The Center for Eating Disorders at Sheppard Pratt is located in Baltimore, Maryland. It offers inpatient, partial hospitalization (PHP), day hospital, and intensive outpatient (IOP) for adolescents (ages 12-17) and adults (18+) of all genders, along with specialized tracks in substance abuse and trauma.
Any reviews? If you have any updated information, please post in comments below! You can check out the FAQ and Guidelines for suggested questions. Thank you!
NOTE (04.03.20): Please disregard our previous update saying that Sheppard Pratt is now partnered with Eating Recovery Center (ERC) Baltimore. ERC is not in any way partnered with Sheppard Pratt, they are two separate programs. Please see Kate Clemmer’s comment below for more information. Sorry for any confusion!
?Full Review from the Past Year?
IM GOING ALL IN!!!
When were you there?
August 2022 – October 2022
What level(s) of care did you do (e.g., inpatient, residential, PHP, IOP)?
Inpatient (Adult)
(they do offer IP, PHP, and IOP Though)
If applicable: Is it wheelchair accessible?
No, only used for transport if you were doing ECT treatments.
Walker and Cane friendly though, just seen people who needed wheelchairs never
allowed them.
How many patients are there on average?
Average depends. Could be 3 Adolecents, and 13 Adults, or vice versa.
It is a 24 Bed unit though, so they usually always have a spot quickly.
Does it treat both males and females? If so, is treatment separate or combined?
They treat both males and females, and treatment is combined, but usually males
get a room on their own most of the time, could have a male roomate if another male is there.
No sharing rooms- like female/males could not room together, obviously.
If applicable: Do they support the gender identities of transgender and nonbinary
people?
Yes, and no. We go around all the times in groups with pronouns, and most staff respect it.. patients almost always respect and support 100%…but of course, there are staff who dead name, use the wrong pronouns, and some who seem not with the times and not understand it what so ever. (frusterating and not safe)
How often do you see a medical doctor, psychiatrist, psychologist (therapist), nutritionist, etc?
You see the Medical Doctor like once for most people, it’s usally your first day and that’s it. They go over your health problems, other complications, conerns, medical stuff whether ED related or not (Ex: diabetes, chronic pain. chronic illness, POTS, etc.) Then they check your heart rate with their scope for some reason, but no other tools like eye scope, ears/throat etc. After that, you won’t see them unless you have a medical problem arise, or you request it (which for some reason could be denied if your psychiatrist doesn’t see it as needed).
You meet with your Psychiatrist every single day, and then on weekends the psychiatrists will rotate, or an on call doctor will be there, weekends are basically seeing the psych to pass on stuff for Monday. Don’t expect much out of the weekend most of the time… maybe you can get some miralax, but they won’t mess with your medications or treatment, as they are not your main doctor (also your main doctor may be on the rotation for weekend so that’s cool). I call weekend visits a prop visit……Anyways, you’ll go through all the questions in the begining, like ED behaviors, columbia suicide assesment, family, trauma, all the new admission stuff. After that, you’ll see them for medications, check on your labs, insurance reviews, current stressors, thoughts of harming yourself or others, eating disorder thoughts and urges, and anything you wanna bring up. I will say that who your doctor is, makes a huge difference. Many people get the dream team, some get newbies who never worked with EDs.
You will meet with your Therapst twice a week. 30-50mins. They are also your Social Worker, so remember that one. They are very short on therapists right now so sessions were shortened for me, which was hard. You can do Indivual therapy twice a week, or Indivual once a week, and Family therapy once a week, if you do not want family therapy, you do indivual twice, and vice versa.
You will meet with a Registered Dietician when you first get there to select your menus, go over the same questions everyone asks, and give you your meal plan. You will also see the RD for nutrition groups, or when they add a standing supplement for weight gain. Good luck seeing them otherwise, they are the LEAST involved in your treatment which is the most frustarting thing, as they are one of the most IMPORTANT for your treatment. They realize this now, and try to do check ins, but not even our doctors can reach, or find the. To be honest, I think besides groups and meeting you at first, or to let you know about adding an ensure plus, they are somewhere around twiddling their thumbs. I feel bad, they literally do bare minimum
What is the staff-to-patient ratio?
We have MHWs (Mental Health Workers) who do rounds Q15 (come around with a clipboard every 15 minutes to check you off, where you are.. basically attendence to make sure you’re not hiding, doing behaviors etc.)They also are in charge of calling names for meals, checking off trays for prepartion, and completion. They are in charge of giving supplemts, standing supplemtns, water, watching the mileu (day room), redirection (telling you to sit when standing), and to talk to if you need to vent, though you read the room and figure out who is there for the paycheck, or who is there to help.
What sort of therapies are used (e.g., DBT, CBT, EMDR, etc.)?
CBT (cognitive behaviroal therapy) Group every Thursday at 10am. Usually ABC model and thought logs. You can do CBT with therapist, though
DBT (Dialetical Behavior Therapy) Group every Thursday at 1:15pm, though it changes sometimes, or has been because lunch runs into it. As always, your therapist can do some DBT with you too. Most focus is Distress Tolerance and Mindfullness.
IPT (interpersonal therapy) Group every Thursday at 11:00am – best one, as the group leader is pretty famous and known in the ED recovery world, and NEDA. We talk about grieve of ED, relationships, role transitstions, etc. Only group that limits throwing papers at you, but when you get papers the objective is good. You talk and write about how you ED has affected your relationships and life/values.
Describe the average day:
FOR NEW ADMISSIONS:
You will be started on a 1-2-3 day menu to acclimate, really doesn’t matter what ed you have, every new person is on it. You will hate it, it is miserable but It isn’t forever. Day 1-2-3 is a set menu; day 1 being smallest, day 2 a little more, day 3 the basic meal plan. You do not get to pick, it is not the same food served usually. It’s usually prepackaged, bad, unpleasent. You will have Milk for every lunch first 3 days, which is a struggle for most. I want to note since people do not mention this. IF YOU DO NOT FINISH YOUR MEAL, YOU ARE NOT ALLOWED WATER AFTER. YOU CAN HAVE WATER AT WATER BREAKS, OR AFTER YOU FINISH YOUR MEAL. This is something i find cruel as people get dehydated, and some can’t even get a vein for blood due to lack of water. Also you will get your blood drawn for your first 7-10 days before breakfast usually, and a finger prick at 4 am to test blood sugar levels your first 4 days, i believe.
A Typical Day at CED
5:45-7:15 wake up via person with vital machine. You will get your vitals laying, then standing. After that you will head down to the bathroom, grab a bad quality paper gown, use the bathroom, change into that and head into the weight room for weigh in. You may be ordered back to scale, most are not, but you can turn around. Weight is in KGs still to this day, yet i still do not understand why they think ED patients can’t convert, i mean for some of us, it’s what we are good at. You will be woken up around 5:45-6am, after weigh in you can take a shower that is timed for 8 mins, use the vanity which is two sinks and a mirror, again limited time for usage but not specified just depends on if others are in line. Then after being ready, you can go back to sleep until 7:15, or chill until then.
You will go out to the day room which again they call mileu, you cannot go back to your room until nightime. You will get morning meds before breakfast if needed, and can use the three 20 year old prison wall phones if you want. Please keep calls to about 15 mins, otherwise no one gets a chance.
Breakfast is at 8:15am you will sit in the dining room, read dining etique (no talk of food, numbers, leave double layers, no personal items to table) and then 3 people at a time will be called up. You will recieve your menu that you circled and tell the service person what you want if it’s at the hot food area, then grab the stuff you need. You will unwrap every single thing, no lids, no plastic, no packaging, no knives. You will set up your tray, a MHW will check you off and then another will again for double assurance. You have about 30 minutes to eat, you always get extra time, unless there’s someone who is less patient. If you do not finish your entree, or 50% you get two Ensure Plus, if you do more than 50%, or finish your entree, you get one. 1 supplent is 15 minutes, 2 is 30 minutes. If you do not complete you get an extra item (for breakfast it’s a rotation of pastry, donut, muffin w/ butter) Must finish meals for speciality drinks like coffee, tea, hot cocoa. Only breakfast coffee is caffeinated. Lunch is at 12:15, all apply but extra item is a buttered dinner roll if you do not finish your ensure or your ordered ensure at supplement/h20 times. Dinner is 5:15, all same apply and extra item is same as lunch. Snack is 8:30pm, which is a bit different as you just line up and set up your snack.
Water Breaks are at 9:30am, 2:30pm, and after snack so around 9pm. Water breaks are also supplement breaks, for those prescribed ensure plus for weight gain i was on every one, so had to go to every water break for ensure plus & water. Reminder: Some will not even wake you up if you are sleeping for these times, kinda messed up. Also, ask your doctor for an extra cup of water for breaks, thank me later.
Bathroom Breaks are at 9:30am, 12:00pm, 2:15pm, 5:00pm, 7:00pm and when you go back to bed area at 9:30pm. Toilets are flushed with key. Bowels, pee, periods, purging are all documented. You can get an emergency bathroom break but door must be open. If you engage in any purging, you are on open door for 72 hours. So, a staff stands by and you can’t lock your stall. Bathrooms are like public bathrooms, with stalls.
Groups: for adults
Monday
10:00am music 11:00am CBT mood management 1:15 OT something, usually healthy living (OT Is occupational therapy) 3:00 CBT body image
Tuesday
10:00am OT snack (make a non bake snack for snack that same night) 11:00 relapse prevention 1:15 Nutrition/menu fill out 3:00pm Body image: art expression (body tracings, poems, collages etc)
Wednesday
10:00am: OT task – make braclets or coasters, or glass pain things like that 11:00 movement: yoga mats with stretching and light yoga. 1:15pm Therapudic lunch group. Each Wednesday the dieticans serve a democratic voted meal, that’s not usually served… pizza, quiche, mexican, indian… and that group is about processing it, and voting for the next weeks one. 3:00 perfectionism the group runner makes you very sleepy.
Thursday aka Therapy Thursday
10:00 CBT 11:00 IPT 1:15 DBT 3:00 Art therapy (a great break, with a great art therapist)
Friday
10:00am Community every other week, you complain, adress conerns with peers, staff, the unit.. basically vent but never see changes. If it’s not the week for it a very good MHW one of the few who are good runs a group. 11:00 Motivation to change 1:15 OT lesiure, where you play games like uno, puzzles, scatticories, apples to apples. 3:00pm nutrition/menu fill outs
Saturday (hell weekend, where everyone is jumping off the walls)
10:00 Menu Fill outs 11:00 relapse prevention 1:15 Nursing group aka write a goal, paint your nails.. maybe sing kareoke and then suffer for the rest of the day.
Sunday
10:00 OR 11:00 depends if the minors are first or second, is an OT roatation of music, art, movement, or task.) Then suffer until 1:15 for the same nursing group.
Incentive Groups: (for meal completion)
Art, Knitting (Fall/Winter) Horticulture (outside, gardening, painig rocks/birdhouses) you do CBT group if you don’t do these.
Vitals are again at 2:15 sitting/standing
9:30 Vanity time/sleep
10:00-11:00 (optional) adults only can go back out.
What were meals like?
Kinda explained above but there’s two meal plans I know, but there is a diebetic one too.
There is Basic (weight maintence)
Breakfast: Dairy + 4 items Lunch/Dinner either sandwhich with 3 items + 1 drink or protein, 2 starches, 1 veg, fruit OR dessert, and a caloric drink. Snack is a snack + drink.
Standard (weight gain which you can still be on if healthy weight, really depends if you’re under your set point)
Breakfast: Dairy + 5 items Lunch/Dinner Sandwhich + 4 items (one must be a dessert) and caloric drink, OR 1 protein, 2 starches, 1 veg, 1 dessert, pick any additional item, and caloric drink. Snack is food + drink + protein (cheese, yogurt, pudding etc)
Depends if you pick a (SW) meal or a (p) (p,s) (p,v) meal. (makes more sense if you are there)
Food is usally good.. good for hospital food. Only issue is their chicken is always dry, portions may differ than everyone else, stock is so bad, so some items you pick might not even be there and you have to replace it. Overall i enjoyed the food.
Ensure Plus for standing or if you do not finish come in strawberry, chocolate, or vanilla.
What sorts of food were available or served?
Breakfast: fruit, fruit juice, eggs, french toast, pancakes, waffles, breakfast meats, breakfast potatoes like hash or homefry, breads: muffins, bagels, toast, pastry, donuts, english mufffins, milk, yogurt
Lunches: hamburger, hotdogs, ham, chicken, turkey, tuna salad, chicken salad, egg salad, roast beef, fish, tacos etc- same stuff for dinner too.
Did they supplement? How did that system work?
Already explained but 50% or less, or not entree = 2 ensure – must complete in 30 mins, extra item added if not. 50% or more, or all entree = 1 ensure 15 mins, same thing
supplements are ensure plus or extra item, for standing/prescribed its ensure plus or homemade chai drink or blueberry drink.
Are you able to eat vegetarian?
NO.
What privileges are allowed?
None, Besides incetive groups. Everyone is treated the same. You engage and are motivated, you get to move to the next level, like res or php, or back to op team you had or will have set up.
Does it work on a level system?
No.
How do you earn privileges?
No, besides incentive group.
What was your favorite group?
OT tast, i like making bracelets.
What did you like the most?
My amazing NPR who was my doctor, ot task group, my therapist, movement group, DBT, Art therapy, OT snack, and body image groups.
What did you like the least?
A lot. The nursing staff besides a few, are awful and rude, some MHWs only cared about money and some even fell asleep! Floats who just come from general psych, and just sit there not doing anything. Weekends where they basically let people lose their minds over lack of stimulation, please stay busy.
Would you recommend this program?
No, if you have commercial insurance, yes if you have medicaid because let’s be real, mediciad ed treatment is scarce. This program I’ve been to 7 times… I reccomend it if you are COMMITED TO RECOVERY. I promise you won’t be a peer favorite if you are not recovery focused, you will be disliked, because you are a trigger. The MHWs need better training on EDs/LGBTQ/Trauma/Addiction/Co-occuring and some need to just quit and work at another place.. some do not care, some do. I was abused, verbally assaulted, and harassed by severeal nurses, i mean to the point where i made complaints, and they didn’t care enough, so i am reporting to the board of nursing, hopefully soon nursing will be better, because a lot are just AWFUL. Structure and meals are great here, do not expect to be cured or close to cured.. you will leave with ed thoughts and urges but you will learn from yourself, therapy, groups that hopefully recovery is worth it to you. If you have medicaid and can go somewhere else (please god not john hopkins though) DO SO. 99.9% of the credit, accountability and work came from me, no one else. This is Volentary, so come in ready as ever. a 72 hour notice is avaiable for those who come just for ip attention, we can tell.
What level of activity or exercise was allowed?
Movement therapy, light stretching once a week. no standing. only walking to groups, and doctor office etc. You get redirected for movement.
How fast is the weight gain process?
There is no process, it depends on your completion, body, and plan. Some go hypermetobolic and can’t gain for some time, some gain fast, some gain slow.. sadly it does affect how long you stay even if you are 100%ing it all.
What was the average length of stay?
Website says 3-4 weeks, which is accurate, but can vary more or less. Some were there for 2 weeks, some months. I was there for about 2 months.
What was the average age range?
12-17 for minors, 20-25 mostly for adults.. but a good majoirty of 30+ and even 50+
How do visits/phone calls work?
Visits must be scheduled before 5pm that day, visit slots are 6:30pm-7:30 and 7:30-8:30. only 1 visit allowed
What is the electronics policy (e.g., cell phones, iPods, Kindles, laptops, tablets)?
am/fm headphones battery opperated ONLY. Can find them on amazon.
For inpatient/residential: Are you able to go out on passes?
NOPE
What kind of aftercare do they provide? Do they help you set up an outpatient treatment team?
Res set up, php set up, iop set up, or your own care team.
Are there any resources for people who come from out of state/country?
No, unless you can afford an airbnb or hotel, you can’d do the php program, only MD residents can stay in housing.
If applicable: How is the program responding to COVID? (Less patients, virtual programming, no visitors, masks, social distancing, etc)
Masks required all the time for everyone, visitiation limitation on people and slots and scheduling, social distancing but that’s always there is a no touch policy
Other?
expect a lot of worksheets, a lot of frusteration, a lot of unfairness, a lot of people who do not know what they are doing, do not care, and are just awful. Expect purging in the hallway or next to you in the stall at times, hopefully this isn’t the case but was so much during my stay… the am/fm headphones came in clutch for bathroom breaks. Expect weekends being slow and stir crazy, expect to come in and do the work, be accoutable for your recovery and take responsiblity… don’t be a trigger on purpose, there are people trying to get their lives back here. You can get better if you want it enough, but this place really tests your limits. I dealt with a lot here, and was put through a lot of hell, i may need therapy from this stay alone, and the abuse i endured… overall kinda turned to be an exposure processs.. really glad i am home, do not want to go back, but for some this is their only option so do it if so, your life matters. I am doing so much better than when i came in, and that is only because of how bad i was and how bad i wnated to live and get a life back.
Am I reading this right that there’s only three meals and a night snack? They don’t offer morning and/or afternoon snacks as well?
That’s right, 3 meals and evening snack!
Not the author of this review, but I did go to SP – I know that it sounds kind of small, but the meals themselves and snacks have many more items than some other programs that do 3 meals/3 snacks (in my experience anyways). I think it ends up being plenty of food, it’s just grouped throughout the day differently than other programs. I have mixed feelings about this. On the one hand, outside of treatment settings, I prefer eating smaller meals and multiple snacks. On the other hand, I think sometimes people w/EDs are afraid of feeling full/satiated and so choose to eat many small portions to avoid the sensation of fullness (I know this can be true for me). SP definitely makes you confront that discomfort and learn to deal with it, which I found helpful bc some days you’re busy and do just need to deal with eating larger meals spaced further apart.
Mixed feelings about that when a tube isn’t a option for completion. I like the idea of 3 meals and 1 snack, as opposed to eating times spaced so close together (because of GI issues), but eating close to bedtime is also an issue for GI problems. I don’t understand why dairy and gluten are forced upon people who can’t tolerate it…just means people have to avoid treatment because it’s kind of one size fits all.
And who can do virtual treatment when they live with other people who are home all day? Has anyone found a way to maintain their privacy and that of other clients if they live with someone who is home while they’d be in virtual treatment? My PCP suggested virtual PHP, and therapist said she doesn’t think I will make progress without a HLOC. I disagree, but am trying to be more open to it figuring out something. Right now, that’s getting a referral to a dietitian, which now that my PCP will refer me, my parent is suddenly accepting. The other step I’m working on (I feel pathetic that I’m slow to get anywhere and people here think I’m a failure, etc) is getting times for some of the online support groups that allow participants to be off-camera, then seeing when my parent won’t be home, and committing to try it. I hope no one gets upset if I post in the Resources area about my findings and commitment to feel accountable to making recovery progress and following through.
Standing supplements are at separate times though, roughly 10 am, 3 pm, 9 pm so those are separate at least, but I def understand the worry about having to eat something you might have a food intolerance to but being in in a medically monitored and supportive environment may help you realize if it’s food allergies/intolerances or if it could be related to ED symptoms
I’m going to second the benefit of discerning true intolerances vs ED symptoms. IME, they honor all medically-documented nutrition restrictions, including intolerances. I know some people specifically sought out allergy testing prior to treatment in order to get ahead of this (and that might be required for IP? not sure). Other patients I overlapped with had permission to avoid ingredients that they reported intolerance to so long as it vouched for by a doctor. For those patients, if there was a menu item they couldn’t tolerate, it was simply swapped for something they could (for example, swapping salad dressings from the menu dressing to an allergen-friendly option).
At the end of the day, ED recovery *is* physically uncomfortable. Nausea, distention, bloating, gas, constipation, diarrhea – it’s all parr for the course, unfortunately. If most of us avoided every food that made us feel uncomfortable, we’d barely be eating (which like, lmao – that’s the point). I’m not gonna lie and say I loved the process of being asked to eat things that made me uncomfortable, but I think it was valuable.
It hasn’t improved in years of working on it. I had allergy testing. It’s intolerance, not allergy. Eating certain things results in bacterial infections in my mouth and small intestine. If I have alternatives (gluten free instead of regular bread, non dairy instead of dairy, no soy, etc) I remain free of infections. When I push it too much, I end up in ER, on antibiotics, can’t eat anything because my mouth is swollen/can’t swallow…at worst I have teeth removed from infection. This is a big reason I avoid care. I understand it bloating, nausea, constipation, and diarrhea work themselves out for many people.
If a person has a condition that isn’t going to work itself out and the only way to manage it is dietary change and Miralax to be able to go, then all foods fit is not a choice. It’s been an issue for 4 years and no amount of eating regularly has fixed it. I’ve weight restored fully during this time and it didn’t get any better. I don’t appreciate someone telling me that unless I’m allergic to these things, it’s not a problem and will resolve with time. My point was people with a condition that isn’t an allergy, but is repetitive bacterial infections that render them unable to eat if not given access to alternatives like a person with an allergy are then not welcome in treatment unless they want to rack up dental surgery bills, lose more teeth, and wind up repeatedly sick because it’s an issue that’s invalidated by other people with eating disorder and treatment centers. Hell, it makes me wish I was allergic to these foods, since I’m not I won’t ever get any help and my ED wins.
Also, thanks for making assumptions about my situation and speaking for me…not! I’m medically stable and my weight has been stable for months. It’s that I do not eat foods that are available at ED programs because of recurrent bacterial infection when I do eat certain ingredients and losing my teeth from too much sugar, which is caused by bacterial infection according to multiple dentists. Treatment centers don’t pay for my oral surgery, but a dentist’s recommendation doesn’t mean shit!
And I don’t matter because I’m not allergic to gluten, dairy, or soy, so I deserve to lose my teeth and have SIBO over and over, which causes me to be unable to eat. As long as I eat the way I was taught by dietitian, I don’t get SIBO and don’t lose teeth. I wasn’t afraid of gluten, dairy, or soy as part of my ED. My GI said I needed to find alternatives with help of a dietitian because repetitive SIBO was making it difficult to get any better. I live with family to help me eat in the 3 meal and 1 snack pattern, but I don’t eat in front of anyone besides my family and am afraid of takeout and restaurants because of the ingredients that make me not feel well. I imagine my therapist and PCP recommended virtual PHP because I’m afraid to eat in front of people outside my family and cannot eat the food at an in person program, and won’t be accommodated. I declined, because my PCP said I’m medically stable and I fear that trying it will lead to restricting, then I’ll be worse.
It’s like you’re saying that gluten free bread or soy free earth balance isn’t valid. Why doesn’t that count as recovering and a success? Why is it only valid to eat bread and cheese unless I tested positive for allergy? If I hadn’t challenged carbs, fats, and begun eating more, that would be one thing, but I’m not restricting and am eating normal foods that happen to not contain dairy or gluten.
Intolerances and allergies are not the same as feeling uncomfortable during refeeding.
I think you may be misunderstanding my statement: intolerances are allowed and honored, and patients are able to avoid foods that trigger intolerances. To be extremely clear – your intolerances, which appear highly documented, would likely be honored. My message was not directed at you (or any person) but a general statement on the difficulty of discerning intolerance vs. discomfort in ED recovery. I replied on this thread not because I was speaking to your experience but because it was topically relevant. I understand treatment can be a difficult experience and sensitive topic and wish both of you peace and healing.
ANAD allows off camera participation in their support groups 🙂
Thanks for sharing your experience with this p! I also prefer eating smaller meals/snacks more frequently throughout the day in treatment because that’s a better match for my regular life, but I appreciate hearing that it doesn’t feel as restrictive as it sounds and that it had its pros in terms of exposure.
