I would really like an honest review of this place, everyone keeps telling me that going here will be the best thing for my condition, but I’m getting mixed reviews and seeing that some people don’t get the care that they need.

• How many patients are there on average? – I think the max is 12. Usually 8-10
• Does it treat both males and females? If so, is treatment separate or combined? – Females only in  residential, everyone in PHP/IOP
• If applicable: Do they support the gender identities of transgender and nonbinary people? – Yes
• How often do you see a medical doctor, psychiatrist, psychologist (therapist), nutritionist, nurse, etc? – Nurse practitioner at least once a week, therapist twice a week, dietician twice a week

Describe the average day:

• What were meals like? – 3 meals and 3 snacks a day. The food quality was fine. Everyone is around the same table in the dining room, and a staff person eats with you. 30 minutes for meals. 
• What sorts of food were available or served? – You don’t get to choose meals, we all got the same thing that the kitchen made, but they do accommodate vegetarians/gluten free. You choose your own snacks. 
• Did they supplement? How did that system work? – Yes, after meals/snacks they would pour supplement proportional to what you didn’t finish. You had ten minutes to work on supplement. 
• What is the policy of not complying with meals? – There’s no punishment for not completing, but your team will have a goal in mind that they want you to work towards.
• Are you able to eat vegetarian? Vegan? – Yes vegetarian. I’m unsure of vegan. 
• What privileges are allowed? – Phone time, outside time (for smoking or just to get fresh air)
• Does it work on a level system? – No
• How do you earn privileges? – You don’t have to earn them
• What sort of groups do they have? – CBT, DBT, art therapy, rec therapy, recovery skills, relapse prevention, nutrition education, medical education, there’s probably more in forgetting
• What level of activity or exercise was allowed? – Twice a week you could do “mindful movement”, which is very light yoga. You have to complete the meal before this group in order to participate. No other exercise allowed, and they will redirect you if you’re pacing or something. 
• What did people do on weekends? – Some groups, but more down time. Visiting hours on one day and a two hour outing on the other. 
• Do you get to know your weight? – No
• What was the average length of stay?  – 4-8 weeks from what I’ve seen. It depends on the person. 
• What was the average age range? – Majority is people in their early 20s, but there are older patients there as well. 
• How do visits/phone calls work? – Visits on Saturday every other week. They last two hours, you get a room for privacy. 
• What is the electronics policy (e.g., cell phones, iPods, Kindles, laptops, tablets)?  – You get 30 minutes of phone time in the morning and 30 in the evening. I think other electronics are allowed as well in that time. I wouldn’t recommend planning on doing any work/school here, there’s just no time  
• For inpatient/residential: Are you able to go on outings/passes? – Yes, there’s a group outing every week. Usually to a store like target, or something fun like a museum. 
• What kind of aftercare do they provide? Do they help you set up an outpatient treatment team? – You are expected to do PHP and IOP after residential, either with them or closer to home if you need to. 

Stay away from the Sanford residential eating disorder treatment. It is not a place of healing. Many unethical ways of treating and carrying out care. Staff is not trained in eating disorder care and were participating in illegal activities while on the job. If you or a loved one need eating disorder treatment do not look here, until they can get their act together and learn ethical ways of treatment, hiring, insurance navigation, and HIPPA compliance. This is very sad for Michigan; hopefully there will be a professional, healing, ethical treatment center in the future.

What type of meal plan structure does Sanford (res) use?

I was a PHP and IOP client this summer at CTED, but I was an outpatient prior to that and I had been in CTED’s IOP program in 2019 before the merger. Overall, the program had a lot of benefits, and I needed the treatment. My treatment team was really decent, but this was specifically because of who I had on my main team. The main issues I had were with upper management and how the upper management handled issues and trained their newer clinicians. But I will start with what I found beneficial:

