Clinical Spotlight
Oceanaire
by Christina Weiss, MPHC
Director of Clinical Outreach

Discovery Practice Management, the parent company of Center for Discovery,  acquired a program for young adult women struggling with eating disorders in December of 2008. Oceanaire is  a beautiful six-bed residential facility in a home-like setting in Rancho Palos Verdes, California (near Los Angeles). I sat down with the Chief Operations Officer of the Eating Disorders Programs, Buck Runyan, and the Lead Dietician, Lisa Arroyos, to discuss the program philosophy, treatment components and resident profiles.

Interview with Buck Runyan, MS, MFT, LPC, CEDS
Chief Operations Officer, Eating Disorders Programs
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Question: What is the overall philosophy for Discovery Practice's Oceanaire Program?

Answer:  The foundation of the program is to include families as the resident's key support system for long-term recovery. We want to work intimately with the families as much as possible on a weekly basis.  We have the parents, husbands, brothers and sisters, whoever has the resident's best interest at heart, come in for family therapy and educational sessions.   In some cases, residents may not have biological families, or the family may be inappropriate for the recovery process. In those situations, we determine family as people who have the resident's best interest, can keep information confidential, and remain available for support throughout treatment and after discharge.

Q: Exactly how are the families involved in the program?

A: We want the family involved at least two times per week on site. We are able to handle weekly phone sessions as well if the family is unable to be on site. We also invite families to participate in the Discovery Therapeutic Family Meal at least twice during the resident's stay. Our position is, the more family work, the more support, the more education, the more training, the better off everyone is going to be for long-term recovery. We do not do family weekends or family weeks, we want the family to be involved from the minute the resident enters our program and throughout the entire process through to discharge and aftercare.

Q:  How many therapy sessions per week are residents involved in?

A:  Each resident gets four therapy sessions a week with their primary therapist.  One of those session’s, at minimum, would be an on site family session, and we will add more if needed. In addition to these sessions, they get one session per week with their psychiatrist as well as a session with our primary care physician.  They also meet with the dietician at least once a week individually, who helps to set up an individualized meal plan and is available to make adjustments when needed.

Q: How many groups do they have per week?

A:  Residents are involved in over 25 groups per week that run about one to one and half hours per each group.

Q: What is the focus of these groups? What is the purpose or overall theme?

A: The focus of the groups is interpersonal relationships and emotion management. We do this through a form of dialectical behavioral therapy, as well as education and skills training. We also help residents to connect their emotions with their thoughts, and integrate cognitive behavioral education and treatment exercises related to self -regulation. We work on their communication skills; they learn how to listen to others, if someone else is struggling how to give support, if someone's behavior is inappropriate, how to confront, but at the same time encourage them to get better.  All of these play out every single day in a residential setting.

Q: Will there be yoga at Oceanaire or other experiential therapies that are included in the program?

A: Currently we offer a couple of yoga classes a week.  The goal is to teach residents ways in which they can relax  - calm themselves and self-soothe, all which are a result of  the yoga process.  We also incorporate art therapy into a resident’s treatment. If a person has difficulty putting words to feelings, and thoughts to emotions, then different modalities of art are very effective. In addition, the primary therapist and the treatment team determine appropriate offsite experiential therapies which may include trying on clothing at a clothing store, or going out with their family to lunch, etc. We also do recreation therapy where residents learn simply how to have fun and play. Often people who are struggling with an eating disorder do not know how to just have fun. As a result, we include many different avenues and experiential therapies in our treatment. The small population at Oceanaire allows us to creatively modify the program throughout the course of treatment.

Q: Why is treatment with young adults different than treating the entire adult age spectrum?

A: The older a person is, the more complex the disorder. The longer that someone has an eating disorder, the more likely they have additional complexities related to marriage, divorce, children, personal finances, legal matters, not to mention, more diverse medical conditions. With the young adult population you have less complexity. Another difference is that younger women tend to have more intact family support from primary members (i.e. mother, father, etc.). This provides for more structured family therapy and education and allows for the family to become a major component of the support system. Finally, younger adult women are going through specific and similar life transitions in comparison to women of varying older ages. Two women in a group ages 22 and 26 will have more in common than two women age 22 and 52.