I actually REALLY preferred the fewer meal/snack times. I guess when refeeding maybe it makes it harder, but it’s not something you take back to the real world. For a bulimic who was not trying to gain weight, it was SUCH a better system.
I just wanted to say I found this to be so much better than basically every other treatment center that ate 6 times per day. If you need it, you do the two supplement times. I just felt like I was able to get hungry instead of eating the same amount of food spaced out all day that never really let me digest or anything. Plus, it was more accurate to how I would eat once I left treatment. I’m sure some people hate it, but I really really liked that aspect of SP (not a lot else – especially lack of water, I was so thirsty)
Wow, this is an excellent review! Thank you for so much detail and for the care you put into it!
I didn’t see any mention of NG tubes for meal and supplement incompletion/refusal? Do you know the policy on that? (I’m sorry if I just overlooked it.)
Thank you!
You’re so welcome!
No, they do not tube… if you do not comply after a month or so, depending on how bad it is, they will ask you to sign a contract that you will, or you will be administratively discharged, they are not technically a medical facility, if there’s extreme medical complications (electrolyte abnormalities etc) you’ll be sent over to the hospital right across the street to the ER and come back. They don’t like NG tubes, they would rather you learn to get your food orally.
Thank you so much and honestly, now knowing this, I’m seriously considering the program. That is my biggest fear and so many places use it as a punitive measure that I do not agree with. From what you wrote, their approach seems to be exactly what I am looking for.
Adding onto OTHER
I forgot at 4pm they do a goals group which is redundant and boring for most, a MHW runs it and asks your goals and something positive for the day.
THERE ARE PEOPLE ALL WEIGHTS, SIZES, AGES, AND DIFFERENT EDS. THEY TREAT ALL EDS. THEY DO NOT DISCRIMINATE. IF YOU ARE ACCEPTED INTO IP, YOU ARE SICK ENOUGH! DO NOT WORRY ABOUT BEING THE “BIGGEST THERE” EVERYONE FEELS THAT WAY BUT IVE BEEN WITH PEOPLE UW, OVERWEIGHT, NORMAL WEIGHT, OBESE… ALL ACCEPTED ALL: TREATED THE SAME
?Full Review from the Past Year?
Review for my experience at CED! Some of this may be repeats of info other reviewers shared; I am including it for consistency. I was in the adult program (not adolescent) for AN-R.
When were you there?
2022 (not specifying further for privacy reasons)
What level(s) of care did you do (e.g., inpatient, residential, PHP, IOP)?
PHP and IOP
If applicable: Is it wheelchair accessible?
The PHP and IOP milieu is all ground-level without any curbs/lips, but the doorways are pretty narrow.
How many patients are there on average?
Anywhere from 2-10
Does it treat both males and females? If so, is treatment separate or combined?
Both, combined
If applicable: Do they support the gender identities of transgender and nonbinary people?
Yes – patients were generally great about this. Most providers were also good, but some MHWs would misgender patients.
How often do you see a medical doctor, psychiatrist, psychologist (therapist), nutritionist, etc?
PHP:
Doctor – as needed
Psychiatrist – 2x/week
Therapist – 1x/week full individual session
Dietitian – groups 2x/week; no regularly scheduled individual sessions
IOP:
Doctor – never
Psychiatrist – 1x/week
Therapist – 1x/week short check in
Dietitian – group 1x/week; no regularly scheduled individual sessions
What is the staff-to-patient ratio?
PHP – 1 MHW and 1 nurse for up to 9 patients
IOP – 1 MHW for up to 10 patients (but we never had that many when I was there)
What sort of therapies are used (e.g., DBT, CBT, EMDR, etc.)?
CBT, DBT, IPTDescribe the average day: PHP: 5 days/week, 6.5 hrs/day. You only eat one meal (lunch) in program, which myself
and a lot of patients didn’t really like. I would’ve preferred a longer program with more
meals included. They did, however, check meal logs when you arrived, so if you’d
skipped breakfast, they would pour you two supplements. If you ate part of your
breakfast, it was one supplement. Every day you have four different therapy groups,
lunch, and break time to rest/get pulled for individual therapy/socialize.
IOP: 4 days/week, 3 hrs/day. Two groups + dinner. Therapeutic check-ins and
appointments with your psychiatrist must happen outside of program hours (usually
before or after programming).
What were meals like?
Menus are the same for all levels of care at CED (IP, PHP, and IOP). Food is prepped in the hospital kitchen and arrives on trays. PHP and IOP are in the same place, you eat at tables in a small dining room. You pick your meals for the week ahead of time.Most people in PHP and IOP were on the basic meal plan (weight maintenance), sometimes with one or more standing supplements added. Standard is CEDs weight gain plan. I got the sense that they didn’t like to admit people to PHP who still had a lot of weight to restore. For patients in PHP/IOP still needing to gain, it seemed like basic + supplement was more common than standard (not sure why, and not a hard and fast rule, just what I observed). Basic:Breakfast – dairy + 4 items (ex. Bagel (counts as two items) w/2 slices of cheese and an egg + banana)Lunches and dinners were eitherSandwich meal: any sandwich + 3 items + caloric beverage (ex. PB&J + apple + veggies with dip + chips + juice)Protein + 2 starch + vegetable + fruit or dessert + caloric beverage (ex. Sauteed chicken breast + dinner roll w/butter + 1/2c mashed potatoes + side salad w/dressing + cookie + 8oz soda)Snacks – snack item + caloric beverage (ex. Gatorade + granola bar) Must have at least one dessert per day, at least two added fats per day (like butter
On bread or salad dressing), and at least one snack/day
To my memory, standard is the same as basic but adds an item at breakfast, an item
to sandwich meals, a starch to non-sandwich meals, requires 2 desserts/day (lunch
and dinner), and snacks need a caloric beverage + protein item + snack item.
In PHP, there were two breaks throughout the day where people could receive
standing supplements as needed. I did not see standing supplements ever given in
IOP.
What sorts of food were available or served?Generic hospital food. It was generally fine, some things were actually pretty good. When I saw other reviews saying hospital food before I went there, I was picturing something super gross, but it really isn’t bad. For each meal, you have one-three choices of entrees and ~6 choices for sides. Entrees included turkey burgers, spaghetti with meat sauce, steak salads (mediocre steak though), marinated chicken breasts, egg salad sandwich, cheese ravioli, pot roast, pork chops, glazed ham, ground beef tacos, turkey and cheese sandwich, etc. Sides were things like cooked vegetables, side salad, dinner roll or bread w/butter, mashed potatoes, french fries, breadsticks, chips, and pretzels. Desserts included rice krispy treats, ice cream cups, sherbet, cookies, brownies, and cake slices. Caloric beverages were apple, cranberry, and orange juice; cola; ginger ale; fruit punch; lemonade; sweet tea.
Did they supplement? How did that system work?Yes. In PHP (and I believe IP), you get one ensure plus if you don’t complete your entree and one if you don’t complete all your sides (so you could get up to two/meal). In IOP, you max at one ensure plus per meal if you don’t complete everything.
What is the policy of not complying with meals?Supplements. If you consistently struggle to complete meals, and especially if you don’t complete supplements, you will be moved to a HLOC.
Are you able to eat vegetarian?No. You can select vegetarian entrees when they’re available, and for PHP and IOP you can eat vegetarian outside of program hours…but strongly consider your motivations for doing so (and staff can help you work through this!). I elected to eat mostly vegetarian outside of program and felt they were very respectful of this decision and helped me make sure it wasn’t a disordered choice.
What privileges are allowed?Not super relevant for PHP/IOP – but note that electronics are not allowed at all during program hours and your belongings are kept away from you in bins.
Does it work on a level system?No.
How do you earn privileges?N/A. Closest thing is that in PHP, the whole group only gets fresh air breaks if everyone finishes meals and/or supplements during downtime.What sort of groups do they have?PHP: music therapy, OT (topics included time management, leisure, snack prep), CBT, DBT, IPT, mindfulness, body image, perfectionism, nutrition, therapeutic goals group (usually some kind of activity led by nurse or MHW), community meetingIOP: OT (usually just time management and leisure), CBT, DBT, IPT, mindfulness, nutrition, body image, family supports
What was your favorite group?PHP: I really liked the DBT groups! I felt like this was where I got the most useful skills.IOP: All of the groups led by the program psychologist were generally great – she is AMAZING!I also loved mindfulness in both PHP and IOP. The same therapist led that for both levels of care and she was awesome.
What did you like the most?I felt like the therapists, nurses, and MHW across PHP and IOP were all generally good (with the exception of the PHP program director, who I didn’t particularly like). The other patients I was with in PHP were also kind and supportive. The IOP program director was AMAZING, I really loved working with her!
What did you like the least?The dietitian I worked with in IOP. Her groups were boring, she had a bad presence, lacked any sense of leadership, didn’t seem to actually know much about nutrition, and was sometimes condescending. I also felt the PHP director was cold and rude. Thankfully, I only saw these individuals 1-2 times/week usually.
Would you recommend this program?For both PHP and IOP, yes! I am much more medically and emotionally stable and way more emotionally resourced than before I began treatment. It’s definitely a situation where you get out of the program what you put into it, but for me, it was super helpful. I think PHP and IOP at CED are great options for people who are ready to work on their recovery, but given the amount of time off from program for both (but esp. relevant at PHP), I do think it requires a pretty high level of motivation and honesty to work.
What level of activity or exercise was allowed?In program, you were discouraged from extraneous movement or excessive standing. Outside of program, activity and exercise are allowed, but you are encouraged to check your intentions before engaging in movement. Movement that you want to do and that brings you joy AND is not conducted to appease your ED/as a compensatory behavior was encouraged, with a strong preference for non-cardio activities. You’re supposed to report exercise to the team (daily for PHP and 2x/week for IOP) – lots of high-intensity exercise will definitely earn you some questions (as is appropriate). It’s a hard line because I appreciated their flexibility, but it definitely puts the onus on patients to determine their exercise motivations which I sometimes struggled with.
What did people do on weekends?Whatever you like haha
Do you get to know your weight?Yes, in kg. Blind weights were strongly discouraged, which I didn’t like personally.
What was the average length of stay?PHP: 4-6 weeks. IOP: 6-8 weeks.
What was the average age range?About 50/50 early-mid 20s and 45+.
What is the electronics policy (e.g., cell phones, iPods, Kindles, laptops, tablets)?Not allowed during program hours. You could request phone access in PHP if you had a valid reason, and they generally would let you use it supervised. Often belongings were not actually locked away during IOP, so it was pretty easy to grab your phone between groups if you needed to.
For PHP/IOP: What support do they provide outside of programming hours?Not much. You can email the staff, but no guaranteed response. I highly recommend still working with an outpatient therapist and dietitian when in both PHP and IOP. Definitely not a good fit if you need crisis support available.
What kind of aftercare do they provide? Do they help you set up an outpatient treatment team?
They can definitely do this for people.If applicable: How is the program responding to COVID? (Less patients, virtual programming, no visitors, masks, social distancing, etc)New admits get tested on their first day. You can request a rapid test any day if you’d like. All staff and patients wear masks except when actively eating. Some staff did not consistently do this which irritated me. Other? Overall, I felt like CED helped me a lot.. I generally felt respected by staff, but I
personally hate the treatment dynamic of being a patient getting babysat by other
adults. That’s not a criticism of this program, though; just a shit reality of ED
treatment.
Bathroom breaks are monitored in both PHP and IOP. In PHP, staff keep the
bathroom door open and listen. IOP, you must be accompanied but they don’t go
inside with you. For both levels you can keep the stall door closed and flush on your
own.
Thanks for the info on the new program. What is HLOC?
Do you know if they have an outpatient clinic for just regular individual therapy and medication management?
HLOC stands for “Higher Level of Care.” So, being sent to a HLOC means that someone is bumped up to a more intensive level of care with more supervision/hours of treatment than their current one. Sheppard Pratt has the following HLOC at its dedicated Center for Eating Disorders (CED): Intensive Outpatient Program (IOP), Partial Hospital Program (PHP), and an Inpatient unit (IP).
I don’t know whether there is an outpatient clinic specifically associated with CED, so hopefully p or someone else can answer that question! However Sheppard Pratt itself has many outpatient clinics across Maryland that provide individual therapy and medication management – https://www.sheppardpratt.org/care-finder/outpatient-mental-health-centers/
Hi! I don’t think they have an outpatient clinic, but I know they are good at referring current (and I would guess past) patients to outpatient providers.
Hello, just looking to get a few questions answered. I see you said the food arrives on trays from the kitchen. Did they do away with the servery where you go through the line to get your food from someone serving it? Also, are you able to say more about the smoothie option versus the supplements? I’m curious as to what they have in them, or if that’s even known? I’m looking at IP so some of this information may be different. Do they still do movement group?
Hey! Food is not self-service, it arrives pre-portioned on a tray. Sometimes I think IOP does a monthly dinner prep group, and that is self-portion (with dietitian guidance). For people who receive standing supplements, you can get smoothies (blueberry or coconut chai) instead of an Ensure Plus. Smoothies are not an option (as far as I could ever tell) when supplementing for an incomplete meal. I have no clue what exactly is in the smoothies, for never asked/saw anyone ask. Yes, movement/mindfulness is still part of it! That was one of my favorite groups, the therapist leading it was awesome.
?Full Review from the Past Year?
When were you there?June 2022What level(s) of care did you do (e.g., inpatient, residential, PHP, IOP)?inpatient in June, currently in IOPHow many patients are there on average?this varied. it is a joint adolescent + adult unit, and there can be up to 24 patients total between both units. I think we had around 10 on average for the adults.Does it treat both males and females? If so, is treatment separate or combined?yes; combinedIf applicable: Do they support the gender identities of transgender and nonbinary people?they treat trans and nonbinary patients, but not all staff respect this. Some of them dead-name and misgender patients, which other patients always had to correct. Other staff members were extremely supportive.How often do you see a medical doctor, psychiatrist, psychologist (therapist), nutritionist, etc?Psychiatrist is seen daily, which can be a MD or NP.I didn’t see the medicine doctor. If you had serious medical concerns that the nursing staff couldn’t handle, you would get the medicine consult.I met with the family therapist once weekly with my family, and once weekly one-on-one.What is the staff-to-patient ratio?Depended on the shift; most times we had ~3-5 mental health workers available to help with bathroom breaks, support during meals, etc. Also usually ~5 nurses at a time.What sort of therapies are used (e.g., DBT, CBT, EMDR, etc.)?CBT, DBT, IPT, music therapy, occupational therapy, body image therapy, nutrition group
Describe the average day:
What were meals like?We were typically called for meals at 8:15am, 12:15pm, 5:15pm, and 8:30pm (breakfast, lunch, dinner, snack). Once everyone arrives to the dining room, they begin calling patients one at a time to go into the “kitchen” in groups of 3-4 to get your food. You have to prepare it in the kitchen with a MHW watching: cut your food, remove from packaging, add dressings/salt & pepper, etc. A MHW will check your tray before you leave the kitchen, and another MHW or nurse will check again before you sit. We also read “Dining Etiquette” before meals as a way to remind ourselves not to engage in ED behaviors to the best of our abilities.Once you finish your meal (whether or not you eat all of the food), a worker will come around and check off how much you’ve eaten and record this online. If you don’t finish your meals, you get supplements. Don’t finish supplement? Extra item at next meal.The first 3 days follow a “1-2-3” pattern plan. This is a bland, extremely basic meal plan to get you adjusted. The meals are smaller and gradually get larger during these days. After the first 3 days, you’ll be placed on the “basic” meal plan. Some patients will remain on the Basic plan for the duration of their stay, and others will be moved up to Standard after 3 days on Basic. Standard is usually considered the “weight gain” plan.Basic:Breakfast: Dairy + 4 itemsLunch and Dinner:Sandwich meal: Sandwich + 3 items + caloric beverageNon-Sandwich meal: protein + 2 starches + veggie + fruit OR dessert + caloric beverageYou must have 1 dessert a day on Basic. This can be at lunch or dinner.Snack: 1 snack item + caloric beverageStandardBreakfast: Dairy + 5 itemsLunch and Dinner:Sandwich meal: Sandwich + 4 items (including dessert) + caloric beverageNon-sandwich meal: protein + 2 starches + veggie + additional item (recommended to be fruit) + dessert + caloric beverageYou must have 2 desserts a day on Standard.Snack: snack item + protein item + caloric beverageYou can be placed on the Tall plan, which has an extra item at breakfast and an extra protein/entree at lunch & dinner, depending on your needs. They call it the “tall” plan, but it isn’t given to all tall patients. While I was there, the only person who was on this plan was average height, but wasn’t gaining any weight on Standard with Standing Supplements.What sorts of food were available or served?Breakfast:Dairy options were always cottage cheese, yogurt, milk, and chocolate milkWhite and wheat toast, bagels, english muffins, fresh fruit, fresh fruit cup, and juices were offered dailyThe menu changed each day, but some of these items are bacon, scrambled eggs, frittata, pancakes, cereal, donuts, muffins, etc. They vary the items to encourage patients to have a variety in their diet.Lunch and dinner:Entrees could be pastas, sandwiches, salads, tacos, chicken breast, pork loin, fish, etc.Offered daily: sides such as bread, dinner roll, side salad, fresh fruit, etc. Drinks (lemonade, iced tea, juices, cola, ginger ale, milk).Some sides varied to “match” whatever entree was being offered. For example, if a chicken sandwich was one entree, they would offer fries as a side to match this.Desserts varied by day, but included ice cream, sherbet, cookies, cupcakes/cake, pie, rice krispie treats, and pudding.Snack: goldfish, pretzels, Nutrigrain bar, Oreos, chocolate chip cookies, chips, etc.Protein additions: pudding cup, yogurt, cottage cheese, cheese sticks, 1/2 sandwichdrinks: same as meals (juices, lemonade, etc)Did they supplement? How did that system work?Yes. Meal replacement supplements are given immediately after meals, and you can get up to 2 Ensure Plus supplements depending on how much/what you eat.Some patients are on a Standing Supplement, which occurs at 9:30am, 2:30pm, or 9:30pm (really, this one is just after snack). Patients who need to gain weight more rapidly (or if they aren’t gaining at all) will be put on these. You can have one or multiple daily depending on your needs. These can be an Ensure Plus or a house-made smoothie. I liked the house-made smoothies better than the Ensure – the options were either blueberry or coconut chai. I preferred blueberry!What is the policy of not complying with meals?Supplementation. If you aren’t eating or drinking supplements, you have to stay longer. You may lose the option to go outside/garden/etc.Are you able to eat vegetarian?No. I was vegetarian for a few years before arriving and was not allowed to continue this at Pratt. However, they do offer some vegetarian meals.What privileges are allowed?Adults can make phone calls any time we aren’t in group. Adolescents have to get help to dial out, but can make a call any time. Adults are allowed to come back into the common area from 10-11pm, and can make calls or watch TV then.If the weather is nice and there are enough staff working, you can go outside during downtime.On Thursdays during the summer/fall, the OTs offer a horticulture group to patients who have finished all of their meals within the last 24 hours prior to group (aka, all of Wednesday’s meals + Thursday breakfast).Does it work on a level system?You can’t “level up,” but you can be placed on different levels/watches if they are concerned about SI/self-harm/etc.How do you earn privileges?Finishing meals & supplements.During warmer months, you can earn the ability to go outside if you finish meals.What sort of groups do they have?Mindfulness (yoga, mind-body connection, etc), OT snack prep, OT task (making bracelets, painting, etc.), OT leisure (playing games/puzzles/etc.), nutrition (making menus, learning about nutrition), body image, perfectionism, CBT, DBT, IPT, music therapy.What was your favorite group?I loved the mindful movement group. Being able to stretch was always so nice, especially because they encourage us to sit at all times. A lot of people took naps during this group, too, which was always nice.I also really enjoyed CBT, DBT, and IPT, which we had on Therapy Thursdays. The staff who facilitate these groups clearly care a lot, are very blunt when they need to be, and really helped us work through our thoughts. Body image was also great, but sometimes really heavy for me.What did you like the most?The psychiatrists are amazing. All of the therapists & social workers who lead group sessions were incredible as well. Some of the MHWs and nurses are absolutely the sweetest people ever, and clearly chose to work in the CED because they care about treating EDs. These staff members made it worth it – they were always supporting you for finishing an item you never had before, for trying something new, for finishing a meal, or literally just for TRYING.What did you like the least?Some of the MHWs and nurses clearly leave much to be desired. They didn’t really care about us, spoke in a rude manner, and generally made the unit feel a bit down when they were there.I hated how generalized the meal plans were. I wanted a more individualized plan, which wasn’t an option. Unfortunately there was only 1 dietitian there while I was there, and she was working in the PHP and IOP as well. When the program changed leadership they moved away from making individualized plans, which never made sense to me. Someone who was 4’8 on the Standard Plan had to get the same amount of food as someone who was 5’11 on the Standard plan, which didn’t make sense to me.The cafeteria workers didn’t always give the same amount of food when making your trays. Also, some entrees were bigger than others.Would you recommend this program?Yes. As many complaints as I had about certain staff members and the lack of individuality in the meal plan, this program worked for me. I didn’t even realize how miserable I was before I got there, and the difference is truly mind-blowing. It seemed impossible at first, but everything is within reach. I watched so many people enter the program at their worst and leave a few weeks later excited and hopeful for their futures.Side note: I recommend this highly for adults, but not as highly for adolescents. I can’t imagine doing this program as a teenager. The inconsistencies between staff members are just too great – some of the MHWs were rude to the adolescents, didn’t support them if they needed help during meals, etc.What level of activity or exercise was allowed?None lolWhat did people do on weekends?There would be 1 therapy group plus “Nursing group,” which just meant that the charge nurse would do an activity with us. The Saturday group was usually nutrition or Managing Emotions, which was an amazing group. Sunday group was usually OT task. Nursing group could be origami, painting nails, or karaoke (my fav).People would watch TV/movies, play games, read, color, call family/friends, and just talk to each other.Do you get to know your weight?Yes. Weights are done every morning and are recorded in kg. Depending on your psychiatrist, you could be told your weight in lbs. This was NOT beneficial for all patients – tread carefully with this.How fast is the weight gain process?It depends on the person. I didn’t gain at all for my first few weeks, but then I started to gain 1-2 pounds a day.What was the average length of stay?3-4 weeks, usually closer to 3 I believe. I was there for ~4.5 weeks.What was the average age range?In the adult side, average is early 20s. 18+ are in the adult side, 12-17 in adolescent side.How do visits/phone calls work?You can make a call any time not in a meal or group session. Adolescents need to get assistance from the secretary, a nurse, or a MHW to make a call. They bring us out into the common room at 7:15, so there’s an hour before breakfast when you can make a call. Again, adults can make calls from 10-11 pm (adolescents have to be in their rooms by 10 pm).Visiting hours are from 6:30-7:30pm and 7:30-8:30pm daily. Each visitor can only use one time slot. They say that you can only have one visit a day, and 3 visits per week, but it depends on who schedules your visit. Your visitors have to schedule a visit at least an hour in advance, but can schedule up to a week in advance. Only 1 visitor per time slot because of COVID.What is the electronics policy (e.g., cell phones, iPods, Kindles, laptops, tablets)?For adults, you can only view your phone/laptop if you have a doctor’s order to send a message or make a call for school/work/etc.For inpatient/residential: Are you able to go out on passes?nope. Apparently this existed pre-COVID, but no longer is an option.For PHP/IOP: What support do they provide outside of programming hours?in IOP now – you can send emails to staff if needed. They give you a food log for all meals outside of IOP. I’m meeting with a therapist and dietitian outside of IOPWhat kind of aftercare do they provide? Do they help you set up an outpatient treatment team?They give packets with information to help you with your meal plan, grocery shopping, portioning, etc. Yes. They make sure you have a plan for PHP/IOP/Outpatient prior to leaving, encourage a family therapy meeting with family/roommates, and will help you set up a safety plan if needed.Are there any resources for people who come from out of state/country?I’m in-state, but I know that out-of-state patients did get help finding in-state IOPs and outpatient teams prior to discharge.If applicable: How is the program responding to COVID? (Less patients, virtual programming, no visitors, masks, social distancing, etc)Visits are limited to 1 visitor per slot, with masks. Patients are supposed to wear masks in the unit, but this isn’t highly enforced by most staff members. One MHW in particular was a stickler about masks, but frequently wore their mask below their nose…which obviously annoyed us all.Other?Generally, this program really worked. I’m grateful to all of the amazing staff that I met while inpatient. I really resisted coming here at first, and I do have complaints, but the benefit FAR outweighs the complaints. This program really does work, but you have to be ready for it. If you aren’t at a point where you’re ready to address your ED and get better, this program will not be good for you. They have you jump right in a soon as you get there, and it will feel overwhelming at first. If you aren’t ready to get better, it will be too overwhelming for you. You need to be ready – or, like me, at least KIND OF ready – to get better before you come, because it is hard. It is so, so worth it. If you’re reading this: I believe in you, even if you don’t believe in yourself. You can do it! It sucks, and some days it feels hopeless. But you can get better! Pratt might not be the place for you, but don’t discount this program. It really helped me so much.