• The billing department handled things with my insurance, including re-authorization, and this did help with my stress level.
• Most of the staff at PHP are very welcoming, especially ***, ***, ***, and *** (not that others are not— many, many are — but these ones stood out the most).
• A lot of the staff go above and beyond, with one clinician helping me with a panic attack even when she was not required to do so.
• The rec therapists are extremely hard workers, and their groups are really beneficial to unlocking your creativity and understanding yourself on a more abstract level.
• The ACT and DBT groups are great for learning new skills and emotional regulation. I use skills I learned from both of these groups on a daily basis, and I was also able to explore ACT more in individual therapy groups. *** and *** are very knowledgeable with ACT, as is *** with DBT.
• There were open discussions about diet culture and fatphobia (though this also caused some problems that were not properly addressed)
• The Soul Hunger group is great for spiritual health
• In PHP, you see your dietitian and therapist twice a week, and I personally found this helpful. I didn’t always feel like I needed a second dietitian appt, but it was still more helpful and didn’t hurt.
• My dietitian and the rest of my treatment team exercised a lot of patience and understanding with my first few weeks there without being negligent or dishonest with me.
• Being able to meet with a NP twice a week when in PHP was really valuable to me, especially since I came in with medical issues.
• In my experience, I was not looked down on or judged when I had a panic attack or anxiety relating to my other diagnoses.
• The staff handled my other mental health diagnoses very well and adhered to my boundaries.
• The groups on values and discovering what you really value outside of your eating disorder was a key component to my recovery.
• There is a wide variety of groups (though, again, this also caused some issues).

I am sure there are more things I benefitted from or enjoyed from this place, but I obviously can’t list it all. I had great discussions with a lot of the staff, and the newer clinicians who have made mistakes are definitely not meaning to.

Now, I had a lot of rocky moments at Sanford. When I first started, the billing department neglected to contact me or meet with me, and instead I got a bill one week in that I was not expecting to get until the end of treatment. The issue was resolved, but it caused a lot of distress in a time where I was really medically vulnerable. Now that I am discharged, I am still having issues with their billing department because they tried to double-dip my insurance on a couple of days and are blaming it on my insurance company instead.

When I first started at PHP, the staff was a lot more welcoming to open conversations about any mistakes they made versus how they are now. On one of my first days, they gave us a handout to fill out about how people help you and how people don’t help you. This activity included people outside of treatment, but it also included the treatment team itself. It fostered an open environment to truly talk about any issues or concerns we may have had. And they were responded to seriously, and they were not met with condescending answers. A few weeks after I started PHP, the upper management began making EXTREME changes that I still believe are negligent to the community. And they never actually addressed it openly and honestly with anyone there; instead, they left it to the staff who had no control over the situation. The main change was a change in their outpatient services, and the other main change (not as negligent) was continual changes to the schedule. After these changes were made, it became much harder to openly discuss changes without being met with condescending tones of “you’re so self-aware” or “change is hard!” or “its exposure!”. None of these statements were helpful, and it instead made me feel like I had to shell up and shut up. Now, there were some staff I could still go to when I was feeling very frustrated, but these were the stereotypical answers I was getting from newer staff and from the upper management (*** and Dr. ***; I did not formally meet any other upper management clinicians).

Touching on that, as I mentioned, I had been an outpatient client with CTED since before the merger and afterward for dietitian services. I had been meeting with my dietitian steadily since the summer of 2020, and it has made a huge difference in my life. At the time, there were no other available options for me. Most dietitians were not knowledgeable about EDs or were mostly nutritionists relying on wellness (diet) culture. My dietitian deemed that I needed treatment, and I opted for Sanford care so that I could still see her during treatment. My initial motivation for treatment was that if I stayed in the program (or a program elsewhere), I would still be able to see my dietitian on an outpatient level, and I really valued her and her help. So, I agreed, put in the work, etc. About a month into treatment, my dietitian shared with me that the upper management decided to obliterate outpatient services and I would only be able to see her through the end of the year. Mind you, it was my dietitian who fought for the end of the year time, as the upper management wanted it to end as soon as possible. CTED no longer offers outpatient therapy or dietitian services, so ignore what they say on their website. Their website is not adequately updated at all to make it clear. Outpatient in any other space means not being in a specific program. Here, outpatient means you go to IOP less than 5 days a week. This issue was and is very upsetting to me, and it was not handled well by the upper management at all. They did not care about client feedback, and they do not care about outpatient services. Outpatient was an initial cornerstone value of CTED prior to the merger; since the merger, CTED is abandoning its central value while teaching us what our personal values are. I think the upper management needs to do a professional value workshop where someone can present the necessity of outpatient services. It seems like CTED is now very profit-based instead of truly wanting to help the community. Again, I mainly iterate this towards the upper management. I view this change as extremely negligent, especially since outpatient services for eating disorders are lacking.
Moreover, by removing outpatient services, CTED also lost extremely valuable personnel. I believe 5 staff total were either fired, forced to resign, and/or quit (idk the whole details about their leaving, but I have my assumptions based on info given) to form their own business so that outpatients can be treated. Thank god for this; otherwise, there really aren’t many great referrals in the area.
The changes to outpatient treatment affected everyone there, but upper management never asked us as clients how we felt about it. When a therapist did suddenly leave, they said we could discuss it in a process group, but when I tried to do this, it was met with: comments about me being self-aware about how I hate change; how eating disorders hate change (which puts the blame on us); or how it is exposure therapy. None of these were conducive, and all were extremely invalidating.