Q: What is going to make the young adult program at Oceanaire different from Center for Discovery's adolescent program?

A: The difference is in the stages of life. Adult residents and adolescent residents are in different stages of life.  A young adult women’s life is naturally more complex, fuller; there is a higher level of independence and responsibility as well as a higher level of accountability.  These attributes of life must be addressed appropriate to their age, circumstances, and resources.  Another important consideration is that for all adults, the choice of addressing one’s disorder is self-determined whereas for most adolescents, it has been determined for them.  In our adult program, it is the resident who chooses to resist or engage in treatment, and it is the resident who deals with the consequences of their actions. Based on this fact, our team will facilitate a course of treatment that is congruent with the resident’s actions but that will also facilitate a commitment and resolve to recover.

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Interview with Lisa Arroyos, MS, RD
Lead Dietician
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Question: What is the overall philosophy of the nutrition program at Oceanaire?

Answer: Overall the program is designed so that the residents are able to manage their nutrition on their own, based on an exposure-response-prevention model.  Oceanaire’s program is hands-on, from conceptualization and preparation to actual cooking, shopping, restaurant outings, etc. Of course, residents are working through the different phases, but ultimately we want to get them to a place where it is mechanical, where they are listening to their own body signs of hunger and fullness. And we work from a model that "all foods fit."

Q: Can you explain what you mean by hands-on food exposure?

A: Often times what we do is called food “exposure.” This is when we address a resident’s food fear, when they are afraid of certain types of food, food they use to binge on, etc, food that may in fact be correlated to weight gain.  In order to overcome this, we actually expose them to their fears in a graduated manner. We talk about how they are feeling about the food, their anxiety, and why the food is making them feel a particular way. We find if we don’t expose them to these types of foods, they will either remain in fear and stay away, or they will end up binging on them.  So, what we do is actually, physically bring in these fear foods, and expose them to it.  We try to address reality and prepare them for life after treatment, these foods will be around them during parties, the holidays, college cafeterias, in every day life - How are they going to react to it? And what coping skills can they use to support themselves.? When they react to fear foods with disordered behavior, we want them to have our support. Ultimately, the more we expose them, the less fear they will have and the less likely they are going to binge on or stay away from these foods. The more exposure with fearful situations the more opportunities they will have for strengthening their resolve for recovery.

Q: What is the Discovery Therapeutic Family Meal?

A:  The family of the resident brings in their food from the outside, the resident makes something in our kitchen, and the therapist and the dietician join the family in eating the meal around the dining room table. We want to analyze what the family is bringing in, watch to see if it triggers the resident, and come up with ways to support her during these moments.   We encourage the family to act as natural as possible, and try to create an atmosphere which is normal for the family, which is easier to do in a home-like setting. At this point in the meal, the staff encourages role playing, and we ask the resident if anything is triggering them.  Then the staff asks if the family has noticed anything different from the resident. We teach them not to “food police” not to “food ignore” but instead to support.  The whole point of role playing is to understand how to support a family member in a time of need, because everyone is different.  Some people like more structure, for example I have had a resident tell me, "I need my parents to be straight forward with me." On the other hand, I have also had one resident state they didn’t want their family to step in at all, and instead she suggested, "I want to have that responsibility, but I want them to be there to support me."  So we role play, what would work, what wouldn’t work. We also talk about red flags, things that the resident use to do at home, so that family members are aware of what to look for and can ultimately help prevent a relapse. When the family knows red flags specific to the person struggling they are able to determine when extra support is needed. It’s very helpful. 

Q:  What is the difference between Center for Discovery and Oceanaire’s nutritional program?

A:  The Nutritional program is the same.  The only difference is it becomes more of a “negotiation" with adults. With adolescents you can catch an eating disorder earlier, before it progresses. Generally, adults have been in their disorder for a much longer period of time.   When I have a forty year old client who has been doing this for over 20 some years, it’s going to be hard to change those habits.  Often we have to find a compromise without compromising their health. It's challenging to identify the behaviors they are willing to change and those they are not. With adolescents they are still developing so we have to push them to 100%. For adults, if we can get them between 90 - 100% of their ideal body weight, then I am OK. I would rather be cautious with them, rather than put them at a place where they are likely to relapse

Q: As far as the educational component of the nutritional program, what do you want residents to know before they leave Oceanaire?