This is awesome!! Thank you so
much for posting such a thorough review. Without a doubt the effort you put into writing and sharing such a thorough review will help hundreds of people over the next couple years. Both for those looking to find the right treatment center for themselves or loved ones, and for those looking to prepare for admission to SP CED. I know a lot of people have been wondering what the program is like since the leadership changed.
It makes me happy to hear that SP is such a solid inpatient program right now. All programs have flaws, but not all programs are helpful enough that the benefits outweigh deficiencies. On a personal note, I can relate to the experience of a program that I complained a lot about ending up being the one that finally (and for me, permanently!) completely turned things around for me. I always appreciate hearing about other people who have this experience at a program as well!
?Full Review from the Past Year?
When were you there?March 2022
What levels of care did you do (e.g., inpatient, residential, PHP, IOP)?Inpatient, discharged to regular outpatient due to my work/school responsibilities
How many patients are there on average?While I was there, we had an average of 5-7 adults and 10-15 adolescents.
Does it treat both males and females? If so, is treatment separate or combined?They treat any gender and groups are combined. Adult group is separate from adolescent group.
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, etc?You see your psychiatrist daily and your nutritionist weekly. Adolescents will have individual therapy and family therapy once a week. Adults may chose to do the same or opt to have two individual therapy sessions in place of family therapy.
What is the staff-to-patient ratio?There is typically a handful of staff, maybe 2-4 mental health workers and 2-4 nurses depending on the time of day.
What sort of therapies are used (e.g., DBT, CBT, EMDR, etc.)?CBT, DBT, and IPT were used.
Describe the average day:
What were meals like?This is the system my nutritionist explained to me (for weight gain). The first three days are always the same for everyone (unless you have allergies/special dietary restrictions). The next three days you are put on the “basic” meal plan. The next three days you are put on the “standard” meal plan. After that, a “standing supplement” may be added.
Day 1-3: the meals were typically 3-5 items with a drink, very bland. You cannot add or remove anything from what is given on these days (so if you need a condiment, you’re S.O.L.) Below I listed three example meals that I had during days 1-3.
Breakfast: toast w/ butter, cereal w/ milk, & juice (coffee optional)
Lunch: chicken salad sandwich, banana, milk
Dinner: turkey w/ gravy, mashed potatoes, steamed carrots, juice
Basic meal plan: From my understanding, this is what would be considered a “maintenance” plan.
Breakfast: dairy + 4 items
Lunch: /Dinner:
· Sandwich meal: sandwich + 5 items + drink
· Non-sandwich meal: 1 protein + 2 starch + 1 veg + 1 fruit OR dessert + drink
Snack: 1 item of choice + drink
Standard meal plan: This is what would be considered a plan meant for gaining weight.
Breakfast: dairy + 5 items
Lunch: /Dinner:
· Sandwich meal: sandwich + 4 items + 1 dessert + drink
· Non-sandwich meal: protein + 2 starch + 1 veg + 1 item of choice + 1 dessert + drink
Snack: 1 item of choice + 1 protein + drink
Standing supplement: typically a smoothie; they’re supposed to be made with “real ingredients” to encourage an extra snack during the day that’s not as intense as an Ensure. They had coconut chai and blueberry as the flavor options (chai was good!).
What sorts of food were available or served?Your typical hospital food, not the worst I’ve had flavor-wise and there’s a decent variety. There should be a sandwich option plus one or two non-sandwich options for lunch/dinner. Breakfast is your usual line up (pancakes, eggs, toast, cereal, yogurt, fruit, etc).
Did they supplement? How did that system work?If you don’t finish your meal you have to do a supplement. I believe if you eat 50% you get 1 supplement, anything less is 2.
What is the policy of not complying with meals?Supplements if you don’t finish. If you refuse supplements, the doctors can get involved; I don’t know if that would result in—probably tube feeds if I had to guess but that never came up while I was there.
Are you able to eat vegetarian?Yes.
What privileges are allowed?Adults can use the phones in downtime, adolescents can use the phone as well but must ask a nurse the dial the number from a list approved by their parents. We were allowed to go outside as a group if the weather was between 65-90 degrees and there was enough staff.
How do you earn privileges?You can always use the phone. You have to complete meals in order to go outside. Some nurses allowed it to slide if you at least did the required supplement.
What sort of groups do they have?Nutrition, CBT, DBT, IPT, mindful movement, music therapy, art therapy, sensory group, OT task group, OT snack group, leisure group
What was your favorite group?I really enjoyed the alphabet therapy groups (CBT, DBT, IPT) which are really helpful, especially if you have a good group of patients who are actively participating. OT task group was my next favorite: we would go to the art therapy room and get to work on whatever project we felt like, with small goals in mind (ex: “how can I challenge my perfectionism while I make a beaded bracelet?”).
What did you like the most?The therapists and doctors were really helpful and knowledgeable. My treatment team was on board with a no-BS approach so they were all upfront and honest about our goals and how to meet them. I felt like I gained a lot more from this round of inpatient than I had at my last place.
What did you like the least?The other staff (mental health workers and nurses) can be really inconsistent with how they want to apply the rules. There’s definitely specific staff you have to watch out for because they’re looking for a reason to reprimand you or confiscate an item.
Would you recommend this program? I would recommend it for adults; I think the staffing issues are troublesome enough that I wouldn’t send my child here because they are less able to stand up for themselves when faced with challenging staff members.
What level of activity or exercise was allowed?Absolutely none (outside of movement group). You were required to sit as much as humanly possible. Standing was rarely allowed.
What did people do on weekends?We had 2 groups per day on weekends, and 1 was typically “nursing group” which could be as lame as coloring pages or as fun as karaoke depending on the staff. A lot of the weekend was spent sitting around, watching TV or playing board games if you felt like it.
Do you get to know your weight?You can see your weight in kg on the scale every morning. If you want to ask your doctor, they might tell you if they feel like it’s safe for you to know. My nutritionist told me what weight they wanted me to reach (in her words, “the floor level, not the ceiling”).
What was the average length of stay?3 weeks
What was the average age range?Adolescents are 12-17, adults 18+
We had a group of mostly 14-16 year old adolescents. The adults were about half in the early twenties and half in the 40+ category.
How do visits/phone calls work?There’s an hour for visiting every night. You can have one visitor at a time (COVID rule) and they need to call in advance to schedule. You would probably be able to have that visitor do a video call so you can see additional family at the same time virtually.
Phone calls are allowed anytime you have downtime and are limited to 15 minutes per call.
What is the electronics policy (e.g., cell phones, iPods, Kindles, laptops, tablets)?Absolutely NO electronics allowed on unit.
I am an adult graduate student and was not allowed to even access my laptop for an hour under supervision to watch lectures I missed.
Adolescent students have access to laptops under supervision during tutoring only.
What kind of aftercare do they provide? Do they help you set up an outpatient treatment team?They have both PHP and IOP at Sheppard Pratt. They also help you set up outpatient appointments; they scheduled therapy, psych, and primary care for me before I left.
Are there any resources for people who come from out of state/country?Several of the patients were from out of state! You’re supposed to have a long-distance calling card if you’re going to be making long-distance calls but you can ask friendly staff to dial out for you to get around that. Local area codes (including some from PA) are free to call.
If applicable: How is the program responding to COVID? (Less patients, virtual programming, no visitors, masks, social distancing, etc)You have to wear a mask (no wire) unless you’re in your bedroom. PHP is in person in the same building but on a different floor. There is virtual programming for IOP for the time being, but I heard rumors that’s going to change soon.
Other?Be prepared for therapeutic lunch & therapeutic snack! OT snack group is a time set aside on Tuesday for adults to prepare a snack together which we then eat at evening snack time. We made strawberry shortcake while I was there. Therapeutic lunch is every Wednesday: everyone gets the same “challenge meal” (unless you’re day 1-3), it’s served in “courses” (drink, then main meal, then dessert instead of all on the tray at the same time), it’s untimed, and the dieticians come to sit with everyone. We had Philly cheesesteaks, fries, mixed fruit, side Caesar salad, a drink, and a tres leches cupcake. You do have to supplement if you can’t finish. The snack and lunch are voted on by the patients; adults pick the entrée and the kids pick dessert.
Hi! Thanks for this review. I have a friend admitting here this week (it’s actually her first time in treatment ever) and she asked me about dress code. I assumed since it’s inpatient it’s the usual stuff (no strings, no jackets at meals, no midriffs, nothing too tight)… is there anything else she should know? I haven’t been to treatment in years so I’m trying to gather info and support her from the other side now. Thanks so much!
That is nuts they do smoothies now! I’ve been going to SP for many years, and always argued about Ensure not being realistic or helping to transition to learning how to eat snacks. I always told them I was not going to carry an Ensure around in my bag in public if I wanted a snack. Glad they finally changed it!
Any recent reviews? The program’s website has little information and appears to only offer inpatient now
any recent reviews? I’m having an evaluation done tomorrow
***
I am writing *** about the traumatic and substandard care I received during my 6-week inpatient stay at The Center for Eating Disorders at Sheppard Pratt in summer 2010. I endured excessive medical procedures, an unsafe environment, dismissive therapy, and dehumanizing treatment that worsened my mental health and violated my rights. ***
I was admitted for bulimia, grieving the recent deaths of my grandparent and aunt, but your program ignored my emotional needs and subjected me to daily—sometimes twice-daily—blood draws. These needle sticks left my arms bruised and painful, and I begged nurses to stop, explaining the harm, but they dismissed me. I question the medical necessity of such frequent draws, as I wasn’t severely ill ***.
*TW* I was sexually harassed by another patient who repeatedly made explicit remarks during meals, asking if I wanted to be “fed in the a with a dld*.” I reported this to staff, but they took no action, leaving me feeling unsafe and violated.*END TW* ***
My therapy was utterly inadequate. I told my therapist I felt worse, more depressed, and wanted to leave, but she ignored my grief and bulimia, stared out the window, and suggested increasing my medication by 20 mg. Her only advice was to “visualize a candle” for my pain. ***
Your program confined me indoors for six weeks, banning brisk walking, pacing, or exercise, and punished me for trying. I couldn’t go outside, and the sterile, controlling environment crushed my spirit. Staff forced me to eat everything, even when full, and gave me gold stars for gaining weight, treating me like a child. I felt humiliated, not helped ***.
Surrounded by severely ill patients—some collapsing or pulling out their hair—I felt out of place, and your one-size-fits-all approach ignored my specific needs *** exacerbating my depression and leaving me with trauma I still process 15 years later.
***
I’ve separately demanded a refund for the estimated $37,800–$63,000 cost of my treatment ***.
***
*** admin note: portions of this post that were not a review have been redacted.
Does anyone have experience with the Collaborative Care Group Skills Classes for support people at Sheppard Pratt? What was your experience like, and would you recommend it? Either from the perspective of having your family/friends/partner attend them while you yourself were inpatient, or attending them yourself while your family member/friend/partner was inpatient.
Here is the info from their website (https://www.sheppardpratt.org/care-finder/the-center-for-eating-disorders-at-sheppard-pratt/collaborative-care-group/):
I have an intake zoom call on Tuesday. I read that they don’t tube. I’ve been on a tube before with my gastroparesis and it’s the only way I’ve been able to get stuff into me because of the severity of GP. Will they consider people with medical issues like myself? I just don’t want to get my hopes up for being accepted. I’m running out of options though bc I have Medicare/Medicaid.
just curious, do you know why they aren’t doing PHP and IOP anymore?
They are moving their php program to the Baltimore/Washington location which is another Sheppard Pratt they just opened
Any idea what this is like? I wonder if it’s on their website yet.
any recent reviews from the past month or so? thank you in advance!
I’ve just heard they are only doing inpatient now. No PHP or IOP which is odd
I haven’t been recently but just checked the website M and it looks like you’re right, they only have inpatient according to the CED website.
Any ideas why? This is purely me being nosy lol, I’m a former patient and not seeking a HLOC atm
Nope but I wondered the same thing, I was also there in the past and was sorry to see they aren’t doing PHP/IOP anymore!
Me too! Totally just being nosy lol. It seems like it’s become less functional after founders B and C left. Which is unfortunate, because Sheppard Pratt is one of the few programs that takes Medicaid, Medicare, and Tricare
Yes, I was aware of this change, but thank you!
Does anyone know how long their waiting list is currently? Do they triage?
WL depends on the level of care. I don’t know how many patients are IP, but I know IOP and PHP are both under capacity atm! You have to do a level of care assessment & then they’ll let you know if there’s a waiting list & when your admission date is.
Sorry I forgot a couple questions!
Do you have to take out your piercings in inpatient? If so, can you have the soft plastic retainers?
Does anyone remember what sorts of foods were served in PHP? Was it just the same stuff as IP?
Was there a grocery store within walking distance of the patient family house? Was there a kitchen there?
Did people start at the PHP level rather then stepping down from IP? How do they decide what level you start at?
What amount of exercise was allowed outside programming in PHP?
I think piercings are allowed, I would think plastic retainer would definitely be ok if not.
Food was the same in PHP as in IP.
There isn’t a grocery store within walking distance, I don’t think
Some people start at PHP. It’s determined based on where you are with your ED/recovery, level of medical stability, or other psychiatric co occurring.
There is no exercise allowed at all. In IP, PHP, and IOP. Their philosophy (which I doubt has changed) is no excercise until you are 6 months out of a higher level of care.
That… would make the logistics of it extremely difficult to impossible without being able to drive. There are so few PHPs that take Medicare and I keep relapsing after inpatient so I’m losing hope for ever recovering. I don’t know what to do. That being the blanket policy just seems really ableist and classist not going to lie. It may be best for most people and I’m sure it would be best for me in an ideal world but it’s not possible for me…
In my experience at SP CED (2022), exercise is allowed in IOP/PHP, but the emphasis is VERY strongly on the intention behind it. They encouraged movement that was mindful/fun (so like going to the pool with friends to hang out on weekends would be ok, but not using that time to tread water to burn calories). Definitely not a program that banned exercise outside of IP, at least in my experience – it just really depends on your capacity to be honest with yourself in assessing what motivates movement. Any intensive exercise like running/lap swim will definitely get you side eye from the team, though (generally for good reason haha). I think if you need to walk to get places, that would probably be something to discuss with the team/dietitian to see if meal plan adjustments are needed.
People direct admit to all levels of care. Factors taken into consideration were medical stability, behaviors, weight change, and personal willingness/availability. If you are medically unstable, I doubt they’d let you do PHP and not IP, but they had some wiggle room for me throughout the process as I became medically stable to move between levels of care.
SP CED does seem to be better than it was under the old leadership. This all sounds much better, especially PHP having its own unit. I think I read smoothies for supplements? That’s pretty awesome. In the “old days” it was just vanilla or chocolate ensure – the program director didn’t want people to “enjoy” supplements.
I was not there under the old leadership, but I certainly did not have any of the horror-movie type experiences from the older reviews! Obviously some things I liked more and less but generally worth my time and helpful. I’m planning on posting more about my experience sometime soon. I was def grateful that PHP and IOP were separate from IP, though. I will also add that I think the smoothie supplements are only used in IP for standing supplements. For PHP and IOP it was definitely just Ensure Plus.
How do they calculate goal weights? is it Hamwi or another standard calculator or individualized? What is the rate of weight gain they aim for when determining your meal plan? I’m just worried since it’s not individualized I’ll gain too fast for me to physically/mentally tolerate on Standard because I am below my IBW but not by a huge amount and am an average height adult female. I don’t understand how a 6′ teenage boy and me could need the same amount of food to gain… does anyone have an idea of how likely an average height adult female was to get a standing supplement? If you don’t have a lot of weight to gain would they be willing to consider Basic with a supplement if you want to learn how to eat a normal amount of food? I always relapse at the transition back to a normal amount of food. Also, for the supplement can you get a cup of water to drink right after? I can’t stand the weird film any kind of supplement leaves in my mouth.
I did ED treatment elsewhere so don’t know the answers to these questions about Sheppard Pratt’s ED program, but IMO, treatment is never going to be successful if you have pre-conditions set about the amount of weight you’re comfortable gaining. This isn’t coming from a place of judgement (I’ve been in that place and honestly am just about back there right now), but just an observation that for me, as long as I’ve had set limits about how much weight I was willing to gain, that was my eating disorder clinging on for dear life. I don’t say this to discourage you from seeking treatment, but you may want to consider waiting until you’re fully ready to relinquish certainty around your own “acceptable” post-treatment weight just so you can give yourself the best possible chance of thriving and sustaining recovery when you leave IP/residential. Best of luck!
How do they calculate goal weights? is it Hamwi or another standard calculator or individualized?
— I’m not sure of exact details, but they base it off a growth chart (for adolescents and young adults), your historical weights/typical set point, and what is considered “healthy” for your age and height.
What is the rate of weight gain they aim for when determining your meal plan? I’m just worried since it’s not individualized I’ll gain too fast for me to physically/mentally tolerate on Standard because I am below my IBW but not by a huge amount and am an average height adult female.
— rate of weight gain depends on how much they determine you need to gain. Usually it’s a few lbs a week, I believe. Each person’s body responds differently to the treatment process, so it’s kind of unpredictable! I know it seems horribly unindividualized, but it gets easier. They wouldn’t give you a plan that you couldn’t physically tolerate – they monitor labs often to make sure of this! As far as mental toleration goes, it’s hard. But, weight gain is hard no matter what the rate is. For so long, we’ve been fighting to do the exact opposite. Gaining weight a little quicker or slower won’t be much of a difference – it will be hard no matter what, but I promise you can do it! Try not to worry about standard/basic plans until you’re there. You don’t know what plan you’ll end up on.
I don’t understand how a 6′ teenage boy and me could need the same amount of food to gain… does anyone have an idea of how likely an average height adult female was to get a standing supplement?
— there’s a “Tall” plan for people that height!
— it’s hard to say how likely that is. It depends on how far from your minimum safe weight you are, your % of meal completion, and your rate of weight restoration.
If you don’t have a lot of weight to gain would they be willing to consider Basic with a supplement if you want to learn how to eat a normal amount of food?
— everyone who was on a standing supplement was on the standard plan. If you want to normalize eating a normal amount of food, that means not replacing solid food with liquid supplements. It’s always worth asking, though!
I always relapse at the transition back to a normal amount of food. Also, for the supplement can you get a cup of water to drink right after? I can’t stand the weird film any kind of supplement leaves in my mouth.
— you can absolutely get water! Meal replacement supplements are the Ensure Plus, which I’m sure you’re familiar with. Standing supplements can be Ensure Plus or a house-made smoothie, which doesn’t leave a film.
You can do this! It’s hard and scary, and it seems intense, but you can do it. I believe in you!
Are you required to know your weight? Can you get on the scale backward? Unfortunately my brain would automatically convert it and it’s really triggering for me to know my weight.
Are groups and meals combined between adolescents and adults or just the unit?
Does their PHP take medicare or only IP?
Are the PHP clients combined with IP during the day or is it a separate program?
Do they have resources for people coming from out of state who want to stay for PHP?
Can you stay for longer if you don’t have any step down options in your area besides OP?
Do they have a specific % IBW they like to discharge people at? Can you stay longer then that if your situation warrants it?
What are their admissions criteria? I’m worried I won’t be considered “sick enough” for IP but medicare doesn’t cover res or 99% of PHPs…
Can you have clothes with strings?
Can you have an old-fashioned iPod that ONLY plays music? Is there any way to listen to music on the unit?
It’s been a few years since I’ve been there, I know the clinical leadership is different but this is my experience and what i’ve heard the program is like since change in leadership:
Best of luck!
Thank you so much, this is so helpful! Do you know what the transportation options to and from the patient family house or residential home are like? I don’t drive.
I had my car so I was able to drive from the patient family house across the street. It’s only like 1/2 mile away (and they definitely won’t let you walk), so I assume they help people arrange a taxi or take an Uber. The residential home is on the campus of Sheppard Pratt and is staffed (but not by ED staff), but I remember seeing those PHP patients escorted over to the ED unit from the residential house staff. It’s been years since I’ve been so I’m not sure how accurate this is now. I’m sure the admissions coordinator would be able to help too.
Do the residential programs take Medicaid?
was inpatient June 2022, briefly IOP in July and now in PHP!
You can absolutely stand on the scale backwards! Make sure you tell your provider you don’t want to know your weight.
Adults and adolescents have separate common areas, groups, and dining rooms.
All programs in the CED take Medicare/Medicaid.
PHP and IOP are separate from IP! PHP and IOP are in the same unit, just at different times.
They have social workers and a discharge team to help you figure out housing & such when you discharge from IP!
They won’t let you discharge until you have a plan in place (unless you leave AMA). They’ll make sure you have a program to go into & housing!
For people who need weight restoration, they give you a minimum safe weight. You don’t have to get exactly to the MSW, but you have to get close. The safe weight is based off of your growth chart, previous weights/set point, and what is considered healthy for your height and age. If you’re at your safe weight but not mentally ready (in terms of ED thoughts and urges), or if you don’t have a discharge plan in place, they’ll keep you until you’re ready.
A lot of us worry that we aren’t sick enough – often, this isn’t the case. Not everyone who was IP was medically unstable – it’s also about your behaviors. PHP isn’t always enough support for people, and they understand that!
No strings allowed! They’re a safety hazard.
You can’t bring an iPod, but they have headphones that play music. Also, there’s a radio to listen to music during meals, and various group leaders will play music.
Good luck – you’ve got this! I believe in you. 🙂
Looking to move my 17 yr old daughter from ERC PHP to Residential. Looking at Clementine, VA or Florida; Sheppard Pratt in Baltimore or Renfrew Florida. Any feedback regarding any of these would be helpful. She is eliminating and restricting. Down X lbs in less than X months. A long way to go for weight restoration.
* this post has been cross-posted from client general forum by admin to increase visibility
* numbers removed by admin per site policy
Does anyone know if PHP is still on the same unit (B1) as inpatient? Last time I was there a long time ago, patients were hoping for PHP to have a separate unit.
Also – since the original program leadership left, does the “atmosphere” of the program/unit feel the same or different? Just as far as rules, structure, approach
I also am very curious as I was also there many years ago and trying to figure out what it’s like now.
PHP is no longer on the same unit, it’s now downstairs!
I don’t know how the atmosphere was before the leadership change but I’ve heard from other past patients that it’s a lot better now than it was.