This is not the only time that I heard comments like this. Around the same time as outpatient changes, the PHP/IOP clinicians no longer had control over the schedule, as upper management took it over. Now, so many amazing groups were added that would not have been if it wasn’t for this. Soul Hunger was one of them, and I enjoyed that change. However, as the changes were first happening, the staff leading them consistently switched (still is), and sometimes the groups itself would change the day of. This isn’t a huge issue, of course, but it was like this constantly for about three weeks (maybe 2). Every day I went into PHP, I never knew what to expect. As a person with an ED and PTSD, this was really hard to adapt to. But again, the only comments I got back on it were “change is hard,” “you’re so self-aware!” and “it’s exposure therapy!” and “eating disorders hate change, right!”. Trust me, we get enough exposure therapy as it is by just being there and by participating in snack and lunch challenges. And those exposures are great, but the other ones are just stressful.

Overall, don’t expect your concerns to be taken seriously by the powers that be. By not listening or taking time to hear us out, they have repeatedly shown that they do not care.

While those were my main issues, there are other underlying issues still ongoing at the PHP/IOP centers (and I imagine at the residential center, but I can’t speak for that) regarding fatphobia. They do have an 8 Keys to Recovery group, but this book is rooted in a lot of fatphobia. It was written at a time when eating disorder treatment was still kinda aligning with diet culture values and genuine fears of fat people. Thus, some of the examples are extremely fatphobic and triggering, and they then do not demonstrate how eating disorders affect every body, every size. I brought this up in a group with Dr. *** and another clinician (I can’t remember exactly who), and I explained how one example they used from the book was really fatphobic and should be removed from the 8 Keys curriculum. They recognized I was right about it being fatphobic, but then decided they still would keep it because then it can foster discussions about fatphobia. This is not healthy at all. Fatphobia is a serious, genuine issue that can be traumatizing to larger-bodied people. Forcing clients who have or had larger bodies and have experienced fatphobia can be re-traumatizing. I do not think the staff at CTED should be re-traumatizing people in a GROUP setting, especially since we are not there for our trauma and because they do not have a specific trauma specialist doing it. I am not the only one who had concerns about this, but the other person who shared was also met with disdain.

Overall, I needed and benefited from the treatment, but I did not need the drama that pervades CTED. I would still definitely recommend it, especially if they can settle down on their changes. But, I’d recommend that every Sanford employee attends workshops about fatphobia and trauma, and I’d recommend that upper management starts taking their clients more seriously. For how for-profit they have been acting, they should care about the clients who are paying so much money for this treatment. We deserve to be treated with respect and not diminished because we have eating disorders. We are taught in groups how to be assertive and the benefits thereof; but us expressing assertiveness there is met with condescension and ignorance. Or, if it is met with compassion and interest, it is from staff who ultimately have no control over the situations anyway.

To conclude, entering treatment at Sanford CTED’s PHP and IOP saved my life, but it is of no thanks to the upper management. It is the hard work of the staff that helped me heal and grow into recovery. So, I do recommend treatment and I really value it! Most days did go okay, but the bad days or groups affected me for days after. But go into it with these warnings of lots of changes and lack of respect from upper management. Recovery is worth it, and I do not regret going.

***names redacted by admin per site policy

I personally did not find sanford’s approach helpful to my recovery. It was very traditional (possibly outdated), and often felt punitive to me. The dietitians and therapists were all kind and professional, but treatment didn’t feel collaborative to me. It was very focused on achieving certain weight goals and clear that not doing so would result in being terminated as a client unless you agreed to do a higher level of care. I can understand reservations about treating someone severely medically compromised, but it seemed to be solely based on BMI. For most adults with obligations to work and/or children, doing higher levels of care may not be realistic. Harm reduction didn’t seem to be considered.
I know that ultimately responsibility for recovery lies with me, not a provider. However, after switching to a different outpatient provider that is giving me more agency and autonomy in my own treatment (with no “threats” of higher levels care), I am actually making strides and making needed changes.

I recognize everyone is different and some people may respond well to very clear directives, meal plans, target weights, and consequences if those are not met. That was not the best approach for me personally and I’ve found other outpatient providers much more helpful for the phase of life I’m in (an adult with obligations to work and family).