A: What we want them to learn is the facts of nutrition, how nutrition affects their bodies and the medical consequences of an eating disorder.  We want to debunk any food or body myths that they may believe.  I frequently have to dispel a vast array of misinformation because residents come to Oceanaire saying that had heard one thing or another. There is a lot of false and inaccurate information about nutrition floating around and I am very sad to say most of it is related to misinformation for financial gain. We make sure our education is based in legitimate research and fact.  Residents, of course, will only take what they are willing to learn but at least the education they are receiving is based on facts focused on all topics food related to the body, mood, metabolism and exercise.

Discovery's Oceanaire program is for young adult women struggling with eating disorders including anorexia, bulimia, binge eating, and other related disordered eating. They accept insurance for their residential program at an all inclusive rate. For more information please contact (866) 406-0166 or go to www.oceanaireinc.com

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Join the Preferred Partner Network
It is important to us that our patients have a quality team to go to after treatment. We look for quality Psychiatrists, Psychologists, Medical Doctors, Therapists and Dieticians across the country to refer our patients out to. Simply click here, complete the online form, and a representative from Discovery Practice Management will contact you.

Alumni Groups

Center for Discovery
Eating Disorder Alumni
For more information please call
Lisa Arndt at 562-698-8888

Dual Diagnosis Alumni
Free Alumni Group for all former residents and their parents of La Habra , Long Beach , and Whittier 's Dual Diagnosis Programs.

Thursday evenings at 8:00 PM at the Long Beach Facility
For more information please call
562-981-0700

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Discovery Practice Intake

When to Refer to Discovery’s Residential Eating Disorder Programs

Discovery follows the American Psychological Association guidelines when referring to the appropriate levels of care for the treatment of eating disorders. Residential treatment is appropriate when someone is failing at the outpatient level, or if they have dropped a significant amount of weight in a short period of time. Other factors that determine the appropriate level of care are the need for 24-hour supervision (especially during mealtime), lower ideal body weight, medical stability, and the inability to stop maladaptive behaviors. The Intake Staff at Discovery understands this process and as a result, adhere to strict clinical criteria before admitting patients to our programs.

Discovery offers a free and confidential assessment for those who are seeking to understand what level of care is suitable for them. If you are currently working with, or have been recently referred an eating disorder client who may be in need of a higher level of care, please contact our Intake department for a free assessment. This assessment will take approximately 60 minutes and includes physical, social, emotional and behavioral aspects, as well as a thorough history of the disordered eating.

We understand that not all individuals struggling with an eating disorder are in need of residential treatment. This is why Discovery’s Intake department has an extensive list of resources at all levels of care suitable for most circumstances. Please feel free to contact our Intake Representatives to obtain information for resources in your area.

Contact
For more information, please contact our Intake Department at 800.760.3934 or info@centerfordiscovery.com
We have immediate placement availability for eating disorder residential treatment!

24 hours a day, 7 days a week
Center for Discovery: 800.760.3934.
Oceanaire: 866.406.1066.

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Center for Discovery
At-A-Glance
Center for Discovery is a residential treatment program dedicated exclusively to adolescents struggling with eating disorders and dual diagnosis issues. We believe that just as eating disorders and dual diagnosis disorders require specialized treatment, so do adolescents. Discovery offers professional, structured environments with the comfort and nurturing of serene home-like settings where adolescents can safely address their challenges. Our individualized treatment approach is provided by a multidisciplinary team and a low staff to resident ratio. At Center for Discovery , we assist hundreds of adolescents and their families annually across our six JCAHO accredited and California licensed campuses. Since 1997 we have been privately owned and operated. Discovery is contracted with most major healthcare insurance providers and will assist families in verifying their insurance benefits. Our Intake Department is available for both professionals and families 24 hours a day, 7 days a week.