When were you there?
– August 2021 on the adult unit
How many patients are there on average?
– It really varies, but 5-15 and usually somewhere in the middle
Does it treat both males and females? If so, is treatment separate or combined?
– Both, combined
How often do you see a medical doctor, psychiatrist, psychologist (therapist), nutritionist, etc?
– Individually, you see a psychiatrist daily, therapist twice a week, medical doctor and nutritionist upon arrival and then as needed. You also will have group therapy with psychologists, OTs, nutritionists, and social workers 4x a day during the week, 2x on Saturday and once on Sunday.
What is the staff-to-patient ratio?
– They’re understaffed right now. There were usually 3-5 nurses on the unit for 21 patients (adults and adolescents combined).
What sort of therapies are used (e.g., DBT, CBT, EMDR, etc.)?
– CBT, DBT, IPT, sensory OT, and ERP if you’re an ARFID patient. Several patients also had frequent PT for various non ED issues.
Describe the average day:
Wake up 5:30/6am for vitals, and shower.
You head to the “milieu” aka lobby around 7:15/7:30am
8am meds (if you’re lucky and it’s a competent med nurse that day).
8:15am breakfast
10am group
11am group
12pm meds
12:15pm lunch
2pm vitals
3pm group
4pm group
5:15pm dinner
8pm meds
8:15pm snack
9:30pm back to the rooms to get ready for bed
Adults have the option of returning to the milieu from 10pm to 11pm
Bathroom breaks are every 90 minutes/2 hours ish. Weekends had no afternoon groups and Sunday had only one morning group. You are not allowed in your room between 7:30am and 9pm.
What were meals like?
Meh. There’s a preset menu for your first three days that’s pretty lowkey (e.g. cereal and fruit for breakfast, sandwich for lunch, chicken breast and mashed potatoes for dinner). After that you’re able to customize your menu to some extent. There are two meal plans–“basic” which is their weight maintenance plan and “standard” which is their weight gain plan. I was on standard which is what I’ll describe here.
Breakfast was a dairy item (2% milk, whole milk, chocolate milk, yogurt, or cottage cheese) plus five additional items (juice, fruit, toast with butter or peanut butter or jelly, cereal, potatoes, pastries, scrambled eggs, sausage, usually either pancakes or waffles or frittata).
Lunch and dinner were either a sandwich plus three items and a dessert, or a protein plus two starches, one veg, one additional item, and a dessert. Starches included dinner rolls, toast, usually one or two kinds of potatoes (french fries, mashed potatoes, tater tots, potato wedges), pretzels, or potato chips. Veg was either a small side salad (greens, one slice of cucumber and one cherry tomato plus your choice of dressing) or whatever the daily vegetable was (green beans, carrots, cauliflower, etc.). Other items included fruit and various kinds of soup (I never got the soup so I don’t remember what kinds but I was told the soups were very good). Desserts included pudding, ice cream, sherbet, cookies, angel food cake, pound cake, banana cream pie, chocolate pie, rice krispie treats, etc..
You also had to have a caloric beverage at every meal. These included apple juice, orange juice, 2% milk, whole milk, chocolate milk, lemonade, fruit punch, and pepsi. Additionally you could have either water or coffee at every meal. The rule for coffee was you couldn’t get it until after you finished the rest of your meal, and it was decaf for lunch and dinner.
Did they supplement? How did that system work?
– If you do not complete your entree you must complete 2 ensures (chocolate, strawberry, or vanilla). If you do not complete any other item it is 1 ensure. Depending on how much weight they wanted you to gain you might also have 2-4 standing supplements throughout the day. If you do not complete a supplement, you are given an additional item at your next meal. If you don’t finish supplement AND additional items the items start to add up which can get a little ridiculous.
What is the policy of not complying with meals?
– See above.
Are you able to eat vegetarian?
– No.
What privileges are allowed?
– If you’re regularly completing all your meals you MAY be allowed outside once a week. They also are currently allowing visitors on weekends for an hour at a time. Otherwise, not much. No electronics and bathroom breaks are monitored.
Does it work on a level system?
– Not that I’m aware of.
What sort of groups do they have?
– A variety of CBT and DBT based groups such as relapse prevention, challenging perfectionism, and body image. Also interpersonal therapy, movement therapy (which was usually very gentle yoga+meditation), art therapy, occupational therapy (usually sensory based), and nutrition education.
What was your favorite group?
– As an ARFID patient the CBT and DBT groups were completely useless for me. Education and activities in every single group were placed in the context of body image, which was obviously helpful for anorexia and bulimia patients but not usually applicable to me. Sensory group was the only group I really got anything from, and I loved the primary OT. Most patients really enjoyed all the groups with the exception of nutrition–most of the nutritionists are great but there are a few who really don’t know what they’re talking about and couldn’t answer any questions or conduct the group in an engaging manner.
What did you like the most?
– The psychiatrists there right now (different people than discussed in previous reviews) are all really competent and generally decent advocates for their patients. There were unfortunately a whole lot of issues with the med nurses and communication problems across the entire unit but you do see your psychiatrist everyday so if there’s a problem it’s usually resolved somewhat quickly. For the most part I think most patients were happy with their treatment team (psychiatrist, therapist, nutritionist, other specialists as needed).
What did you like the least?
– The nursing staff leaves a lot to be desired. A few of them are absolute gems and generally they’ll all get the job done but a lot of them are rude and condescending as hell and have no business working with mentally ill patients. There are also several of them who truly just make up rules at will. Just ridiculous stuff like no laughing too loudly, no fidgeting, etc.. You can tell those ones are only nurses for the power trip. It can be incredibly frustrating. Communication between different members of the treatment team and also between the treatment teams and the nursing staff was just horrendous.
Would you recommend this program?
– For anorexia and bulimia patients with tough skin who are comfortable speaking up and advocating for themselves, probably. But for real, be prepared for a lot of really frustrating conversations with staff pretty much hourly. For patients with any other eating disorder, absolutely not. If you have ARFID/OSFED/orthorexia anything besides typical standard anorexia or bulimia, you’re not gonna get much out of this program.
What level of activity or exercise was allowed?
– Practically none. We were very rarely allowed to even stand. We did have movement therapy a few times a week but it was limited to very gentle seated yoga.
What did people do on weekends?
– Color, read, watch tv, puzzles, journal, hang out and chat, nap. It got incredibly boring and if you’re easily under-stimulated or need to be distracted from your ED thoughts it can be incredibly tough, especially because your treatment team isn’t around if you have a crisis or even just need them to address something basic (such as a change in medication, in my case).
Do you get to know your weight?
– You are weighed every morning and can look at the scale if you’d like, but it is in kilograms.
How fast is the weight gain process?
– Pretty fast. I gained about half a kilogram (so one pound ish) a day pretty much everyday while I was there.
What was the average length of stay?
– Around a month but it really did vary. Some people only stayed for 10-12 days, some for months.
What was the average age range?
– There were 15 adults for the majority of my stay. Most of us were in our early 20s, but there were like three 18 year olds and three people in their mid 30s. I was lucky to get a really good cohort and generally everyone got along with everyone while I was there.
How do visits/phone calls work?
– You have a lot of opportunities to make calls throughout the day. It’s easiest to make in-state calls but if you want to call a non-Maryland number you can either get a long distance call card or have a member of staff make the call and then transfer it to the patient phones. The visitation policy while I was there was monitored hour-long visits with up to 2 adults during the evening on weekends and Tuesdays and Thursdays.
What is the electronics policy (e.g., cell phones, iPods, Kindles, laptops, tablets)?
– No electronics, period. Not even MP3. They have a limited number of radio headphones available.
Are you able to go out on passes?
– Not to my knowledge.
What kind of aftercare do they provide? Do they help you set up an outpatient treatment team?
– I left against medical advice so I couldn’t say.
Are there any resources for people who come from out of state/country?
– Again, I’m not totally sure about this but there were definitely a lot of out-of-state people who didn’t seem to have any issues.
If applicable: Do they support the gender identities of transgender and nonbinary people?
– Meh. We had a transgender patient who got a single room with no problem and whose identity was respected, but there was one nurse who used they/them pronouns and the entire staff misgendered them constantly. I actually don’t think I heard a staff member use their correct pronouns even once. That was really upsetting to me as a closeted nonbinary person.
Thank you so much for sharing this Grace!! This is very helpful. We haven’t had a review of Sheppard Pratt since SP’s original Center for EDs psychiatrists/team left a couple years ago to start ERC Baltimore.
I’m curious if they allow someone to be weighed backwards if that is their preference. Do you happen to know?
Do they allow you to get phone numbers off your cell phone to use on the unit phone, or to check voicemails if you think you might have an urgent one coming? For example, some places let you check voicemails if it might be something related to disability, government benefits, medical leave, health insurance, or school, but then make you still call them back from the unit phone.
I’m also curious about their overall ARFID protocol. Feel free to answer as many or as few of these questions as you’re comfortable with – no pressure to answer any if it’s too much!
Obviously as you said, most group therapy patients attend isn’t useful for ARFID. That must have been extraordinarily stressful for you! Were the group leaders at least aware of that? I’m very proud of you that you gave it a chance, and I’m very proud that you stood up for yourself and your needs and it sounds like stuck to your boundaries and your truth and left once there was no more benefit to you. It sounds like a delicate painful balancing act, and your strength in navigating it jumps off the screen. I hope you are proud of yourself for all of this as well. Keep doing what you’re doing and I’m positive you will find recovery.
Generally speaking, what is SP’s ARFID protocol? You mentioned that they have ARFID patients do ERP, are those food exposures, sensory exposures, is it individual or group? Do you happen to know if you can do individual sessions with the OT? Outside of group, were staff knowledgeable of the difference between ARFID and the other EDs, or did you feel that it was mainly only just a few people who understood (the psychiatrists or individual therapists for example)? Did you get the sense that the ARFID program is still in development and might be more helpful down the line once more work has been put into it, or that it’s pretty much settled and will remain as is?
Thank you again so much.
You were allowed to step onto the scale backwards and that’s what the majority of patients did.
You also may get phone numbers off of your cell phone under the supervision of your therapist/with an order from your psychiatrist, but it’s best to ask about this in advance because some patients who took advantage of this had to wait a few days after their request to check voicemail/get phone numbers.
Their “ARFID protocol” was individual ERP (food exposures based on a hierarchy of challenge foods you create with your team) with your assigned psychotherapist. This ERP actually took the place of psychotherapy, so while the rest of the patients received individual talk therapy twice a week I did not and instead did the food exposures. I didn’t have much of a choice in this and while it was a bit frustrating not to receive talk therapy, the food exposures did definitely help for me.
All patients do sensory exposures in group once a week. You can get the OT on your treatment team and have the occasional consultation with her, but I wasn’t able to meet with her individually on a regular basis. The OT was actually the only person who I felt had a solid understanding of sensory-based ARFID and how to treat it. If your ARFID is more anxiety/emetophobia/OCD-based, the individual therapists and psychiatrists can also be helpful. My ARFID is pretty exclusively related to sensory discomfort and a lack of appetite, which I really felt only the OT and maybe my psychiatrist understood/believed. Nurses and group leaders had no knowledge of ARFID and were not even aware of my diagnosis, and when I brought it up they were usually confused/indifferent. My guess is that their ARFID programming is about as good as it’s going to get, but I could be wrong. Myself and other patients noticed that CED in general doesn’t seem interested in changing despite a lot of similar, consistent feedback from patients over the last couple of years.
In my experience the major challenge with being an ARFID patient at Sheppard Pratt is that the majority of your treatment is not actually individualized and many of the group leaders and nursing staff seem to have no knowledge of eating disorders beyond anorexia and bulimia.
Please let me know if you have any other questions! That goes for Rachel and anyone else.
I personally do not believe Sheppard Pratt is a bad program, but it’s definitely not right for everyone and for anyone considering it I recommend asking a lot of questions and getting as much info as you can before you admit.
Has anyone been here for IP since COVID who could provide a review?
I was at Sheppard Pratt when it was still the CED at Sheppard Pratt. Has anyone been there since the CED folks lef to form the PHP ERC Program? They don’t have IP and that is what I will need so it looks like I’ll have to go back to SP. But Im sooo curious about what it’s like there these days. I would be on the adult unit.
I will first say that my experience was in 2015 so it’s been a while but it was HORRIFIC. It was by far the worst place out of the 14 I’ve been to and I was treated like an animal. I haven’t even been able to open up to anyone about the abuse I experienced there. Absolutely horrible.
Do you have any recommendations? John’s Hopkins or Brandywine?
I did IP at SP and PHP at Dominion Hospital in 2014 (as an adult), so it’s been a long time but from what I saw (IP and PHP patients were together at Dominion), I would definitely choose Dominion if I had to do IP again in/near Maryland. SP seemed to have a very narrow view of what an ED looked like and what recovery looked like, and I didn’t “fit the mold” for either, so the experience was traumatic for me. Dominion was less rigid than SP in that way, which allowed for more individualized treatment.
This is helpful K! I haven’t seen yet anyone comparing their experience between the two. Do you think you could also write this on the Dominion review page, so that people who go to that page can see it too? https://edtreatmentreview.com/reflections-at-dominion-hospital/
When were you there?
I was on B5 (the children/adolescent unit) in March 2018, June 2018, and October 2018.
How many patients on average?
On B5 the number of patients widely varied, they had 13 beds but could have some people room on B1 (the adult unit). I have seen as few as two inpatients (including me) and as many as 15 at one time.
Does it treat both males and females? If so, is the treatment separate?
It treats both males and females. The only difference is that males cannot room with females, and the male population is typically quite low (which seems to be common for eating disorder treatment).
How often do you see a medical doctor, psychiatrist, therapist, dietician, etc.?
You meet with a medical doctor on the day you’re admitted and as-needed from then on. You see your psychiatrist every day, and then there are usually one or two psychiatrists who work on the weekends. You have therapy twice a week, and family therapy twice a week (with a different family therapist). You don’t see your specific dietician unless necessary, your psychiatrist is usually the one to give you updates on your treatment and meal plan. You do see all the dieticians one Wednesdays for therapeutic lunch (which I will get into later), but it’s not for an appointment,
What is the staff ratio to patients?
There were always a good number of staff members. I think there was always one nurse and then maybe 3-5 MHW’s (mental health workers) whether there were a lot of patients or not. It was an inpatient unit, so they kept a close eye on you.
What sort of therapies are used?
DBT, a lot of CBT, and that’s about it.
Describe the average day:
It’s been a while so I don’t remember the schedule verbatim. We woke up at six, and they would wake you up by turning your lights on and then taking your laying and standing vital signs. During your first three days, they’d come in at about 3 AM to prick your finger and force you to eat a snack if your blood sugar was too low. You’d go use the bathroom, change into a paper gown, and get weighed. Next, you’d grab your towels and anything else you need before sitting down to wait for the shower (though “shower” is a generous way to describe a room with a showerhead and some curtains around the area where the drain is). Then you get everything out of your room that you’d need for the day before they locked everyone’s rooms (you could sometimes persuade a staff member to let you back to your room if necessary). Then you sort of waited around until breakfast came. Since it’s a hospital, the food comes up on trays from the kitchen which tend to be late. I’m pretty sure that breakfast was scheduled to be at 8 AM (I could be wrong), but trays could be up to an hour late. After breakfast, you essentially have groups until lunch. Your psychiatrist will most likely pull you for your appointment in the morning, but it really just depended on how busy they were. There was also a water break at 9 AM where you could get a cup of water or you might have to drink a supplement depending on your meal plan. This was also when phlebotomists would come on Mondays and if anyone needed labs any other day. We had to get our blood drawn every Monday, plus your first seven days there. Lunch was supposed to be at twelve. Then more groups until either 2 PM or 3 PM when we had an hour-long break and they would take our vitals again. There was also another water/supplement break. Then more groups until dinner at 6 PM I think. After dinner was visitation hours and just free time. The TV could be put on (it was only allowed in the morning before breakfast and the evening after dinner). Snack and another water/supplement time were at 8 PM. Your visitors would also have snack with you if they hadn’t left yet, and you had to finish your snack in order to get water. Then they’d open the bathroom up to get ready for bed and everyone had to be in their rooms with the lights off by either 9 PM or 10 PM (the adults get to stay up later, though).
What were meals like?
Meals were 45 minutes and were standard hospital food (i.e. not that good). There were two regular meal plans: basic and standard. A meal for basic included a protein, two starches, a vegetable, an additional item or dessert (you needed dessert once a day on basic), and a caloric beverage. Breakfast was a dairy plus I think four items. On basic, you also needed three added fats (salad dressing, butter, etc.) a day. They were very strict about the added fats, I had to butter cold rice and cold vegetables along with once putting two servings of butter on a roll. A meal for standard included a protein, two starches, a vegetable, an additional item, dessert, and a caloric beverage. Breakfast was the same with one extra item. Same number of added fats a day. There was also a “metabolic” meal plan which was the same as standard except with double protein and an additional item. There was also the option of “50%” and “75%” if someone was particularly struggling. 75% allowed you to take any one item (other than the entree) off of your tray. 50% let you take two off. Everyone could have one eight-ounce cup of water with their meal unless they had a doctor’s order for two cups of water. At mealtimes, there was a playlist that the patients made that would be turned on. People would talk or play table games. We weren’t allowed to talk about food and we’d be redirected if we were engaging in any behaviors. There would be one MHW at each table who would be monitoring. Staff was not allowed to eat or drink anything in front of us unless it was therapeutic lunch or we were at a pacing meal. Next, I’ll go into different dining situations that are not the typical dining experience at Sheppard Pratt.
For your first three days, you’ll eat in the aptly named “123 Room”. This dining room combines all the new adolescents and adults with one staff member for probably a maximum of five patients. Your first day you eat the 50% meal plan, then you go up to 75% on your second day and full basic on your third day. In the 123 Room, you cannot have water until you complete your meal.
Next is therapeutic lunch. On Wednesdays, the adults on B1 would pick the meal for this (Hawaiian, appetizers, breakfast for lunch, tacos, pasta, etc.) and we’d pick our dessert the week before. This was essentially where there would be a hot bar set up with what we were eating and you would (with a dietician breathing down your shoulder) serve yourself the proper portion of the food for the meal. There were usually a few choices here such as what you wanted on your french toast or whether you wanted to add something that wasn’t part of your meal plan. Then, the dieticians would also fix themselves a plate and two of them would eat with us. This was usually the only time staff would believe us if the food was terrible. This kitchen had a terrible reputation of serving us disgusting or inedible food, but the staff never believed us if we told them since they weren’t consuming it. Once, for therapeutic lunch, the pasta was SO overcooked that me and some other girls decided that we were going to supplement for it, but the dieticians decided that it was inedible, so we had to make the kitchen cook us new pasta. After therapeutic lunch, we had therapeutic lunch group, where we would discuss our feelings, find out what the lunch would be for the next week, and vote on the next dessert.
Next, we have pacing meals. A lot of people struggled with finishing their meals in the allotted 45 minutes, so much to the point that they had to get a timer that we could see while we ate in order to finish in time. If you were really struggling, they would set up a pacing meal with an OT (occupational therapist) where the two of you would have the same tray, and they’d eat with you while giving tips for reducing disordered behaviors and better pacing.
Another situation for meals is a family meal. I don’t know if these were a thing for the adults, but you could have your family come in to eat a meal with you under the guise of your family therapist. Mine was breakfast and we had to serve ourselves, and my family therapist knew absolutely nothing about my meal plan which was irritating.
A final meal situation is 1-1. You could be placed on 1-1 for meals if you were really struggling at meals. With 1-1 you would sit at a table separated from the rest of the group and had an individual staff member with you. This could be useful when you were placed with a good staff member, but a bad one could make it miserable.
What sorts of food were available and served?
Entrees included things like fried chicken, taco salad, turkey tetrazzini, roast beef, turkey sandwich with mayo, tofu stir fry, etc. There were a couple of strange entrees such as a fruit and cottage cheese plate which had A LOT of cottage cheese, so I’d only recommend it to someone who really likes cottage cheese. Side options included side salad, fruit of some sort, roll with butter, some form of cooked vegetable (peas, green beans, zucchini, etc.), rice, pretzels, potato chips, etc. Some examples of dessert are rice krispies treats, sherbet, ice cream cups (like the ones from elementary school), slice of cake or pie, pudding, ice cream sundae cups, etc. Caloric beverage options included coke, ginger ale, apple juice, orange juice, cranberry juice, etc. Breakfast foods included cereal (rice krispies, plain cheerios, cinnamon toast crunch, raisin bran), french toast, cinnamon roll, glazed donut, bacon, breakfast sausage, yoplait yogurt (peach, blueberry, strawberry, cherry, or vanilla)(they would give you a flavor and you could ask for a different one, but that wasn’t always an option), 2% milk, chocolate milk, scrambled eggs, muffin, etc. Snacks consisted of one item (pretzels, goldfish, potato chips, yogurt, etc.) and a caloric beverage. They also started therapeutic snack where it would be something “special” like tortilla chips and salsa, etc.
Did they supplement? How did that system work?
They did supplement. The policy was that you had one supplement if you finished >50% of the meal and two if you finished <50% of the meal. The way they determined your percentage was based on the entree. If you completed your entree it counted as 50%, but anything other than a complete entree counted as <50%. The supplements they used were ensure plus. They had chocolate, vanilla, strawberry, and butter pecan. One supplement was one eight-ounce bottle of ensure plus. Some people would have daily supplements to increase their weight gain. I think the maximum amount of supplements you can be forced to drink daily in addition to your meals is three and a half, but it could be four. If you're really struggling with picking supplements over food, your doctor can put in an order to have an extra supplement if you don't complete the meal (50% would be three).
What is the policy of not complying with meals?
If you didn’t complete, you’d be given a supplement. You had until the next meal started to drink your supplement. You weren’t allowed to have anything at the supplement table and you weren’t supposed to talk to anyone. If you didn’t drink your supplement(s) by the next meal, you’d dump the drink down the sink (you didn’t drink straight from the bottle, an MHW would always pour it into an eight-ounce styrofoam cup), and have an extra item on your tray at the next meal. For lunch and dinner, the extra item was always a roll with butter, and you’d have an extra item on your tray at breakfast the next morning if you didn’t drink your supplement from dinner or snack (or both). The breakfast items were on a rotation. I remember Sunday was a cinnamon roll and Wednesday was a slice of cranberry-orange bread with butter. If you didn’t eat or drink supplements for three days you would get the tube and you could also get it if your team thought it was appropriate. They didn’t like to give people the tube because it was a tedious process. You had to pack everything up and get “discharged” from Sheppard Pratt and get admitted to St. Joseph’s right next door to Sheppard Pratt for about a week. Then, you’d have to be admitted back to Sheppard Pratt. If your team thought the tube was what you needed, you’d usually get a “warning sign” of having to go to the ER for IV fluids. I had this experience because I was in the 123 Room and you couldn’t get any water unless you finished your meals. I hadn’t been completing my meals, so the only water I had been drinking for three days was my tiny cup of water with my meds at night. I was severely dehydrated, so I had to go to the ER and get IV fluids and was essentially threatened with the tube if I didn’t get it together.
Are you able to be vegetarian?
Hard no. There are absolutely no exceptions to this: everyone has to eat meat at Sheppard Pratt.
What privileges are allowed?
When you’re inpatient, your privileges are extremely restricted. You can watch TV and there’s a computer in the milieu that everyone can take turns with. You’re allowed to have visitors every day (I don’t know how that’s panning out with the whole pandemic, though). Other than that, they’re very strict on many things: no strings, no staples, only people under 18 are allowed to bring in a singular stuffed animal, no metal, no pillows or blankets from home, eight-minute showers, no pen caps, no books about eating disorders or inappropriate topics, chapstick is kept at the nurse’s station, anything with a pump is monitored by a staff member, no distressed jeans, no clothing that shows your bare shoulders, no tights, socks have to have grippies if you’re walking around with no shoes, etc.
