re in one room all day long and they don’t make an effort to have fun stuff for us to do. The focus seems to be all around food and they have meals and snacks so freakin’ close together that we’re eating all day long.
They use ensure to supplement any food uneaten, or if you’re on weight gain and it just gets to be too much food, you’ll drink it with your snack.
However compared to a lotnog places, it’s more
Layer back cause it’s pretty new and protocol isn’t followed well at all, which is annoying because girls were treated differently in the same situations…
Hope this helps.
thank you for the review! i’m sorry it wasn’t helpful for you, though.
a few more questions, if you don’t mind–
– how do they determine goal weights? do you have to reach a certain % IBW? & how fast is the weight gain? do you get to know your weight?
– is it mostly medical stabilization / weight gain-focused or more all-encompassing?
– are any therapists better than others? (to request one)
– any examples you could give of the protocol inconsistencies?
– are the staff supportive / helpful / knowledgeable?
How does reflections compare to hopkins or sheppard pratt?
I really wish someone could do a review of this.
My guess is it’s so new though that not many people have gone through the entire program.
re: adult admits, maybe I was thinking about another hospital in DC?? Anyways, they DO accept medicare but as to specific types, you’d have to call the business office.