EATING DISORDERS PROGRAM
• Helping males and females 10 to 19 years old
• Disorders treated:
- Anorexia Nervosa
- Bulimia Nervosa
- Binge Eating
- Other related complex disordered eating
• Weekly Family Involvement
• The Discovery Therapeutic Family Meal
• Four private therapy sessions per week
• Over 41 structured groups per week

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DUAL DIAGNOSIS PROGRAM
• Helping males and females 12 to 17 years old
• Disorders treated:
- Addictive Disorders
- Anxiety Disorders
- Depressive Disorders
- Childhood/Adolescent Disorders
• Weekly Family Involvement
• 12-Step Focus
• Four private therapy sessions per week
• Over 41 structured groups per week

Our mission at Center for Discovery is to combine the finest traditional inpatient approaches with creative, innovative and individualized interventions that position our therapeutic experience at the forefront of adolescent treatment.

For more information please call 800.760.3934 or visit us at www.centerfordiscovery.com 

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Oceanaire
At-A-Glance
Oceanaire is a spacious residential six-bed setting in a serene and confidential location on the Palos Verdes Peninsula for young adult women struggling with anorexia nervosa, bulimia nervosa, binge eating disorder or compulsive exercising. Nestled above one of the greens of the Los Verdes Country Club Golf Course, Oceanaire provides ocean vistas and Pacific Coast sunsets, creating a peaceful and healing environment for the mind and body. The home has a private interior courtyard swimming pool and lovely patio for outdoor relaxation and events. The space at Oceanaire provides a peaceful setting for healing where young adult women can safely and effectively address their issues and begin their path to recovery. Oceanaire provides an intensive treatment program with four private weekly therapy sessions, a strong family component including weekly family conjoint sessions, multi-educational groups including DBT (Dialectical Behavioral Therapy) groups, hands-on food exposure, restaurant outings, nutritional education, medical and psychiatric consultations, yoga, relaxation and stress management techniques and much more. Oceanaire is contracted with most major healthcare insurance providers and will assist families in verifying their insurance benefits. Our Intake Department is available for both professionals and families 24 hours a day, 7 days a week.

EATING DISORDERS PROGRAM
• Disorders treated:
- Anorexia Nervosa
- Bulimia Nervosa
- Binge Eating
- Other related complex disordered eating
• Weekly Family Involvement
• The Discovery Therapeutic Family Meal
• Four private therapy sessions per week
• Over 41 structured groups per week

For more information please call 866.406.1066 or visit us at www.oceanaireinc.com

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Upcoming Events

Networking

The South Bay Network – Torrance, CA co-hosted by Discovery Practice Management and Thelma McMillen Center. Next meeting is Thursday, February 24 from 8:30 – 10:00am at Thelma McMillen Center featuring Candy Bartole, MFT “The Weigh to Self – Esteem”. For more information, contact Christina Weiss at 562-457-7373 or christina.weiss@centerfordiscovery.com

Adolescent Resource Network – Sherman Oaks, CA co-hosted by Discovery Practice Management and Clearview and Insight Treatment Centers. Next meeting is Friday, February 27 from 8:30 – 10am at Insight Sherman Oaks featuring Leli Sarsozo, RN, CNS, “Understanding the Educational Consultant’s Role in Adolescent Treatment”. For more information, contact Christina Weiss at 562-457-7373 or christina.weiss@centerfordiscovery.com

The SD Network – La Costa, CA co-hosted by Reasons Eating Disorder Treatment at BHC Alhambra, Discovery Practice Management, Hope by the Sea, and Miracle Recovery. First Thursday of each month from 11:30 – 1pm. Upcoming events: Thursday, March 12 featuring Alan Gatlin, MS, MFTI; Thursday, April 9, featuring Buck Runyan, MA, LPC, MFT, CEDS from Discovery Practice Management; May 7 featuring Lisa Hoffart, from Reasons Eating Disorder Treatment at BHC Alhambra Hospital. For more information, contact Alexia Mowry at 562.881.9886 or alexia.mowry@centerfordiscovery.com

IAEDP San Diego – San Diego, CA . Next meeting is Friday, March 20 from 11:15 – 1:30pm at Aurora Behavioral Hospital featuring Evelyn Tribole, RD on “Intuitive Eating”. For more information, contact IAEDP San Diego at iaedpsd@gmail.com.