Does it work on a level system?
No. You can totally get privileges taken away and be put on precautions. Different types of restrictions include:
-SO (suicide observation)
With SO, you have to sleep with your bedroom door open and your lights on. You have a different type of blanket, and you have to stay in the milieu during the day if you’re not in a group (you can’t sit in the hallways although you’re technically not supposed to do that anyway). You also have open-door bathroom and showers.
-SO 1-1
This is essentially the same idea, but you have to have a staff member with you at all times.
-Open Door Bathroom and Showers
Bathroom breaks are already quite restricted. You’re only supposed to use the bathroom during the specified bathroom breaks and the toilets flush by a staff member using their key. Staff will record things such as whether you’re on your period or if you have a bowel movement. You have to ask the staff for feminine hygiene products. Males and females have to have separate bathroom times despite the fact that the bathroom has two stalls. If you have to use the bathroom when it’s not a bathroom break, you have to find a staff member and ask them for an emergency bathroom break where they will have to leave the stall door cracked and watch you while you use the bathroom (it’s really uncomfortable but you honestly get used to it). If you’re purging or accused of exercising, you can get put on an open-door bathroom and/or shower. It means that you’ll always have a staff member observing you while you use the bathroom and a staff member will also bring in a chair and go into the shower room with you.
-Safety Searches
When you first come in, you get a safety search to make sure you aren’t hiding anything to sneak in and that you don’t have any self-harm on your body. It feels pretty invasive, one staff member holds up a paper gown while the other asks you to take off each article of clothing while they also check your arms, calves, etc. If you’re hiding food or self-harming, you can get put on mandatory searches at certain times of the day. For self-harm, it will typically be in the morning and/or evening. Once you get your evening search you’re not supposed to leave your room and you’re not supposed to enter your room again after your morning one (though you could usually get away with it). If you were hiding food, you could end up getting them after every meal and/or snack. It really depended on what your team thought was appropriate.
-Elopement Precautions
If you tried to elope (run away), you could get put onto elopement precautions. You wouldn’t be allowed to wear shoes on the unit (only grippy socks) and you wouldn’t be allowed to leave B5. It honestly sucked when someone was on this because it meant that no one who was inpatient could leave B5, which is a pretty small unit. We suddenly had to have art therapy in a crappy little room rather than in the proper art studio on B1. Plus, it’s just very easy to get sick of the same small unit.
-Codes
Since this was a hospital, they could call “codes” for certain emergencies such as a major behavioral issue or a medical emergency. I don’t know everything that these entailed, but they usually brought a lot of staff who would pin you down and give you “booty-juice” at the order of your psychiatrist if it was a “code green” (behavioral). You could also get restrained to your bed if you were excessively self-harming and possibly if you were over-exercising. These were usually few and far between, so not anything to worry about as long as you behave.
How do you earn privileges?
You can’t earn privileges unless they’ve already been taken away. As long as you follow the rules and don’t use many behaviors, you won’t get privileges taken away.
What sort of groups did they have?
Different types of CBT groups, DBT, mindfulness, art therapy, IPT (interpersonal therapy), body image art, music therapy, community meeting, therapeutic lunch group, and OT (occupational therapy).
What was your favorite group?
My favorite was music therapy. We mainly got to play ukuleles or work on the mealtime playlist. You could also get recommended for individual music, art, or body image therapy where things could be a little more individualized.
What did you like the most?
I found that Sheppard Pratt was where I met some of the kindest and most compassionate staff out of every treatment center. They might not have completely understood what we were going through, but you could tell they cared and that they wanted to help.
What did you like the least?
I have a couple of main issues with the program at Sheppard Pratt. One of them is the supplementation system. If you aren’t drinking your supplements, you don’t get to attend groups and possibly get the help that would get you to drink your supplements. Plus, I would sit at the table for hours on end with absolutely nothing to do which made it feel like I was being punished for having a hard time. One more issue is that the environment can change very easily and quickly. Since it’s a small unit made up of children and teenagers, drama and struggling are common. It’s just quite unfortunate that it spreads very quickly. This is partially due to the competitive nature of eating disorders. But one person would begin struggling, and then the entire group would start to have a hard time. Then it just felt like a cycle that was really hard to break.
Would you recommend this program?
I think Sheppard Pratt could work for some, but you have to be prepared for a pretty intense treatment experience. It’s definitely a hospital and they are quite strict about their rules. Go into it expecting this and you could have some amount of success. If it doesn’t work, I’d say you aren’t alone with struggling with Sheppard Pratt’s Center for Eating Disorders.
What level of activity or exercise was allowed?
Next to none. The only “exercise” was walking to groups. You had to be sitting all the time, with your butt back in the chair. You also usually got reprimanded for shaking your leg. I once didn’t make weight and the psychiatrist told me that I might have made weight if I wasn’t shaking my leg so much. There were also security cameras to make sure that you weren’t doing anything you weren’t supposed to be doing.
What did people do on weekends?
We had a lot more free time on weekends, Most people would watch TV (we could turn it on after lunch on the weekends), read, take turns on the computer, journal, and take turns with the two phones. There were also much longer visiting hours on the weekends, so your family/friends could spend more time with you on the weekends. Therapists and dieticians weren’t usually there on the weekend, there would be probably one of each for each unit (B1 and B5). There would also be one psychiatrist who was there to check in with everyone on the weekend. It would very rarely be your psychiatrist unless you had the main child/adolescent psychiatrist on the unit.
Do you get to know your weight?
Yes, but it’s in kilograms rather than pounds.
How fast is the weight gain process?
You have to gain 0.2 kg (which is a little under half a pound) daily at least. You could gain more than that, but I think they capped it at 3 kg a week (which is a little over 6 pounds). If you didn’t make weight for two days in a row, they would increase your meal plan or add a supplement. If you were going from standard to basic, you would have a supplement at the end of the day before you went onto standard.
What is the average length of stay?
I’d say the average for inpatient is about 4 weeks, but some people’s insurance kicks them out at two weeks inpatient. It can also be much longer than that depending on how you’re doing. It does feel like they “kick you out of inpatient” and into PHP if you’re not self-harming and you’re completing your meals which sucks if you’re still mentally struggling.
What was the average age range?
About 12-17 on B5. There always could be younger kids, and they sometimes would put someone who was 16 or 17 down on the adult unit. I heard that there was once an 8-year-old child there, so they don’t really have an age minimum.
How do visits/phone calls work?
Visiting hours are every day after dinner. You have a list that your parents have made of who can visit you or your parent could bring someone with them when they visit. For phone calls, you have a phone list of people who are allowed to call you and who you can call. When you want to call someone, you have to go to the nurse’s station and ask them to call that specific person. You cannot be visited by past patients and you can’t call/be called by past patients.
Are you able to go on passes?
When you are trying to go to PHP, they send you on an LOA (leave of absence) or PLOA (practice leave of absence). With an LOA you go to an approved restaurant with a family member and you have to follow the meal plan. You get about three hours left and you can go to PHP if your LOA is successful. A successful LOA is determined by you completing your meal, following the meal plan, and making weight the next day. A PLOA is an hour-long snack “LOA” where you go down to the cafeteria and eat a snack from the vending machine. This is just to prepare you for a real LOA. You can also have a pet visit (these are pretty rare) where you get to go outside to Sheppard Pratt grounds and hang out with your family/pet for about an hour. You’re not supposed to walk around, but I definitely broke that rule.
Are there any resources for people who are out of the state/country?
A lot of patients’ families and the patients would stay at the Ronald McDonald House nearby while they were in inpatient and PHP. I don’t know what other resources they have with regard to that.
I hope this long-winded review is helpful to someone. I tried to be as thorough as possible so that anyone can know what to expect if they go to Sheppard Pratt.
Hi Rachel,
I’d be happy to provide a brief update here to help clarify as we realize this transition is a little confusing. The new program you are referring to is actually a partnership between the Center for Eating Disorders (CED) and Eating Recovery Center (ERC). CED has been led by Dr. Harry Brandt and Dr. Steven Crawford for over 30 years. Our team of experts designed and operated the eating disorder services at Sheppard Pratt from 2005-2019. During this time we were referred to as the Center for Eating Disorders (CED) at Sheppard Pratt. On January 1, 2020 our partnership with Sheppard Pratt came to a close and we began an exciting new collaboration with Eating Recovery Center (ERC), the only national health care system dedicated to the treatment of eating disorders and related disorders. On January 17, 2020 this new partnership allowed us to open ERC’s first East Coast location. Now known as ERC-Baltimore, we currently provide PHP and IOP programs for children/adolescents and adults of all genders as well as comprehensive outpatient treatments. Drs. Brandt and Crawford and all of our clinicians are excited to be a part of ERC and to continue meeting the needs of individuals and families impacted by eating disorders in the Mid-Atlantic through new and innovative programming. Please don’t hesitate to call 410-427-3900 or visit http://www.eatingrecovery.com for more information and details about the Maryland programs. We are located in Towson, Maryland.
Thanks,
Kate Clemmer, LCSW-C, Eating Recovery Center, Baltimore
Clinical Outreach Coordinator
Sheppard Pratt’s Eating Disorder Program has changed leadership, and as of February 2020 it is no longer run by its original founders. The former directors left in order to open Eating Recovery Center‘s new location, ERC Baltimore.
Any updated information about who is running the Sheppard Pratt program now that CED is no longer contracted with them? Also, any updates on how the program is running? Do they still have a separate child/adolescent unit? Trying to make a decision and not sure which direction to go at this time. Thank you.
Just an FYI, Sheppard Pratt has contracted an outside physician’s group to run the CED for years and as of January 1, 2020, that contract is ending and it will be run under Sheppard Pratt’s medical direction. I have no idea if this means any policies or staff will change, but I wanted to share just to let people know that there could be changes. (This info is from a letter Sheppard Pratt sent me and I assume their other former patients.)
Thank you for the update! I’ve been wondering what is going on. I just saw a post a couple hours ago from Eating Recovery Center about them joining with the Doctors from Sheppard Pratt to open a Maryland ERC location: https://www.eatingrecoverycenter.com/about-us/media-resources/press-releases/eating-recovery-center-opens-maryland-location
Any recent experiences? There was a very punitive and non-individualized vibe when I was there in 2008, but that was clearly a decade ago.
Sheppard Pratt saved my life. I am 14 years old and was referred here from the Johns Hopkins ER. I spent 8 weeks inpatient and 5 weeks in PHP. The staff is absolutely amazing! They will do anything in their power to help you. On the adolescent unit, the youngest was 10 and the oldest was 16. Days are filled with groups including many CBT groups, art, OT task, music, mindfulness, DBT, and IPT. There are two meal plans- basic and standard. Basic is an entree plus three sides, while standard in an entree plus four sides. Although, there is also a metabolic meal plan which is an entree, four sides, and an extra protein. On basic you need 2 added fats a day while on standard you need 3. A caloric beverage is required on every meal plan with lunch and dinner, but optional for breakfast. All patients start on basic but may be moved up based on their needs. If a meal is not completed, supplements will be given. 2 supplements if the entree or less than 50% is completed and 1 supplement if 50% or more is completed. There are also standing supplements which may be prescribed if a patient is completing meal sand not gaining the appropriate amount of weight. Personally, I was on 2 for about 4 weeks. For your first week in inpatient you get labs and a finger stick at 4 am for the first 5 days., In PHP you get blood drawn for the first 3 days. No matter what program you are in, everybody gets labs every Monday. When you first arrive, you also get a physical and EKG. Many patients will also get a DEXA scan. For inpatient, you wake up at 5:30 and can take an 8 minute shower. You must be in bed by 9:30. For PHP, you arrive at 7 and leave at 7pm. There are 4 doubles and one triple on the adolescent unit, so there can be 11 patients up there at a time. If it is full, patients may sleep on B1 but program on B5. I was on B1 for my first 3 days inpatient. Roommates are assigned based on age. My oldest roommate was 19 and my youngest was 14. The no touch rule is a huge policy on the unit. If broken, patients will be redirected. Staff is super helpful and supportive. I absolutely recommend this program! – a thankful survivor
This place is not any help. I’m manic they send me home 3 times.because my eating disorder and they said I cant bd on mental ward restricting. If this is a mental hospital it needs to cover all aspects to stabilize patients. Very unprofessional very irragonat staff. Very forceful of agenda and not caring. Cold environment. Wouldn’t recommend.
CED at Sheppard Pratt has been a lifesaver for me. I can see why some may have posted negative reviews but through my time with this program I have come to believe in what they do. The center for eating disorders is located within the main hospital of Sheppard Pratt. Sheppard Pratt is a psychiatric hospital that has units for other things as well. Sheppard Pratt hospital is always ranked within the top 5 best psych hospitals in the country.
The daily inpatient schedule from others listed above is pretty accurate, PHP follows a similar schedule but inpatients and PHP don’t have groups together except for community meetings.
There are lots of benefits of this program. First of all, they don’t turn anyone down just because they don’t have certain criteria of being “sick enough” they are not like that at all. Another great benefit is that in inpatient and php you meet with your psychiatrist everyday, which you don’t in some other programs. Your psychiatrist is your treatment team leader, and you also have a dietician, individual therapy, and family therapist. Individual and family therapy is 2x per week.
The schedule for inpatients is definitely very structured and they do this to help you block your eating disorder symptoms. Bathrooms are always monitored and staff actually flushes the toilet with a key, so you have no way to hide if you purge.
You can see your weight everyday if you choose but weights are in kilograms so you don’t have to just see your weight in lbs.
Since this is a major psychiatric hospital, the staff is great with all the psychiatric disorders that you may have like anxiety, trauma, or mood disorders. If you need your medication adjusted they are good for that.
I would say one of their main priorities is safety for all patients, so there are searches of bags in inpatient, and each day in PHP you have a search, for safety and to make sure you aren’t bringing any diet pills, laxatives, ect.
The program is big on CBT and DBT, they also have group like interpersonal therapy, motivation to change, and occupational therapy.
As others have stated the unit is locked 24/7, even for PHP patients during program hours. PHP has their own day room and dining room though. Another good thing is that if you first do inpatient and transition to PHP you have your same team you have been working with for inpatient.
Kids 15 and a below are completely separate from adults, they have their own unit upstairs from the adult unit.
From what I hear the unit has been renovated within the last year, so it has a different look from what I hear, although I have not been there since.
If you have never been in eating disorder treatment before this program is great and structured although arriving and getting adjusted can be daunting at first. There are just a lot of rules and regulations, and since they are within a psychiatric hospital there is more of this than in the average Ed program.
The Center for Eating Disorders also has an IOP that is Monday-Thursday 3:30-7:30pm. This program is good because you specifically have to be doing well and you must be motivated otherwise they won’t keep you at this level. So the group is usually a pretty good one. IOP is also much smaller than the inpatient and PHP programs. IOP is completely separate from the inpatient and PHP unit, and of course it is not locked and bathrooms are not monitored, but you are only allowed to use the bathroom once- before dinner, definitely not after for obvious reasons.
After IOP they also have a regular outpatient program, which is where I have been for the last year and a half. You have a psychiatrist and therapist and you can choose to add appointments for family therapy or with a dietician.
One thing I will say for sure is that the program throughout all levels of care are very consistent. All rules are expected for all patients, and the staff is very consistent. The only thing I will say is that the meal plans could be a little more individualized but besides that this program is great, especially if you have the chance to do all levels of care. Just doing inpatient can hard when you leave because you are in a very protected environment and then you just go out in the real world- so they like everyone to do their PHP and even IOP if you live in the area.
The staff is great and the program directors are leaders in the field!!
Part of recovering from an eating disorder requires you to eat all different types of food. She will learn that ALL food is healthy in moderation. No hospital or ED program is going to feed your child unhealthy food. As a parent, it is important for you to encourage her to think this way rather than supporting her in believing some foods are “healthier” than others. When someone with an ED say she will only eat certain “healthy” foods, that is her eating disorders way of helping her restrict – the underlying reason is not so much about the nutritional value of the food but rather about avoiding certain foods.
Hello,
My daughter is 15 yrs old and is an avid runner. In late May, she started skipping meals and losing at lot of weight. She said that she was researching the internet and was following different “runner’s diets,” but now it has gotten to the point that if she doesn’t find out the nutritional value of everything she puts in her mouth, she won’t eat it. She is 5’2″ and weighs 88 lbs. I took her to two doctors, a general pediatrician and a sport medicine pediatric doctor, and both said she has an eating disorder. One of the doctors recommended Sheppard Pratt, but I am concerned that my daughter, being an athlete, will not find some of the foods that others have commented on in this forum I.e. Desserts, healthy enough to eat. Can anyone comment on whether SP has an adequately healthy meal plan for people like my daughter? Do you think SP would be effective for her? I would appreciate anyone who can reply. Thank you.
[Note: I truly hope that this response is admitted to this thread, in spite of it being somewhat controversial in taking a hard line against certain treatment centers and methodologies, and of it discussing not only SP, but other facilities as well. I do feel that all of this was very important to write.]
Hi Anne,
In many respects, I agree with the above statement about your daughter needing to learn that it is okay to eat all kinds of food, and that moreover, with a new eating disorder diagnosis, you and the rest of your family will likely need to re-learn entirely what ‘healthy eating’ is. But this is anything but a lecture, and I want to offer a few caveats that I would personally add to the above, as someone who has anorexia and has been in and out of several different treatment centers for the majority of my life.
I think your comment resonated with me in particular for two reasons: first, I was at Sheppard Pratt when I was first diagnosed—having just turned thirteen, so barely younger than your daughter. From what I hear, not much has changed regarding that facility; to that end, I want to IMPLORE YOU NOT TO ADMIT YOUR DAUGHTER TO SHEPPARD PRATT. Please do NOT settle for a treatment center just because it is close to you—not all facilities are created equally. This brings me to my second point: I was diagnosed with anorexia when I was thirteen. I am now twenty-seven. It is no one’s fault that I have an eating disorder, but part of the reason that I now refuse to seek further treatment and continue down this path, knowing where it will end if not exactly when, is because of traumatic treatment experiences like those that I endured at Sheppard Pratt and other facilities. In addition to anorexia nervosa, I also have a diagnosis of PTSD from my subsequent hospitalizations.
Full recovery is, and always will be, possible for your daughter… and she has the best shot at recovery if you treat this with the individualization, compassion, and tenacity that someone as exceptional as your daughter deserves. To that end, it is likely that you will—if you haven’t already—be told about a certain treatment method known as Maudsley or FBT (Family-Based Treatment). I do NOT recommend you attempting this method with your daughter, and I say this emphatically and explicitly because Maudsley/FBT—with its emphasis on rapid weight gain often above and beyond a child’s set point, on parental deception, and on resenting, rather than having compassion, for the eating disorder—is being touted as the ‘best treatment method,’ particularly in the Sheppard Pratt area. The data that support Maudsley/FBT are based on scientific studies, yes, but the error analyses for these studies are about a mile long. This is the method, and these are the principles, that have made me so fearful of treatment now, as several treatment facilities have adopted certain tenets of the Maudsley methodology categorically.
Some things the philosophy gets right, however, are that, first, this is neither your daughter’s fault nor your own: parents do not cause eating disorders. Ever. Ever. Ever. They also cannot cure eating disorders (although as written previously, one can recover fully), and yet, whenever possible, families help to play a central role in an individual’s recovery… but this involves, like I said, re-writing your own beliefs about food, weight, and health. It means learning a new ‘language’ where foods are neither ‘good’ nor ‘bad’ and that very often, at least in the early stages of healing (and sometimes long after), the word ‘healthy’ means ‘fat’ to your daughter.
One of very few facilities I would recommend is called Center for Change in Orem, UT. In fact I did not have a particularly glowing experience there, but this is because of a number of factors that just had to do with me possibly not being a very good ‘fit’ with the facility. I have been there twice. The vast majority of the women I was with both times have gone on to recover fully… and these women were severely ill, in the grips of their eating disorders. CFC may have changed substantially from the time that I was there, but again, from what I hear it is still quite similar.
Another excellent center is Monte Nido in southern California; I have heard several individuals speak highly of its remote affiliates as well. Monte Nido and CFC would be my two primary recommendations.
Although several of my friends speak very highly of the Eating Recovery Center of Denver, where I have also spent time—and these friends are also very strong in recovery or recovered—I cannot in good conscience recommend ERC without noting that I disagree with certain aspects of their treatment philosophy. Similarly, however, I cannot in good conscience neglect to mention it, since they have done very good work across a full continuum of care for several of my friends.
Finally, I would recommend avoiding at all costs not only Sheppard Pratt but Castlewood and its affiliates (Monarch Cove and The Highlands). Castlewood used to be a remarkable facility—perhaps the best in the country—and the new management that has long since overtaken these centers have continued to ride on the coattails of the model that they no longer abide by, and of phenomenal staff who are no longer in any way a part of their centers.
All my best to you and your daughter… and please do remember… all foods are healthy for your family.
Take care of yourself as well,
AJ
Thank you for this info I’m a 49 year old woman abt to go into Treatment I’ve spent two weeks looking into treatment centers reading reviews, doing hour long assessments, and I have finally narrowed it down to Center for Change, Monte Nido and The Ranch In Nunnely Tenn. this is a very hard decision and I suffer from depression too! Thanks for the info.
Amy,
I think you would do very well at CFC, not least because of your age. Of course I can’t guarantee anything about what the population census is like right now, but every time I was there, all throughout my stay there seemed to be several women who were 30- and 40-plus. I have been to tour Monte Nido and visited its outpatient location on a number of occasions and while of course they treat individuals of all ages, both the client census and groups themselves seemed geared more to younger folks and/or those newer (though not entirely new) to eating disorders.
Again, with the enormous caveat that I have not been to Monte Nido in recent years, several of my friends report that ‘it’s changed from what it was’ and that the founder is not as involved with the facility as she once was. However, if you get a different impression or are leaning towards Monte Nido, go with your gut, since all of this is coming significantly secondhand.
I hope you find the healing you deserve. 🙂
I just wanted to say that I’ve also heard that Monte Nido programs have changed a lot over the last two years. The founder stepped down about two years ago, the program bought Oliver Pyatt and opened some adolescent facilities and the expansion seems to have changed them. There’s also been a huge staff turnover. I personally haven’t been recently but I have heard that it’s not what it used to be.
Dear Anne, I am a recovering runner as well and I am looking for a place with healthy options. Did you have any success? I need help soon if you can offer any advice! I hope your daughter is okay!
this was my first inpatient treatment experience, which took place in september 2016. it was absolutely atrocious. there is no way i would advise that someone seek treatment here unless they were going to die waiting for a better treatment center. i threw out the paperwork i had received at my time there, but i will try to summarize everything the best i can.
i felt deceived pretty much the moment i entered the unit. the photos they show online are of their admissions office in an unrelated building, the PHP milieu which inpatients are not allwed to use, and of the children’s/adolescent’s unit, upstairs. both look modern and bright. the actual unit i arrived on, however, was old, filthy, painted in yellows and brows, and carpeted (carpets… throughout the entire eating disorders unit… yeah). it might sound silly but i feel like i had had my trust betrayed then and there. not only that, but they also started doing major renovations on the unit while we were all in there. twice the paint fumes were so bad that all the inpatients had to be relocated for an hour or so.
next there’s the shower situation. there are 4 showers between the 27 available beds. if you’re not woken up super early, you have to wait for an open shower in the paper gown you’re weighed in. once one person leaves the shower, it’s “cleaned” by a staff member lazily spraying shower cleaner on the walls a couple of times. you have 8 minutes to shower. my first morning, a staff member accused me of not showering and instead exercising because he apparently didn’t hear the shower running. i did indeed shower, my hair was even wet and i left in the towel, but he kept accusing me and i was very scared given that it was my first morning. after your shower you have to walk down the hallway to your room past the other patients on the carpeted floors in only your towel. in order to do things like put on makeup, dry your hair, or even brush your teeth, you have to wait in line for “vanity” – it’s a tiny room with 2 sinks and basically the only mirror you’re allowed to look at on the unit. this, again, has to be used by all 27 inpatients.
you spend your entire day in the “milieu” and you are not allowed to be in your room except to sleep. there’s never enough chairs for everyone. there’s a long bit of time after everyone has to go to the milieu before breakfast starts where there is literally nothing to do. you’re forced to sit in the milieu and watch tv before going to breakfast for no real reason. you aren’t allowed to sleep during this time.
the meal plans make no sense whatsoever. the portions are ridiculous even if you don’t need to gain weight, as there are very few meal plans offered. i only knew of 2 – “basic” and “standard,” basic being the initial meal plan everyone begins on. others have went into more detail about this, but i’m still shocked about it to be honest! treating a donut as equivalent to a cup of juice or a huge slice of chocolate cake as equivalent to an apple doesn’t help anybody learn normal eating habits. it’s also absurdly difficult to get enough water here. you’re only allowed one non-caloric beverage per meal; even utilizing all the water breaks, if you want coffee in the morning, you’re down to 5 cups of water per day. if you have to gain weight, like i did, and you get increased to “standard,” you have to have two desserts (meaning things like cookies and ice cream) per day. the only way to get a smaller meal plan is to have symptoms of refeeding in your blood work. then you get reduced portions until your blood work normalizes. even more out of touch with reality, you only get one pass to practice what you’ve learned, and it’s only one meal planned to happen right before you discharge.
staff was outright rude at times. one nurse actually neglected to give out morning medications entirely one day. very irresponsible. staff can be very inconsiderate and insensitive at times. it really felt like no one cared about your well being. at one point they admitted so many people on the unit that 2 patients had to sleep on cots. combined with the construction, and the milieu that didn’t have enough chairs to begin with, it’s hard to feel like they’re treating you with any motivation but the money.
the way that “bathroom breaks” are run feels inhumane. the bathrooms all have multiple stalls and are key-flush. multiple women will use the bathroom at the same time. you have to wait in a long line because there are 4 stalls for all the inpatients. if you’re a guy you get to wait until literally everyone else has already gone before you’re allowed in. staff does a terrible job at letting patients use the bathroom for an emergency even if the patient has a medical reason to do so. if a patient needs to use a hat to measure urine output (for kidney function) the hat is left on the window sill with their name on it for anyone and everyone to see. no privacy.
there are other things that made this program terrible but these are the main ones that made it a useless and upsetting experience for me. i wish it was more widely known just how mistreated patients sent here are. please avoid this if you have any other options!
Any current summer/fall 2016 reviews?
Any recent spring/summer updates? I also want to check out Hopkins but the comments are disabled for some reason!
I am in my mid-40’s and pretty chronic so I just want to get a sense whether it is a program worth pursuing.
Hopkins seems to have so many strong opinions on both sides that it freaks me out a bit since I can be difficult at times (:
I was at Hopkins a few years back and am also chronic and in my 40s. I can share details if you want to email me direct. Not sure how to do that, though.
I am in a similar situation and am also interested in knowing the programs benefits/lack thereof for an older/chronic patient. A recent review would be great!
When I was there in 2015 I was stripped searched by two nurses several times. The first time was when I was admitted and then again when I left the unit for a sign-out and then returned.
When you are in day treat you have to be “processed” everyday. You need to completely strip into a hospital gown, wait in a line to be weighed. If you are an adult waiting in line with teenagers that can make you feel very self-conscious about your body.
When I was in day treatment for some unknown reason they strip searched me when I left for an appoint and returned later in the day.
The pro’s are competent staff and a wide variety of groups including movement and art therapy which you can have both in a group and individually. The therapists are highly qualified. I haven’t been that impressed with the doctors. I think it’s luck of the draw.
I want to refute this sentence of paula’s comment: “Because you voluntarily sign yourself in for treatment, they can keep you there until they need to, essentially.” If you are voluntarily inpatient (at Sheppard or any hospital in the USA), they CANNOT legally keep you unless you are a threat to yourself or others (as in, you’re going to kill someone, having an eating disorder is not a reason they can hold you). You may being leaving AMA (against medical advice) but you have the right to leave and they are violating those rights if they hold you after you have expressed your intention/desire to be discharged. When I was at Sheppard, they made it sound like you had to wait 72 hours from the time you expressed wanting to leave to the time they would discharge you, but this is a lie. You DO NOT have to wait 72 hours if you are voluntarily and aren’t a threat to yourself or others. They also made it sound like insurance companies would not cover further treatment if you discharge AMA but as far as I can tell (from my own experiences and from several people I’ve known), this is also a lie.
I was in SP from December 2 – 28, 2015. My first thing would be to say: DO NOT expect to get out in the 10-14 days they say the average stay lasts.
I suffer from generalized anxiety, which got so bad that I couldn’t eat (I don’t have the typical type of ED; my issue stems from anxiety only), and a lot of the time I spent at SP was really devoted to getting me back to a medicated state that I could maintain outside of the inpatient program. I spent a lot of days in a medicated fog because of trying new meds and seeing what worked. If you chose this program you NEED to tell your doctor everything; symptoms, mood, thoughts, opinions… They can’t help if they don’t know.
Meal times were usually okay but could be stressful for a lot of different reasons. Some of the food sucked, and some of it was generally pretty decent. Don’t order something you don’t like or know you like after trying. Supplements suck and can screw up your digestive system (there’s a reason the patients talk about supplement farts all the time), so try to eat your meals if you can do it.
Some of the staff members are absolutely wonderful, sweet human beings. Then there are some real big jerks there. It’s a hit or miss depending on the day.
Sheppard Pratt’s ED program saved my life by getting me on medications again and by refeeding my body. However, if you’re NOT going to take this program seriously, DON’T sign yourself in. Go somewhere else or don’t go at all. Because you voluntarily sign yourself in for treatment, they can keep you there until they need to, essentially.
If you need an immediate save, try SP. Need to learn really good life skills and how to cope? Might not be the best choice, even if your individual therapist/family therapist is good.
Hello,
I am hoping to get some clarity on a few questions I have. I have heard that you are strip-searched by two staff members upon admission. Is that still true? Also, what about clothing, shoes, etc? I have heard that you can’t wear anything with hoods, strings(including shoes), belts, pockets, etc. Also, no boots or any shoe that goes above your ankle? Are you allowed to have hair driers, makeup, etc.? Is there a minimum weight gain that is expected for each day? Do they drop your meal plan once you have hit the target weight? I have read on here that they do not, but these reviews are a bit older. Thanks!
Hi! Sorry for the late response.
Every time you leave and reenter the locked ward, you’re strip searched. This is so that people can make sure you aren’t hiding contraband or things for self harm. Sometimes my individual therapist would take me off the ward for therapy sessions, and I wouldn’t be searched upon reentry.
You’re correct about the clothing. Leggings are okay as long as a shirt or sweater/sweatshirt/something covers near your butt. Most people wear slippers, slip on shoes, or hospital socks– you can ask for hospital socks with the grippies on the bottom at any time and you’ll get a pair. No pockets or hoods. Might be different for PHP.
You can have hair dryers and curling irons or flat irons but they have to be kept behind the nurses station. Makeup and personal toiletries are kept in a labeled bin for each individual person.
Each day, they would like you to gain at least 0.2kg. I think that’s what it was anyway. You start out on basic meal plan (or a smaller percentage of that if you have trouble completing meals or if you’re a refeeding syndrome risk). Once you stop gaining, your doctor may move you up to standard. My doctor increased to standard by meal. First couple days, just standard at breakfast, then next day standard at breakfast and lunch, and so on. Your meal plan will never drop once it increases unless you’re once again struggling.
But eating 100% at meals is really one of the only ways to get out of SP. If you’re not progressing mentally, emotionally, and physically, they’ll keep you as long as they can.
Our daughter was at Shepard Pratt in 2015.It was a horrible and traumatizing experience…we still cry when we talk about it. The nurses gave her the wrong dosage of meds 3 times and she was all zoned out and a couple times they could’ wake her in the mornings until I finally started asking questions and it turns out they were doubling her dose…this happened 3 times in 1 month.Also they aren’t supervised at all with the Internet and our daughter was online and came across pornographic pictures( did I mention she’s 11?) The nurses literally screamed at her when she wouldn’t complete her meal.ED are very frustrating for the caretaker but if you can’t handle it better than that then please find a job elsewhere. Our daughter came home from Shepard Pratt with triple the problems she went with and a year later we’re still dealing with the consequences.I would definitely not recommend this center to anyone.
Here is a more recent 2015 review!
When were you there? April-July 2015
Where is it? Towson, MD just north of Baltimore

Type of treatment: inpatient, partial hospitalization, intensive outpatient, outpatient (the following is my inpatient experience)
Age range? They have an adolescent ward upstairs and adults downstairs. I was with the adults and average age was around 20 with the oldest in her 70’s
How many patients? 20ish?
Do they accept men? Yes
What professionals do you see? Medical doctor, nurse, psychiatrist, dietitian, and therapist
How often do you see them? Nurses every morning, medical doctor as needed, therapist twice a week, psychiatrist every day
What sort of therapy/ groups do they do? CBT, DBT, art therapy, individual and group, occupational therapy group, snack prep group, nutrition group, body image, horticulture, mindfulness, community meeting
Electronic allowed? You are allowed older iPods or MP3 players as long as they can’t access internet but you must have wireless headphones
Computers? they have 2 computers that you can use during the allowed times
Exercise program? No
What was the typical day like? Staff will wake up between 5:30 and 6:30. Your vitals will be checked laying in bed and again standing. You then go down to the bathroom to use the toilet and change into a paper gown. Then you go down to the weight room to get weighed and get your towels. You sign up for a shower and wait your turn. They have a closet with cubbies and your shower bin is kept inside. They have 4 showers and you get 8 minutes to shower. Then you go to the vanity room where the sinks and mirrors are. Everyone waits at the top of the hall until they let us out to the main area at 7 and lock the sleeping area. Their common room is called the mileu and you watch tv (always the today show) until breakfast at 8. You can also get meds and they open the cabinets that have your personal bin where you keep books and pencils and such. Breakfast is at 8 in the locked dining room until 8:45. See below for more about meals. Meds are after breakfast. Groups vary each day but you have a pretty busy schedule. They offer bathroom breaks at certain times during the day. A staff member has to use a key to flush the toilet and you may be on “open door†precautions if they suspect purging or self harming. Lunch is at 12, dinner at 5, and night snack at 8. If you are on supplements, they give them at 10, 3, and at night snack. There is free time/visiting hours after dinner. We go back to the sleep area around 9. At 10 they let us back out to the mileu to watch tv until 11 and then it’s bed time.
What are the weekends like? There are some groups but visiting hours start earlier
What are meals like? You start out in a smaller room called the 1-2-3 room. You are here for the first 3 days and then you move out to the main dining room. There are no assigned seats and you wait until they call your name and then go up to your tray. You then “set up†your tray with staff watching. This means removing wrappers, spreading butter, using condiments, etc. you can them sit down. No double layers can be worn in the dining room and no personal belongings. You have 45 minutes for meals. When they call time, a staff member comes and checks your tray before you can bring it back to the cart. They check to ensure all your silverware is still there. Then everyone has to say in the dining room for 15 mins for support. We usually play games. Get ready to learn bananagrams!
Can you be vegetarian or vegan? Not at all
Do they supplement? Yes it’s Ensure
What’s the food like? They have 3 meal plans: basic, standard, and tall. They base it off of the number of “itemsâ€. I didn’t like this because chips count the same as an apple for example. Foods: Yogurt, regular milk, chocolate milk, eggs, pretzels, chips, cookies, soup, French toast, pancakes, cereal, bread, bagels, pasta, potatoes, lots of sandwiches, lasagna, macaroni and cheese, peanut butter, cottage cheese and fruit plate, French fries, rolls, granola bars, pudding, fruits, veggies, salad, wraps. You have to have a calorie drink at every meal and a dessert at least once a day (twice for standard and tall). Drink choices are ginger ale, cola, regular milk, chocolate milk, and various juices. Desserts are cookies, cheesecake, ice cream, sherbet, chocolate or vanilla cake, brownies, lemon bars. Wednesday’s are therapeutic lunches where a challenge meal is voted on. Saturday night snack is a challenge snack on a rotating schedule. Tuesday snack is something made by patients in snack prep group. I thought the food was pretty average for a treatment center.
Do they use feeding tubes? No they will just send you to the hospital
Is there a level system? Not really. They do have something called one-to-one level that you are out on if you are suicidal or self harming. This means a mental health worker is assigned to be with you 24/7. You have to sleep with your door open and the lights on. You can also be “put on camera†which means the camera in your bedroom will be activated. Usually this is for of they suspect you are exercising.
What happens if you don’t comply? You have a team meeting to discuss your treatment plan. You may be forcibly discharged.
What’s the weight gain like? 2-4 pounds a week (their scale measures in kilograms though)

Can you see your weight? It depends
Are bathrooms locked? Yes and a staff member has to use a key to flush the toilet
What’s the phone/visits like? You can use the phones in the morning and evening and as long as there is no group or meal. Visiting hours are between dinner and night snack and are extended on the weekend.
Do they allow smoking? No

Can you go outside? They have a small courtyard that that take people outside usually just once a day for 15 mins if there is enough staff available.

Can you go on passes? You start having passes to go out for meals when you are getting ready to transition to PHP.
The good=
•Staff is so good! I loved 95% of the staff and that’s good for me haha. They have something called mental health workers and I loved a few of them so much!
•every day you are assigned to a mental health worker or nurse as your “contactâ€. They check on you during the day and see if you want to talk.
•I got introduced to the concept of an altered book, which is an old book that you glue cut out magazine pictures and whatever else you want inside. The art therapist will explain it the first group you have and almost everyone does them because they are really fun! You can even do it during free time in the mileu because they have drawers full of magazines.
•Art group and occupational therapy group were really neat! You could make so many different crafts!
The bad= 
•The common area they call the mileu is too small. There are not nearly enough seats for everyone and it is a race each morning to rush out and claim your seat so you don’t have to sit on the floor.
•Chapstick and lotion are seen as “prescriptions†and must be approved by your doctor and kept in the nursing station.
•you will quickly learn that have a lot of food rules and some seemed a little ridiculous to me
•food and coffee was often cold by the time we ate
•I wasn’t a fan of the way the meal plan system worked (see above under meals)
Overall:
They are a strict program but I think that really helped me. There are lots of rules but you will learn quickly. The staff was the best I have encountered in my various treatment stays. I would recommend this program for anyone suffering with an eating disorder.
any recent feedback from 2014 or 2015?
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i know alot of people think sheppard pratt is bad but i do have a few questions. Do they deal well with self harm in the ED unit? Do they use feeding tubes? Do they ever restrain/physical holds on patients? or do they transfer you to psych for that
Does it treat both males and females? Yes. They have separate bedrooms but joint therapy. There aren’t many males though.
How often do you see a medical doctor, psychiatrist, psychologist (therapist), nutritionist, etc? MD: first day, psychiatrist: every day for 10 minutes or so, psychologist: once or twice a week for 45-60 minutes, nutritionist: on your first or second day, in groups twice a week, when making menus (if you are an adult because parents make adolescent menus) and if you pull them over
What is the staff ratio to patients? Not sure, but lots of staff
What sort of therapies are used? (DBT, CBT, EMDR) etc? DBT, CBT, OT/task
Describe the average day: Wake up at 5:30, get vitals, shower, use the vanity, hang around until breakfast at 8, eat breakfast, go to groups, supplement, water, and bathroom breaks, go to lunch at 12:15, eat lunch, go to groups, supplement, water, and bathroom breaks, go to dinner at 5:30, eat dinner, have visitors until 8:30, eat snack and supplements, go to vanity at 9:30, go to bed at 10 (though adults can stay up until 11)
What were meals like? In inpatient, they were very structured (in PHP you had more freedom). You had to read the “dining room etiquette”, wear one layer of clothing, not bring any personal items, eat in a “not-disordered” manner… You would read the etiquette, then go set up your tray, then get 45 minutes to eat and make conversation/ play 20 questions, contact, etc. with your “peers”. A nurse would sit at each table and then check trays, shoes, and pockets. Then you’d put your tray up and play a game at the table for 15 minutes. People who didn’t finish were taken down for supplements.
What sorts of food were available or served? Pretty typical foods. There were two meal plans: basic and standard, and if you were over 5’9 you could be put on tall. Breakfast: Dairy+ Four items if on basic, + Five if on standard. Items were cereal, toast, eggs (from a carton), milk, yogurt, fruit, pancakes, french toast, bagels, donuts, breakfast meats, oatmeal, cream of wheat, grits… Lunch: sandwich meal plan: Caloric beverage+ sandwich+2 sides if on basic, 3 if on standard + dessert (at least 1 sweet a day if on basic, 2 if on standard). Some items were lemonade, pepsi, gingerale, milk, iced tea, juice, pb&j, tuna/chicken salad sandwich, grilled cheese, wraps, pretzels, chips, salad w/ dressing, other veggies, soup w/ crackers, fruit, applesauce, ice cream, sherbet, cake, cookie… Other meal plan: Caloric beverage+ 2 starches +1 protein +1 vegetable +dessert +extra item (if on standard). Items were potatoes, rice, dinner roll, toast, pasta, soup w/ crackers, chicken, beef, fish, corn, peas, cooked carrots, salad w/dressing, mixed vegetables, ice cream, sherbet, cake, cookie, and the extra item could be fruit or an extra serving of any other item. Wednesdays for the adults and Thursdays for the kids were therapeutic lunch days, where you ate with the nutritionist and ate food that people voted on and portioned out with the nutritionists’ help.
Did they supplement? How did that system work? Yes, if (and when) people did not gain the required amount of weight, they would get put, progressively, on a one time supplement and then on the standard meal plan, then on one supplement at night, then one in the morning, then one in the afternoon. Also, if you didn’t complete a meal you would get 1 or 2 supplements. An uneaten entree was 2, and if you ate half of the sides or so and the entree, it was 1. But there was no hard and fast rule, other than the entree one, about whether it was 1 or 2 supplements.
What is the policy of not complying with meals? You would get 15 minutes to complete replacement supplements or you would get a replacement tray ordered for the next meal (those were much bigger). If you didn’t complete them you would sit in the dining room until the next meal. Privileges sometimes got taken away on an individual bases, and you could not leave if you were not completing meals.
Are you able to be a vegetarian? No, because it was considered disordered behavior to eliminate a food group.
What privileges are allowed? Making phone calls at certain times, having visitors at certain times, speaking to nursing staff or the treatment team when you wanted… Not really that many privileges.
Does it work on a level system? I guess so, because they eventually break you (so it’s better to just start out with a good attitude).
What sort of groups do they have? CBT, DBT, mood management, social skills, snack group (ages 16 and up), OT/task, art, stress management, goals, structured leisure, nutrition, mindfulness, yoga (if you were at your goal weight and did not have a history of exercise problems).
What was your favorite group? OT/task because you could make crafts, and mindfulness because you could sleep. I think I would have liked yoga, but never got to do it.
What did you like the most? Some of the nurses and some of the patients were very funny and nice and it made it feel like teamwork rather than a struggle all alone.
What did you like the least? Inconsistent rule enforcement in terms of the dress code, triggering language (you’d get redirected), hugging/ high fiving other patients (we were in theory not allowed to touch) food rituals, emergency bathroom breaks, etc.
Would you recommend this program? I think staying home is always easier in the long run, but if that doesn’t work out, Sheppard Pratt has the structure that you might need to get back on track, so I would reccommend it.
What level of activity or exercise was allowed? None. You mostly had to sit, but in PHP they were not as strict about that. The only thing ever was yoga.
What did people do on weekends? Have visitors if inpatient, or sleep/watch TV if they had no visitors or were in PHP and didn’t have days off.
Do you get to know your weight? Unless you or your doctor thought your weight was too upsetting and you were “back to scale,” you got to know it every morning, in kilograms.
How fast is the weight gain process? .2 kilograms a day (.44 pounds).
What was the average length of stay? I stayed 2 weeks inpatient and 3 weeks PHP, which is what they say is average. But most people were inpatient for like 3 or 4 weeks and PHP for 3 or 4, if they cooperated. If they didn’t cooperate, some people went back and forth from the two programs for like 6 months. After a certain point though, if they think they’re not helping, they might send you elsewhere.
What was the average age range? In the adolescent unit it was ages 9-16. For the adults, most of them were in their 20s-40s.
How do visits/phone calls work? Phone calls are whenever there are no scheduled groups/meals. Visits are from 6:30-8:30 PM on weekdays, and from 3-5 PM and then 6:30-8:30 PM on weekends.
Are you able to go out on passes? If there are enough staff, everyone has completed meals and not self-harmed, and it is over 64 degrees, they might (but rarely) take you out to the walled courtyard.
What kind of aftercare do they provide? Do they help you set up an OP treatment team? They recommend IOP, but if you don’t do it (like me), then they find reliable people for an OP team. They were very good about that.
All I have to say is Sheppard-Pratt is HELL ON EARTH!!! I wouldn’t wish this place on my worst enemy!!!!!!!!!! I can’t believe someone said they would recommend it because I’ve NEVER EVER met someone who would go back.
I was in patient at Shepard Pratt February and March of 2010. It was the most humiliating and traumatizing experience of my life. The cruel and inhumane methods they used for you to gain weight was emotionally devastating. We were treated like prisoners who had no rights. The only way to survive the program was to comply. If you did not comply you were basically punished. There was only one focus gain weight at all cost. You had to finish every morsel of food on your plate. The staff hovered over you to ensure this. If you did not you were humiliated and told to finish. Every morning you got weighed. Not matter how heard you complied to the program if you did not gain weight you were punished….. No shower, no phone calls at all, couldn’t sit in the computer room, no visitors even if it was already scheduled. Would someone please tell me how this was motivating in any way. It was abusive. There was also a limit on water. My medication makes.very thirsty. I woke up one night and went to the bathroom. My. Mouth was parched . I went to splash a little water in my mouth and I was told to stop. I tried to explain but to no avail. I could not get back to sleep I was so thirsty. I could go on and on how horrible this experience was. My stay there still haunts me to this day. If you are suffering with an eating disorder my heart goes out to you. I would encourage anyone to seek help. You will gain weight at Shepard Pratt but at the loss of your dignity as a human being. I would highly discourage anyone to enter this program. There must be something better out there. Shepard Pratt is most definitely not that place!!!!!
Wow. I was there in 2007 and it seems to have not changed a bit. Even Hopkins was better despite it being a brutal program as well at least it was a bit more individualized and humane. Though Sheppard Pratt meal plan and nutritionist were a bit better than Hopkins.
Well I was at Hopkins several times, and my experience was absolutely horrible. In my experience, it was not inhumane, and not individualized at all. I would say it caused PTSD.
I wouldn’t wish this place on my WORST ENEMY. should lose it’s accreditation.
thanks for participating, could you offer and objective reviews or answer some questions?
My stay at Shepard Pratt was traumatizing. They used cruel and inhumane methods to get you to gain weight. The program should lose its accreditation. No one should have to experience humiliation and loss of their dignity to get well. There are other programs out there. I highly encourage you to seek them out.