The OC Network – San Juan Capistrano , CA co-hosted by Reasons Eating Disorder Treatment at BHC Alhambra, Discovery Practice Management, and Hope by the Sea. Meetings are held on the third Friday of every month at Hope by the Sea from 11:30 – 1pm. Upcoming events: Friday, March 27 featuring Lisa Foley from Willow Springs Treatment Center; April 16 featuring Lisa Hoffart from Reasons Eating Disorder Treatment at BHC Alhambra Hospital; May 15 TBD. For more information, contact Alexia Mowry at 562-881-9886 or alexia.mowry@centerfordiscovery.com

Adolescent Resource Network – Pasadena, CA co-hosted by Discovery Practice Management, Insight Treatment Centers, Clearview Treatment Center, and The Matrix Institute. Next meeting is on Friday, April 10 from 8:30 – 10am held at Casa de Las Amigas featuring Dr. Melissa Johnson “Therapeutic Essentials for Healing Adolescent Girls”. For more information contact Christina Weiss at 562-457-7373 or christina.weiss@centerfordiscovery.com

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CEU Events

A Father’s Voice: Engaging Dad’s in Adolescent Eating Disorder Treatment
Featuring: Buck Runyan, MFT, LPC, CEDS

Using Expose-Response and Systematic Desensitization Techniques
for Nutritional Recovery in Eating Disorders
Featuring: Rachel Liger, MS, RD

Understanding Substance Abuse and Eating Disorders: A Psychiatric Perspective
Featuring: Brian Holt, MPH, MD

Seattle, Washington: May 15, 2009
Portland, Oregon: June 12, 2009
Orange County, California: July 24, 2009
Los Angeles, California: October 9, 2009
San Diego, California: October 16, 2009
Berkley, California: November 6, 2009

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Featuring Buck Runyan
Come see Buck speak at one of the following events:

CAMFT - Ventura
March 13, 2009
10:00-2:30
Spanish Hills Country Club, Camarillo, CA
A Family Systems Approach for Treating Adolescent Self -  Injurious Behaviors and Eating Disorders
Featuring: Buck Runyan, MA, LMFT, LPC, CEDS
For more information contact: Christina Weiss
562.457.7373 or christina.weiss@centerfordiscovery.com

St John’s Eating Disorder Conference
April 14, 2009
8:00 – 9:30am
St John’s Hospital, Santa Monica, CA
Eating Disorder Levels of Care
Featuring: Buck Runyan, MA, LMFT, LPC, CEDS
For more information contact: Christina Weiss
562-457-7373 or christina.weiss@centerfordiscovery.com

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Upcoming Conferences

A Father’s Voice: Engaging Dad’s in Adolescent Eating Disorder Treatment
Featuring: Buck Runyan, MFT, LPC, CEDS

Using Expose-Response and Systematic Desensitization Techniques
for Nutritional Recovery in Eating Disorders
Featuring: Rachel Liger, MS, RD

Understanding Substance Abuse and Eating Disorders: A Psychiatric Perspective
Featuring: Brian Holt, MPH, MD

Seattle , Washington : May 15, 2009
Portland , Oregon : June 12, 2009
Orange County , California : July 24, 2009
Los Angeles , California : October 9, 2009
San Diego , California : TBD
Berkley , California : November 6, 2009

Stop by Discovery’s booth!

Eliza Project Symposium
February 27 -28, 2009
City Place Conference Center
Dallas , Texas

IAEDP Symposium 2009
March 5 – 9, 2009
Long Beach , California
The Westin Hotel

Featuring:
March 4: Buck Runyan, MS, MFT, CEDS, LPC
“The Directive Use of Imagery and Art Expression to Motivate Complex Clients”

March 7: Rachel Liger, MS, RD
“The Use of Exposure – Based Nutrition Therapy for Adolescents with Eating Disorders”

CSNO State Conference
Sacramento, CA
March 5 – 7, 2009

Sailing into the Sunset
IAEDP So Cal Benefit Dinner
March 7, 2009
6:30- 9:30pm
www.iaedpsocal.com

WAAMFT
March 14, 2009
Seattle, WA

Society for Adolescent Medicine
March 25 – 28, 2009
Hyatt Regency, Century Plaza
Los Angeles, CA

State ASCA
March 26 – 27, 2009
Mesa, AZ

Academy of Eating Disorders
April 30 – May 2, 2009
CasaMagna Marriott Cancun Resort and Spa
Cancun, Mexico

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