I won’t repeat all of the meal and supplement information, as that is basically unchanged over the years. They now have the ages separated- 15 and under upstairs, and over 16 downstairs. It is tough to have 16 yr olds in with the adults though. Some of the conversations are very inappropriate for kids that age, yet these are topics that are critical to the adult patient. (marriage, relationship, sex, jobs, etc.)
I saw a lot of people significantly above the goal weights, and continued to be push to gain further. This would make a difficult situation much harder than need be. The expected rate of weight gain is very rapid.
It is very difficult to be able to go to the bathroom when needed, especially if that time of the month. Did not matter to the staff.
The primary focus was always on the food and weight gain. Most of the groups were structured around food. The groups repeated themselves, and became very non-productive after a week or so.
Co-existing diagnoses were often dismissed in the quest for weight gain. Relapse will certainly occur if these other issues are not properly addressed. I saw this happen time and time again.
Some of the doctors were good at communicating with us and our families, others made it clear that they didn’t have time and didn’t want to be bothered with this.
The mental health workers (not nurses) would often repeat information to other patients that was not appropriate to share. They would often present their opinions on diagnoses, treatments, and other matters that they were not trained on.
The nurses made it very clear that they preferred to work with the younger patients. They would talk openly about this, and would sometimes grumble if assigned to work on the first floor. Some of the nurses were seen covering up for patients who were breaking the unit rules, especially in regards to bringing in contraband such as gum. I am sure they would quickly confiscate anything that would cause harm. Many of the nurses were very good though. These nurses showed compassion and caring.
The family therapists all seemed to be very involved and well respected. Didn’t have any complaints, nor hear of any in regards to the family therapists.
The individual therapists had no contact with the families, even when requested.
The dieticians were very difficult to reach out to, as they were always busy. I would have considered the dietician spending time with patients and especially the families as a very critical part of the program, but it seemed to be dismissed after the first week.
Visiting hours were very awkward, as everyone has to sit in the dining room together. The tables were often not even cleaned from dinner when visitors would come in.
The discharge process is very chaotic and disorganized. Needs a lot of improvement.
sounds like everything bad about a program happens here :/
This place is honestly terrible. I spent three months there. There are definitely some inhumane practices in this building. Do yourself a favor and find a different place to heal and recover… This place has scarred me for life. When I went, I was 12. I didn’t even have anorexia. The military hospital blamed me with having an eating disorder (when in reality, I had hyperthyroidism, which has since turned into hypothyroidism–hereditary). What people are saying is true; if you don’t gain the 1/2 lb, regardless of how well you comply with the system– your general rights are taken away– no shower, no phone call, and no visits. Oh, and just to put a cherry on top, while everyone else has their visits and you don’t, and your parents come to see you, they tell your parents you said you didn’t want to see them….. Classy.
They also wake you up at 4 a.m. and poke you with needles in your bed for vitals and whatnot, then let you sleep for another hour or so. There is no walking or exercising… The staff is completely horrible. If you have to pee really bad–forget about it. Not gonna happen. I’m glad they at least have 3 bathroom breaks… When I was there it was 8 a.m and 8 p.m. That’s it. And if you can’t poop, you’re instantly trying to throw the system… obviously….
The food is another thing: I was a vegetarian my whole life, and have a lactose intolerance… If you have any food allergies or eat a certain way for your health, (not talking about people who cut gluten out just for weight loss, but for actual health reasons), you are instantly just trying to be anorexic…. You can HARDLY talk to everyone in there… We would be talking about something completely unrelated to body image or anything at all, and instantly it is not an “okay topic” and we can’t speak…
The staff treat you like you are a disease because you need to regain your health. Oh, and if you are cold, don’t bother borrowing a friend’s sweater; they will make you take it off because it isn’t yours. And you did not get even 4 cups of water a day, when you need at least 8. You are lucky to get 2, really.
They put you on a bunch of medication that is completely unnecessary. I was over the weight that I needed to be to leave, and was passed the agreed stay time…. They tried to keep me there even though legally I was able to leave. It was to the point where my dad had to fight security guards and literally pull me out of there. Not even kidding.
I did not have an eating disorder, so I’m not particularly bitter over any sort of weight gain ( for the record, I’m 5’0″ and 125 and completely happy with my body), so I can say in full confidence that none of this is a biased review. This place is terrible, and I wish I could have sued.
As a last note, unless things have changed since I was there, in order to be able to leave, they put you on a “test” that is truly ridiculous. You have to go out to dinner with your parents or whomever. While dining out, you must: order at least 1 caloric drink and drink it all, order 2 appetizers to share and eat it all, order a meal and eat it all, and order a dessert and eat it all.
My point is that this facility does nothing for your long-term health aside from devouring any ounce of happiness you possibly had left. They do not teach a healthy lifestyle… Which is necessary. There is no healthy form of exercise (even if it was a slow walk, it would still promote a healthy lifestyle outside of the program), there is no healthy sense of eating. They don’t teach patients what is healthy; they force you to gorge your face within their time limit and eat all your food, otherwise you get a penalty tray of food at your next meal. They bring you down and tell you how worthless and dysfunctional you are. It is NOT A GOOD PLACE TO GO.
Please, do yourself a favor and search elsewhere for a loving and supportive program.
I was inpatient for 3 1/2 weeks in March 2013. They say average stay is 10 to 14 days, but it really depends how you are physically and emotionally and how much weight you have to gain.
A typical day:
The first week you get woken up at 4:30 for a finger prick to check your blood sugar levels, which is super annoying, but it only takes a second and then you can go right back to sleep.
5:30-6:30 you get woken up and vitals. Then you go to the bathroom where you change into paper gowns and go get weighed.
Then are showers – 8 minutes max and vanity time, which is basically the only time during the day you get to see yourself in a mirror.
7:00 you go out to the mil-u (lounge) where most people sleep or watch TV or make phone calls until 8:15/8:30 when it’s breakfast time.
After breakfast is labs if you need, then 9:30 is bathrooms and water break and supplements if you need.
10:00 – group
11:00 – group
12:00 – bathroom break
12:15/12:30 – lunch
1:30 – group
2:30 – bathrooms and water/supplement break
3:00 – group
4:00 – group
5:00 – 5:30 – free time
5:30 – dinner
After dinner is free time and visiting is from 7:15 – 8:30
8:30 -snack and supplements
9:00 – free time
9:30 – go back, bathrooms, vanity time
10:00 – cerfew for anyone under 17, if you’re over you can go back out to the mil-u till 11:00
When I was there the adolescents and adults were together, but they changed it, so now they’re separate.
There are males and females together, but rooming is separate. Most of the rooms have 2-3 beds, but they have a few single rooms and a couple with 4-5 beds.
You see your doctor/psychiatrist every morning and your therapist 2-3 times a week, family therapy 1-2x a week.
They have CBT, DBT, IPT, nutrition group, goals group, art, OT, mindfulness (that’s the worst – SO boring and pointless!!), body image, leisure, family dynamics, etc.
The first week you get blood work every day, and then, assuming your labs are showing up okay, only every Monday. You get vitals 2-4 times a day depending on your condition.
Meals were okay.
There are 3 meal plans, basic, standard, and tall (for people over 5’9”)
Basic meal plan:
Breakfast – 4 items plus a dairy
Lunch/dinner Рsandwich plus 3 sides (includes your dessert) or an entr̩e, 2 starches, and a vegetable and dessert plus a caloric beverage. You also have to have at least 1 sweet dessert a day
Snack – one item and a caloric beverage and an optional fruit
Standard meal plan:
Breakfast – 5 items plus a dairy
Lunch/dinner Рsandwich plus 3 sides and a sweet dessert at each meal or an entr̩e, 2 starches, a vegetable, an extra item, a sweet dessert, and a caloric beverage.
Snack – same as basic
Tall meal plan: Standard plus an extra item at breakfast and double protein at lunch and dinner
You get menus to fill out during the week. Breakfast you have a choice of different cereals, juice, fruit, English muffins, toast, bagels, muffin, doughnuts, French toast, pancakes, etc. It varies from day to day, but there are usually a decent amount of choices. All breads/muffins have to have an added fat – PB, butter, margarine, or cream cheese. There is optional jelly, coffee, hot chocolate, tea, etc. Sugar and creamer are also optional.
Lunch and dinner you pick from one of three mains and add your required amount of sides and your dessert and beverage from that days choices.
Mains can be chicken/turkey/fish/ham, grilled cheese/PB and jelly/turkey (needs mayo)/deli/ sandwiches, hamburgers/cheeseburgers/veggie burgers/hotdogs, main dish salad (has cheese, meat, hard boiled eggs, croutons, dressing…), mac ‘n cheese, lasagna, quiche, pizza, cottage cheese and fruit plate, stew, etc. Vegetarianism is absolutely not allowed.
Sides are French fries, baked potato/sweet potato (needs added fat – margarine/butter), salads (needs dressing), carrot sticks (needs dip) various cooked vegetables, bread/dinner rolls (again, needs added fat), soup (comes with package of 2 saltines), fruit etc. If you’re having a sandwich meal you can have pretzels/chips as a side.
Dessert can be pies, cookies, brownies, lemon bars, ice cream, sherbert. Non sweet desserts are canned fruit, applesauce, or fresh fruit.
Beverages include milk, chocolate milk, ginger ale, pepsi, and juices. You can also have decaf coffee or tea if you want.
Condiments – ketchup, mustard, mayo, etc are optional, but you need to have picked them on your menus ahead of time. You get one tiny pack of pepper and one of salt at every meal – no more.
Snacks can be snack packs of cookies, pretzels, chips, granola bars, fishes, cheese and creackers, cereal (with milk as your caloric beverage). etc.
Every Wednesday you make your own snack in snack group that everyone votes on and you have to have it that night.
Saturday nights are therapeutic snack nights and they give everyone a snack they pick.
Wednesday is therapeutic lunch. Everyone votes on what to have and you have to have that. You serve yourself that day with the dietitians supervising and they also sit with you and eat for that meal.
If you don’t finish your meal you get 2 supplements, unless you ate your entrée, then you get 1. If you don’t drink your supplement then you sit in the dining room until you do, which is horrible cuz that place is FREEZING!
Supplements are also given if you’re on weight gain, during the 3 supplement breaks, so which breaks depend on how many supplements a day you’re on. You can be on up to 4, in rare cases they’ll put you on 5.
Privileges include showers, going in the second day room where there are computers that you are allowed to use (only when there’s enough staff around to open the room though, so not always), phones, visitors, going outside (only in the summer)… If you don’t complete meals you’re on restriction and all those privileges are taken away. So basically, as long as you’re cooperating you can do all those things.
My favorite part was definitely the people – they’re all so supportive and there’s always someone to talk to when you’re having a hard time. There is a no touch policy though, so no hugging or touching at all!!! 🙁
My least favorite part was the no touch policy and the mindfulness and body image groups.
Would you recommend this program? It’s a good program I guess.. it didn’t really work for me, but if you’re motivated then it could be really good.
What level of activity or exercise was allowed? Absolutely none. If you’re standing too long you get yelled at or for sitting on your legs or stretching or just anything.
Weekends there’s free time after lunch and an extra visiting time from 3 to 5
Do you get to know your weight? Only if you want to
How fast is the weight gain process? You have to gain .2 kilo (1/2 pound) a day – aprox 4 pounds a week
Are you able to go out on passes? No. It’s a closed unit, so you’re locked in all day unless it’s the summer and then you might get to go out once or twice a day for 15 minutes or so with nurses supervising. You’re basically always supervised, if you’re on suicide watch you have a one on one.
Bathrooms are key flush, so they flush after you. If you’re on open door then a nurse watches you the whole time.
All in all, it’s a very nice facility, very clean,, nice staff, but very VERY strict!! If you’re motivated then it can be great!
So I know that the last time somebody posted here was about 6 months ago, but I thought it’d be worth sharing my experience. I was admitted to Sheppard Pratt on February 12th, 2013 for anorexia nervosa. My perspective isn’t that much different from everything other posters have said, so it’d be useless to repeat it. I do want to make a few comments, though. I’ve slowly realized that in reality there’s no pleasant way to recover from an eating disorder. Yes, sheppard Pratt was a living hell, but it saved my life. That’s the only reason I am grateful for my admittance. There are quite a few things I would change about the program, nonetheless.
I’m 13 years old. Spending all day mixed in with adults battling eating disorders is quite uncomfortable. I’m glad they are considering completely separating minors and adults into different units. But while I was there, I had to share the same powder room with 20 adults every night. Don’t get me wrong, there were other teenagers. They were good friends on the unit and it was interesting to hear their stories and struggles. But not a second went by where I wasn’t devising an escape plan. To an anorexic with an excercising obsession, it’s misery. Did the hospital cure my urges? Not at all. I see the hospital merely as a way to keep my heart beating. It’s been a little over 1 month since I was admitted, and I’m 4 pounds away from being my admittance weight. I still count my calories constantly. I’m still consumed by this disorder. 1 hospital trip will not cure it. What will work is different for every single person.
I’m the first patient in a long time to be released straight from IP. It’s because every time I made contact with my parents I begged them to let me come home. Going home was all that was on my mind. Just taking a tour of the place was enough to make me consider suicide. Treatment is traumatizing, some more than others. And what’s motivating me to at least keep living normally is to think of SP.
For future patients- just know that it is far from enjoyable. I would have never admitted myself if I was an adult. What annoys me is that I was admitted against y will, being a minor. Your control of anything is completely taken away. Please; work with outpatient therapists and just try your best to see the good in recovery without a hospital (if you can help it). I could write a whole book about my experience but ill leave it at that.
I spent from Oct. 8 -25, 2012 inpatient and Oct 25-Dec. 13 in their partial hospitalization program. I WOULD NOT recommend this treatment center. Even after I had reached my “goal weight,” they refused to put me on a weight – maintanence meal plan, and instead kept me on a weight-gain plan. I finally left AMA due to the amount of weight I gained while there. When I left, I was TWENTY pounds over my goal weight. I do have to say, though, that during the refeeding process, they monitored me medically more than any other treatment center ever has.
How many patients on average? 22 inpatient 20+ php
Does it treat both males and females? If so, is treatment separate or combined. Yes, both males and females are treated there, but the groups aren’t separated by gender.
How often do you see a medical doctor, psychiatrist, psychologist (therapist), nutritionist, etc? You see your psychiatrist every day for 15 minutes or so, a medical doctor when you first get there, and tindividual therapy and family therapy are both two times/week. The nutritionists are easy to find – they are always on the unit, but are incredible unhelpful.
What sort of therapies are used? (DBT, CBT, EMDR) etc? DBT and CBT
Describe the average day:
Weights/Vitals at 5:30 am
Hang out til Breakfast at 8
Bathroom break and water/supplements at 9:30
Group at 10:15 and 11:00
Bathroom break before lunch at noon.
Group at 1:15
Bathroom break, water/supplements at 2:30
Groups at 3 and 4
Bathroom break before dinner
Dinner at 5
Bathroom break at 7:30
Visiting hours from 6:30-8:15
Snack at 8:30
Return to sleeping area at 9:30
What were meals like? Meals were gross and cold. Always. There are 3 meal plans: Basic, Standard, and Tall. The dieticians did not use athe exchange system, they used a system of “items.” For example, the standard meal plan requires “Dairy + 4 items” at breakfast, “Sandwich + 4 items” for lunch and dinner. On Standard you must have a “sweet dessert” at both lunch and dinner. You aren’t allowed to have 2 cold entrees a day, a caloric beverage is required aat every meal (and NOT included as an item.) They have very strict rules about what foods can be eaten together. For example, you cannot make a peanut butter and banana sandwich, you cannot add cereal to yogurt, you must have some sort of fat (butter, peanut butter) on any bread product. You can only have pretzels once/day. On their “item meal plan,” pretzels and Lays potato chips are considered the same.
What sorts of food were available or served? Lots of beef. Vegetarianism is not allowed.
Did they supplement? How did that system work? Supplements were used to help those having difficulty reaching their goal weight, and also if you didn’t eat 100% of your meal. If you ate the entree and nothing else, you had to drink at least 1 supplement (Ensure Plus). If you didn’t eat the entree, you had to drink 2 supplements, even if you ate everything else. If you refused the supplement, you had to sit and stare at it until the next meal.
What is the policy of not complying with meals? You sit and stare at a supplement for hours.
Are you able to be a vegetarian? No, not at ALL!
What sort of groups do they have? CBT, DBT, Body Image CBT, Body Image Art, Art therapy, Snack Prep, Occupational therapy, No real “group therapy.”
What was your favorite group? I was lucky enough to have my doctor prescribe an individual art therapy session every week
What did you like the most? They monitored me medically very closely.
What did you like the least? The stupid “item” meal plans!!
Would you recommend this program? Only if you are okay going over what they tell you what your goal weight is.
What level of activity or exercise was allowed? NONE!!!
What did people do on weekends? There were some groups, otherwise you hope you have visitors…
Do you get to know your weight? Yes – in kg
How fast is the weight gain process? at least 0.2kg/day
What was the average length of stay? I think 2 weeks inpatient, and 3 in PHP
What was the average age range? most were teenagers and women in their early 20’s. I am 36 and was the reigning old timer.
How do visits/phone calls work? Visiting hours every day and 3 patient phones. If you don’t “make weight” you cannot have visitors or use the phone
Are you able to go out on passes? You take one “Leave of Absence” for 4 hours with a family member the day before you are transferred to PHP
What kind of aftercare do they provide? Do they help you set up an OP treatment team? I’m sure they would have set up appointments for me, but I left AMA.
Are there any resources for people who come from out of state/country?
There is a hotel grant for those who qualify to use during PHP. If you have a history of self harm or drug/alcohol use, forget it – you aren’t eligible for the grant.
Any recent updates/reviews? Please….
Recent reviews?
Pre-2012 Reviews
My take on it: Describe the average day: Wake up at like 6 or so for weights and vitals, showers, then chill out until breakfast at 8. then menu planning, groups, supplements at around 10 or so if needed, groups, lunch at 12, groups, supplements at 3 if needed, group or free time until dinner at 5, free time, snack at 8:30, then at 9 go back get ready for bed.
What were meals like? Depended on if you were on rehab or stabilization, but overall it was a balanced meal containing a protein, starch, vegetable, etc…
What sorts of food were available or served? It actually wasn’t too bad, most of the things weren’t gross or greasy. Had a lot of vegetables and fresh fruit, sandwiches, hot meals, etc
Did they supplement? How did that system work? yes for weight gain or if you didn’t eat your meals
What privileges are allowed? phones, outside
Does it work on a level system? nah
What sort of groups do they have? CBT, body image, movement, OT task, art, relationships
What was your favorite group? Didn’t really have one
What did you like the most? They actually new what they were doing
Would you recommend this program? yes
What level of activity or exercise was allowed? Very little except for movement group
What did people do on weekends? there was a lot of visiting hours but if you didn’t have a visitor they had a group or two and people would often get together and play things such as pictionary or something
Do you get to know your weight? kind of…the scales did not give you your weight in pounds..but you did get to see it unless you wanted a blind weight
How fast is the weight gain process? .2 kg per day
What was the average length of stay? depended on person..some like a week….some for months if that’s what they need
What was the average age range? all ages pretty much…just not really young kids I guess
When were you there? July 23 – August 11, 2008 Describe the average day: Wake up between 5:30 and 6 for vitals, weight, and shower. Go out to the main area at 7 and either sleep on a couch or watch the Today Show until breakfast at 8:15. Then meal planning, various groups, lunch at 12:15, more groups, dinner at 5:15, free time until snack at 8:30, another half-hour of free time, then back for “vanity” and bed at 9:30. Adults can go back out to the dayroom at 10, until 11, but adolescents have to go right to bed at 10.
What were meals like? Not bad! The first three days, you get standard trays; after that, you choose your own. During your first 3 days, you’ll meet with a dietitian who will explain the menus & meal plan to you. The meal plans are based on the food pyramid, which I liked because it’s simple – no need to figure out exchanges, just servings. The meals for the first 3 days SUCK, but somehow after that, it tastes better.
What sorts of food were available or served? This is one of my menus (I kept some for reference): breakfast: 2 scrambled eggs, wheat toast w\ butter, yogurt, grape juice, coffee w\ creamer & sugar lunch: baked ham, dinner roll w\ butter, chicken noodle soup w\ crackers, garden salad w\ dressing, sherbet, lemonade dinner: honey mustard chicken breast sandwich, green beans, pretzels, banana, ginger ale
Did they supplement? How did that system work? Supplements were given for not gaining weight (up to 4 per day), and as meal replacements if you didn’t finish (1 or 2, depending on how much you ate).
What privileges are allowed? “fresh air break” – aka a chance to go outside – if there is adequate staff and you aren’t on restriction. Um… idk what else. Privileges are based on weight gain. If you don’t make weight, you can’t shower, make phone calls, or go outside on that day, and if you don’t finish a meal, you can’t make calls or go outside until the next day.
Does it work on a level system? Not really.
What sort of groups do they have? CBT, Self-Esteem, Motivation to Change, Art Therapy, Movement Therapy, Occupational Therapy, Interpersonal Relationships, Family Dynamics. Also specialty groups such as Healthy Sports Managements, Substance Abuse, and Male ED’s, that meet once or twice a week.
What was your favorite group? OT Task Group! We made jewelry, picture frames, stress balls, and other stuff. Well, there were those options… I just made jewelry at every group.
What did you like the most? The staff. They are wonderful. I don’t know how long ago the people with negative experiences were there, but I just got back 2 days ago, and the current staff is amazing. They are so kind, and patient, and really seem to care about everyone. Everyone is assigned to a staff member every day – your “contact person,” who will check in with you at some point (well, they’re supposed to, but it doesn’t always happen; however, there is a list posted by the nurses’ station, so you can always find out who your contact is if you need them) to see how you’re doing, if you need to talk, etc. Your contact person is also who you go to if you have any questions or concerns, or just want to talk. I will agree with others that sometimes they are very focused on “the program,” which can be frustrating. I had issues because of this, but I was able to talk to my individual therapist about it, and she helped me work out my situation and find ways to help.
What did you like the least? That privileges are tied to weight gain. I didn’t need to gain, but I felt bad for those who did, and who ate 100% and followed all the rules, and were still restricted because of things beyond their control. I also think they tend to overmedicate. I was upset and crying one day, and a nurse asked me if I wanted a PRN. I said no, I don’t even have anything prescribed, and she offered to talk to my doctor and get something. I had to argue with her, and later with someone else, about why I didn’t want more meds. It struck me as very odd – I was trying to learn to experience emotions and deal with them, not drug them away. However, you have the right to refuse any medication. Also, I told my Doctor that I didn’t want my current med combination messed with, and other than one small change, she respected that.
Would you recommend this program? YES. However, I would more highly recommend it for someone who can do PHP as well as IP. The program is designed with the assumption that you’ll do both, and most people are only IP for 10-14 days. So the IP groups are super repetitive. The IP groups are veeerrrryyy basic CBT, mostly for education and motivation… you do a lot of identifying negative patterns, etc. Then in PHP groups you move on to actually changing things, and it’s more in-depth. I could only do IP because of my insurance, and sitting in the groups for 3 weeks, literally going over the same stuff EVERY time, got really old. Sometimes people who can’t do PHP are allowed to go to the PHP groups for their last week or so, but I couldn’t because my Doctor said I wasn’t ready. That was frustrating, because I felt like I wasn’t really being prepared to go home.
What level of activity or exercise was allowed? NONE. EVER. If you are standing up for too long, you’ll be told to sit down.
What did people do on weekends? There would be 2 groups, and the rest of the time everyone watches movies, plays games, sleeps, etc.
Do you get to know your weight? Yes, unless your Doctor doesn’t want you to.
How fast is the weight gain process? 0.2 kg/day.
What was the average length of stay? 10-14 days IP, then 2-3 weeks PHP.
What was the average age range? Probably late teens/early 20’s. The youngest when I was there was 12, and the oldest was in her 60’s, I think.
When were you there: October-December 2008
Describe the average day: wake up at 5:30/weights/vitals…showers if permitted, out in the milieu by 7, breakfast at 8, groups/school until lunch at 12, groups/free time until dinner at 5. free time until snack at 8. bedtime at 10 for minors and 11 for adults.
What were meals like? huge. no really. the meal plans are very un-individualized. there are only 2. basic and standard. basic is as follows: breakfast=dairy + 4 items lunch=sandwich + 3 items + caloric beverage dinner=protein+ 2 starchy side items + veggie + fruit or dessert + caloric bev. snack=1 item + caloric beverage standard: breakfast=dairy + 5 items lunch=sandwich + 4 items(one of the items is required to be a dessert) + caloric bev. dinner=protein + 2 starchy sides + veggie + dessert + extra item + caloric bev. snack=1 item + caloric bev. if you’re on basic and still gaining when you aren’t supposed to, they won’t change your meal plan. I’ve seen girls gain as much as 20 pounds over their ideal weight and they never adjusted it. the first day you don’t gain 1/2 pound, you’re bumped up to standard…and after that they just add ensures in between the meals.
What sorts of food were available or served? the food was really disgusting. typical hospital food. everything that was supposed to be hot was cold, juice was frozen, milk was expired half the time…it was bad.
Did they supplement? How did that system work? supplement was the same for meals regardless of what meal plan you were on…which really didn’t make sense. if you didn’t eat at all, you got 2 supplements, if you ate all of your sides but not your entree you still got 2 supplements, and if you ate the entree but not the sides, or just couldn’t finish all the sides in time, you got 1 supplement. they also used ensure plus on top on the regular meal plan for weight gain, if there was ever a day that you didn’t gain a 1/2 pound, they’d add another ensure plus, even if you’d gained like 2 pounds the day before.
What privileges are allowed? all privileges are tied to weight gain. if you don’t “make weight”, you can’t shower, talk on the phone, do laundry, have visitors, shave etc. if you DO gain 1/2 pound…you can. it has nothing to do with how well you are complying with the program though. if you are eating 100% of your meals and you happen to not gain 1/2 pound on any given day-you automatically lose all privileges. but if you gain the 1/2 pound even if you aren’t complying with the program, you still have privileges. it was really frustrating.
Does it work on a level system? no.
What sort of groups do they have? a LOT of CBT and DBT.
What was your favorite group? I didn’t find any of them helpful.
What did you like the most? nothing.
What did you like the least? there are so many things I hated about Sheppard Pratt. first off, they told me point-blank that I would never recover. they told me that I could go into “remission” but that I would have an eating disorder for the rest of my life, and I had to accept that this was a chronic illness. secondly, the meal plan is ridiculous. it’s not based on food groups, calories, or exchanges, but “items”…which is such a loose program it’s basically as if you aren’t on a meal plan at all, and it feels very uncontrolled. like, with their system, an apple or a huge slice of banana cream pie are the same thing=1 item. depending on the person’s eating disorder, this system could really be abused. there was one girl there while I was inpatient who was a compulsive overeater, and she would order 4 donuts and a chocolate milk for breakfast every morning-and they were okay with that! it was really kind of crazy. third, the showering rule. it’s inhumane. and it’s NOT about exercising like everyone will try and tell you. …because if you try to wash your hair in the sink all hell with let loose. it’s a punishment. there’s really no way around that. fourth, the staff is incredibly rude. they make it very clear that they’re there for the money and then to get out. I was even told by a nurse when sitting with a supplement after a meal, “I don’t give a sh*t whether you eat or not, I just want my d*mn shift to be over so I can go home.” I’ve been in programs where the staff really does care, and it makes a HUGE difference.
Would you recommend this program? never.
What level of activity or exercise was allowed? they weren’t that strict on it. people could walk around, stand…there were even girls who would do laps up and down the hallways and never get caught. basically, you could do whatever you wanted…it was all about whether or not you wanted to shower the next day.
What did people do on weekends? nothing. the weekends were really boring.
2011
t’s been about a year since I’ve been in SP, however I have been there a few times in the past two-three years. My most recent trip there was difficult. I was hospitalized because I was in the midst of a severe manic episode, I just happened to have a history of an ED. The CED focused primarily on my eating disorder and not my manic episode, which was what really should have been addressed. Once they did manage to get my mania under control, I was able to eat, sit still and attend groups (which I was initially banned from because my hyperactivity was so disruptive). So if you have a comorbid disorder, think about what issues are most disruptive to your life. The CED did help with my eating disorder but it was difficult to get the comprehensive treatment I needed. I would suggest advocating for your needs. After all, you are your own best expert. With the exception of a few staff members, most were extremely caring and helpful. As an employee of SP I know that the staff at CED far exceed what the employee expectations are on other units and I am grateful for them going beyond what is expected of them. Other units do not hesitate to medicate patients and the CED is one of the only units in the entire SP health system that will talk you through your problems. The staff are truly there to help you. As a mental health worker I can tell you that absolutely no one is in it for the money, they do it because they care.
his goes on and on the whole day long. If staff sees a patient moving something, this gets fast attention. Moving a chair from one room to another gets a reprimand:
please don’t move the furniture, ask a staff member for help
you’re not supposed to move furniture
I don’t want you moving furniture, you’re supposed to ask someone for help
Shorthand and abbreviations at SP
ALP – activity limitation protocol. If a patient is suspected of exercising, excessive walking or is not gaining weight, a doctor may assign extra observation. On ALP, a patient is observed more carefully and told to sit more frequently. Officially, they are supposed to be seated at least 50 minutes per hour.
Zoning – if a patient is not gaining weight, their doctor might assign them to a specific seat in the milieu. This means that they must return to the same seat each time, instead of choosing any available chair.
On camera – a patient is monitored on a camera in their room which a nurse watches. If a patient is suspected of exercising, their doctor might put them ‘on camera’ so that nurses can catch them in the act.
Open door – if a patient is suspected of purging in the bathroom, a nurse will follow them and keep the bathroom door open while they use the bathroom. This is an extra level of observation, since every toilet requires a key to flush.
One-on-one – if a patient is found to be a risk to themselves or suspected of exercising during the day, a nurse will be assigned to follow them around all day wherever they go. If a patient is put on one-on-one, they usually have ‘open door’ bathroom breaks.
Your typical day at SP as an inpatient:
530-7 wake up around 530 for vitals and weigh-in, take a shower if you’ve gained at least 0.2kg
7-8 hang around in milieu
8-915 have blood drawn for lab tests if scheduled
915 bathroom break
930 water break and supplements
10 therapeutic group
11 therapeutic group
12 lunch
1 therapeutic group
215 bathroom break
230 water break and supplements
3 therapeutic group
4 therapeutic group
5 dinner
6-830 hang around in milieu
830 snack, supplements and water
930 evening bathroom
10 bedtime for minors
11 bedtime for adults
blood tests – Inpatients have daily tests for the first week, and weekly tests on Mondays afterward. PHP patients have daily tests for the first three days, and then weekly tests on Mondays. Doctors can also request other tests if they suspect eating disorder behavior since exercise and purging affect blood electrolyte concentrations.
water and nutritional supplements – during these breaks, all patients can drink an 8 oz cup of water along with any prescribed supplements. If patients do not gain weight by eating foods from the meal plan, their doctor will prescribe a supplement (ensure plus) each day. Each day a patient does not gain weight, their doctor can add a half supplement to their daily nutrition plan. Patients usually end up drinking 2-3 supplements daily, divided among the two breaks during the day and evening snack.
bedtime – minors (under 18) need to be in their bedrooms at 10pm. Adults can return to the milieu to read or watch TV until 11pm.
therapeutic groups – these can be any of CBT (cognitive behavioral therapy), DBT (dialectical behavioral therapy), IPT (interpersonal therapy), relapse prevention, mindfulness or nutritional education. Sometimes patients are taken for class to have individual therapy, family therapy or for a short daily meeting with their doctor.
medicines – SP provides all the medications patients are prescribed. There is a medication nurse who dispenses medications throughout the day. After talking with many patients, I found that seroquel was one of the most commonly prescribed drugs. It seems to relieve some of the patients’ anxiety, but they complain of drowsiness and fatigue through the day. It was frustrating to engage some patients in conversation, since they had trouble maintaining focus and would drift off.
Sheppard Pratt is a hospital just north of Baltimore MD for treating eating disorders. I went through a course of treatment starting as an inpatient and later PHP (partial hospitalization program). During my stay, I experienced what it’s like to be a patient. Looking back, I would give a mixed review of their program. If your are considering an eating disorder program, learn as much as you can before signing up.
Each meal was well prepared, including the buffet-style ‘therapeutic lunch’ each Wednesday. While some of the items were better than others, I have no complaints about the general quality of the food. Nurses were also flexible with patients in replacing any item that appeared undercooked or spoiled.
While the meals were usually tasteful and reasonably portioned, they had to be selected at least one day in advance. Once a patient submitted a menu with their selected items, they were only allowed to eat those items. Although patients were stuck with what they selected, it did prevent surprises during meals.
Mealtime rules seemed complicated and rigid to me. One of the major prohibition was making mixtures or combinations of foods. For example, dipping bread into a sauce or dipping a grilled cheese sandwich in tomato soup were not allowed. Combining two types of cereal in a single bowl was also forbidden. There were more prohibited combinations, such as:
adding salad greens to a sandwich
using salad dressing in place of mayonnaise on a sandwich
adding ketchup to any sandwich
dipping french fries in mustard
dipping cookies in milk during a snack
adding chocolate milk to cereal
While these rules were intended to ‘normalize’ eating behaviors, they felt restrictive and arbitrary.
On my first day at SP, the biggest change was the amount of water I could drink. Ever since I can remember, I always drank large amounts of water both during and between meals. At SP, patients are limited to water only at three break times throughout the day. We are allowed up to two 8 oz drinks with each of our meals, but additional water requires a doctor’s order.
Besides having limited water to drink, the air on the unit was usually very dry. My lips and skin dried out quickly, and I wanted to use chapstick and hand lotion. However, both of these need to be dispensed by the medication nurse, only at specific times. Like extra water, they required a doctor’s order. Even later in PHP, patients needed to first turn these in to the medication nurse who would later allow patients to use it when requested.
SP gives incentives to patients who gain weight, by allowing them privileges like phone and computer access. Each morning, patients wear a hospital gown and are weighed. Values are given in kg, to discourage anxiety about weight gain. Patients were expected to gain 0.2kg or more each day, and were put on ‘restriction’ otherwise. This meant that phone and computer privileges were revoked until the next day they gained 0.2kg.
Something that really irritated me were the times when staff enforced a rule, and then tried to comfort the patient. For example, they might tell a patient to stop talking on the phone if they were on restriction (from not gaining at least 0.2kg). The patient might have been in the middle of a conversation with one of their family members, a friend or their boss. Even so, they would disconnnect the phone with a switch in the back office and the patient would become visibly upset. Then the staff member would see them in a bad mood later, and ask if they ‘wanted to talk about it.’
Another bad mark on their report card would be the way they described their program at the outset. They say that the average stay for a patient is about two weeks as an inpatient, and then two or three weeks in PHP. However, you might end up staying longer if they judge your progress as insufficient. It can be tricky to leave SP when you want to, since they have ways of keeping you longer than you expected or would want to. All of the patients at SP are there voluntarily, since they sign a notice of signing up for voluntary treatment. In order to leave the treatment without a doctor’s consent, a patient can sign a 72 hour notice. However, your doctor might choose to commit you if they judge you a risk to yourself. The main reasons that they threaten involuntary commitment are:
being a risk to yourself (i.e. suicidal thoughts or self harm)
being under 75% of your ideal body weight (one of the criteria for anorexia nervosa is an inability or refusal to maintain 85% of ideal body weight)
not progressing in treatment (i.e. saying that you don’t want to recover)
Ending up in involuntary treatment is not fun. You get sent to a different part of the hospital for general psychiatric disorders, instead of the voluntary unit for eating disorders. This happens rarely, since most patients eventually withdraw their notice before 72 hours after talking with their parents or doctor.
SP prohibits physical exercise to help patients gain weight for therapy. However, it seems like they try to stop any mental activity also. Between classes, patients are expected to spend time in the ‘milieu,’ or community room. There are chairs and a few low tables, plus a television. Since many patients are in the milieu at the same time, it can get noisy. Patients and nurses are constantly talking, and at least one patient is being ‘redirected’ for doing something. Whenever someone vomits or breaks a rule in a major way, the group is called to a ‘community meeting.’ it’s hard to focus on anything when you’re in a noisy room full of constant motion.
Imagine trying to focus in an airport concourse or inside a moving bus. There are people all around you talking, television blaring, and information being announced. There is no surface to write on, and everything you have needs to be screened by security. They’ve taken away you scissors, glue, spiral bound notebook, three ring binder, headphones, computer and your cell phone too. I could tolerate these conditions for a few minutes while waiting for my flight. I would wait for my plane to arrive and get ready for departure. I would arrive at my destination and do something new.
This doesn’t happen at SP. If you change your seat, someone will tell you to sit down. If you try to stretch too much, someone will tell you to stop. This happens all day, with nurses watching what you are doing.
‘Caloric conservation’ is one of the major headaches I went through at SP. The protocol or rules are to prevent patients from moving in any unnecessary way, and to have them remain as sedentary as possible. Walking for any unnecessary distance will get you ‘redirected’ by nurses. Even standing for what they judge to be an excessive time will get you requests to sit down. Their voices still echo in my head:
could you please have a seat?
I need you to sit down now
please sit down, you’ve been standing for a while
you need to sit down now
I’d like you to find a seat now
I need everybody to sit down
if you aren’t waiting in line for the bathroom, you need to have a seat
Before you check in to Sheppard-Pratt, consider whether it matches your needs.
Sheppard-Pratt has two main programs: inpatient and outpatient. Inpatient focuses on gaining weight and introduces patients to cognitive therapy techniques. PHP, or partial hospitalization program, continues after patients have reached at least 75-85% of their goal weight. Cognitive behavioral therapy, dialectical behavioral therapy and family dynamics are the main therapies in both programs.
SP takes safety very seriously. patients cannot leave the locked unit without approval, and visitors are monitored. nurses watch the patients 24 hours a day, and log their location every 15 minutes. since some patients self-harm, the rules are obsessive towards safety. any items that might be used to harm (this includes staples and paperclips) are prohibited.
Since some patients have a habit of hiding foods or purging, any items that could hide foods are also banned. plastic bags and even envelopes were banned during my stay. There must have been some clever patients before my stay, since adhesive tape is also banned. Their explanation was that some patients like to hide things by taping them to the undersides of furniture.
The unit was also very clean, even with 30 people sharing the common spaces like dining room and living room AKA “milieu.” the dining rooms were used for classes too, but a visitor would have never known that a meal for thirty people had been served only hours before.
during my stay, most of the patients
the obsessive rules are my biggest complaint. it felt like living in a hostile environment since several nurses would supervise me during the entire day. Their main job is to remind us to sit down, since all inpatients are on ‘caloric conservation.’ This means that any activities that might burn any calories are prohibited. We were reminded to sit if standing for more than a minute or so. Some nurses even tried to remind patients to stop stretching.
Since more than half of the patients are minors, the nurses also monitor patients to ‘change the topic’ if conversation shifts to anything about food or a non-PC topic. The rules had to cater to minors too. This meant that movies rated above PG were prohibited, all CD’s needed to be screened before they could be played during meals or leisure, and magazines advertising articles unsuitable for minors were prohibited.
While therapy groups were divided by age, all other activities were communal. everyone would gather in the same living room for the times between classes, and meals were not divided by age. I understand that the rules were in place to protect safety and keep bad influences away from minors, but it felt like I was back in elementary school for my entire stay.
it took me a while to get used to the meal routines at SP. Among some of the many rules for this central event, we were expected to:
eat items separately and not combine foods
spread butter evenly across the entire surface of bread
add enough milk to cereal to keep it covered
wear only a single layer of clothing
Many of the patients had problems with the rules. One meal was an open face sandwich. While rules for this entree were not published or discussed before the meal, they were enforced. I watched staff members hover around several patients during a meal.
When one patient was seen eating the meat separately from the bread, the nurses took away her first sandwich and replaced it with another. They did the same after seeing another patient tearing portions with a fork instead of separating the portions with a knife. During the same meal, they replaced a third sandwich for another patient, saying that it must be cut with fork and knife, then eaten so that each forkful contains at least a portion of both meat and bread. Apparently, all of these rules are intended to ‘normalize’ eating behavior.
chronic disorganization was a big problem. at least one staff had to be in any room for every 5 patients. the staff were usually spending their time ‘supervising.’ the problem here is that if a patient had a request, the staff who were watching them could use the excuse that they were busy supervising patients and would not respond to the request.
it was hard to get a good night’s sleep here. every 15 minutes around the clock, a staff member has to record the location of a patient for security. while the staff can do this unobtrusively during the day and during classes, it made it hard to stay asleep. every 15 minutes, a staff member would open the door of my room and peer inside to make sure that i was still there and breathing. Plus, we had to wake up around 530.
Besides having a hard time sleeping at night, we were not allowed to take naps during the day. the staff justified the no-naps rule by saying that there were not enough couch spaces for people to recline without taking a seat from someone else. since everyone needs to remain seated instead of standing for long periods, they could say that napping would prevent someone else from sitting. even at times when there were spaces enough for people to recline and sit, the staff would tell us that we should spend the time between classes socializing, since this was another part of the therapy.
drinking enough water was another challenge. we were limited to 16 ounces of liquid during any meal, and had to get a doctor’s order to get an additional 8 ounces of water with a meal. aside from beverages at mealtimes, we were offered water during 3 breaks throughout the day. eight cups of water are recommended as a healthy intake. this means water, not water included in other beverages or food. doing the math, a patient with a doctor’s order for additional water who also took advantage of each water break would only get 6 cups: 3 during breakfast, lunch and dinner, plus the 3 breaks.
I wouldn’t recommend an eating disorder to anyone. this seems like a lifelong condition that I will need to deal with. I’ve only been to one inpatient treatment center in my lifetime, and can only offer my limited perspective. If you’re looking for a treatment center and considering SP, see if it matches your needs before signing up.
I was in SP inpatient in June 2011. It is hard core disciplined, there are no exceptions for acting on symptoms, and excuses are heard but not tolerated. It is the most restrictive eating disorder recovery environment I’ve been in. If you are interested in saving your life and can tolerate that this inpatient program is in the business of life saving and is less hard core therapy but rather hard core behavior modification, you will get a lot out of the program. I moved to a different program for PHP/IOP management as I don’t live in Maryland, but the experience. The program is “cookie cutter” but I do think that is based on the likelyhood that if you are sick enough to be inpatient that you need to have some serious intervention. I hated every second but I liked the outcome. It’s like taking a nasty tasting medicine that works; it’s worth it if you REALLY want recovery. Don’t waste your time if you aren’t ready.
2010
I have been here for a while now.
I fully believe the program is productive and good as long as YOU are willing to do the work. If you want a treatment that is comfortable/plush and where you can get away with behaviors without consequences – you will despise SP. If you want a program where behaviors are not tolerated, this is a good place. Yes, some aspects really honestly suck. Privilegeds are based upon weight gain, and while acting on your ED gain cause you to not make weight, sometimes you honestly do everything you are suppose to and do not make weight. However, this makes weight gain more of a positive thing. Additionally, many of the treatment team are very skilled. Some of the nurses suck ass, do not know anything about ED’s, and deserve to be fired… but some are simply amazing and I would love for them to adopt me. I am making progress in this treatment. They do not have gorgeous rooms or equine therapy, but they do provide you with abundant opportunities to not utilize your ED, learn new coping skills, and process what is going on. I would return here.
2010
When were you there?
i’ve been there several times but my last admission was this march-august (2010)
Describe the average day?
weights/vitals at 5:30, breakfast at 8, groups from 10-12, lunch at 12, groups from 1:30-5, dinner at 5:30, visiting hours from 7-8:30, snack at 8:30, lights out at 11.
What were meals like?
they have two dining rooms (one for PHP and one for inpatients) you sit at the tables and get called up by staff to prepare your tray. after you prepare your tray, you have 45 minutes to complete it. (they’ll usually give you extra time if you need it though) staff walk around the table and monitor and at the end of the meal, they check your tray to make sure you’ve completed everything.
What sorts of food were available or served?
a sample day on the basic meal plan:
breakfast- 2 servings of cheerios, 1 c. milk, 1 c. juice
lunch- pbj sandwich, pretzels, apple, ice cream, iced tea
dinner- baked fish, rice, vegetables, roll with butter, fruit cup, iced tea
snack- granola bar, apple juice
it’s pretty basic stuff. cereals, yogurts, juices, fruits, toast, scrambled eggs, bagels, muffins etc. at breakfast…you have a lot of options. they tell you how many items you need and you can pick whichever ones you want. lunch is usually sandwiches and you get to choose the amount of sides you need for your meal plan from a selection of things like chips, pretzels, soups, fresh fruit or canned fruit, desserts, side salads etc. there are always three options for both lunch and dinner entrees, and you get to choose all of your sides.
Did they supplement? How did that system work?
if you eat less than 50% of your meal you get 2 supplements, more than 50% you get 1.
if you aren’t making weight, they’ll add permanent supplements to your meal plan (9:45 am, 2:45pm, and 9:00pm) you can get up to 4 permanent supplements.
What privileges are allowed?
if you are eating/making weight you can use the phones, have visitors, and use the computer at night.
Does it work on a level system?
no.
What sort of groups do they have?
art therapy, CBT, DBT, IPT, mindfulness, occupational therapy, motivation to change, family dynamics, nutrition education, relapse prevention, mindful movement, stress management, horticulture, snack prep, body image…they also have specialty groups (substance abuse and PTSD)
What level of activity or exercise was allowed?
none.
What did people do on weekends?
you have groups in the morning and then the whole afternoon/evening is visiting hours. so if you don’t/can’t have visitors it gets pretty boring.
Do you get to know your weight?
yes. every morning.
How fast is the weight gain process?
they aim for .2 kilos a day (roughly 1/2 pound) so about 3-4 pounds a week.
What was the average length of stay?
it varies a lot. i definitely stayed a lot longer than most but i think in general it’s about 3 weeks inpatient and 3-4 in partial.
What was the average age range?
that varies a lot too. when i was there the youngest was 13 and the oldest was 57. they do divide up the groups though (18 and under, 18-24, and 24 and older)
What kind of aftercare do they provide?
they have a php program (7am to 7pm) and IOP (3pm-7pm), and they have outpatient providers as well.
Do they help you set up an OP treatment team?
yes.
How many IP beds?
26
Has anyone been to Sheppard Pratt’s free weekly support group? I’m looking into going, but I’m slightly hesitant because I don’t know what to expect or whether it’s worth it. Is it any good? What does the typical meeting look like?
I used to attend the group every week, but haven’t been in a year or so. I think it was worth it. There are “rules” that are explained at the beginning of what you can or can’t say (i.e triggering stuff). The group starts with an ice-breaker question that everyone answers, which is helpful. Some weeks there are about 10 people, and other weeks, there are like 30+. There is a group leader who is on staff at the CED, which is also good because they can add another view to things and they can also redirect inappropriate talk. You don’t have to raise your hand to speak, and after the initial “shyness” of the group, people are pretty comfortable talking. The group leader also prevents one person from taking the floor for too long….gives everyone a chance to speak if they chose to. The group takes place in a big room and you sit in chairs in a HUGE circle, so it’s not like you’re sitting right across from someone