Outpatient Eating Disorder Treatment at Opal

At Opal: Food+Body Wisdom, we offer three levels of care in outpatient eating disorder treatment. We offer comprehensive care and treatment for eating disorders and disordered eating from a variety of different modalities. Our goal is to treat the client holistically, with the belief that full recovery from an eating disorder is possible. 

Levels of Care

Partial Hospitalization

In-person. 6 or10 hours per day. Monday - Friday.

Intensive Outpatient

3 hours per day, 3-5 days per week, Monday - Friday.

Outpatient

Outpatient services are virtual and include: Individual psychotherapy, individual nutrition counseling, group therapy and psychiatric care.

Partial Hospitalization

Population Served: Adults of all genders (ages 18+) with anorexia nervosa, bulimia nervosa, binge eating disorder, exercise compulsion, avoidant restrictive intake disorder, orthorexia, and other specified feeding of eating disorder.

Hours:  Monday-Friday.  Ten hour and six hour in-person treatment options available.  

Ten hour option is 8am-6pm. Six hour option is 8am-2pm, or 11:30pm-6pm. 

Vaccinations required for PHP clients. Medical and religious accommodations observed.  

These services included in Partial Hospitalization Program:

1) Individual psychotherapy, two times each week

2) Support System Therapy 

3) Group therapy, including: Radically Open Dialectical Behavior Therapy Skills, Body Wisdom, Acceptance and Commitment Therapy, Facing Fears, Art Therapy, and several other therapist-led groups. 

1) Two-three meals and one-two snacks, dietitians present  

2) Individual nutrition counseling weekly

3) Weekly cooking classes, meal outings, and food experientials (limited during Covid-19) 

4) Group nutrition education

Individual medication management session weekly

Close medical monitoring done by offsite medical providers that are Health at Every Size aligned and trained in the treatment of eating disorders.  Streamlined communication with Opal team. 

Intensive Outpatient

 Hours: 3 hours/day, 3-5 days/week (Monday-Friday). 

Population Served: Adults of all genders (ages 18+) with anorexia nervosa, bulimia nervosa, binge eating disorder, exercise compulsion, avoidant restrictive intake disorder, orthorexia, and other specified feeding or eating disorder.

Vaccinations required for IOP clients. Medical and religious accommodations observed.  

These services included Intensive Outpatient Program:

 1) Individual psychotherapy

2) Support System Therapy/Programming as appropriate 

3) Group therapy which can include , Acceptance and Commitment Therapy, Re-Thinking Exercise and Sport, Facing Fears, Body Wisdom, and Process Group

 

1) One therapeutically supported meal daily

2) Individual nutrition counseling weekly  

Medical visits as recommended. Psychiatric medication evaluation and/or monitoring provided by Opal Psychiatrist.  

Outpatient Program

*Program components are individualized to suit each client’s unique treatment needs

We want clients to find the treatment team that is the best fit for their needs and we know the importance of maintaining established treatment relationships.  As a result, clients are encouraged to continue working with providers in the community while seeking a component of their services from Opal. There are many fantastic eating disorder treatment practitioners in Seattle and we are happy to collaborate care with these providers.

Hours: Monday-Friday

Adults of all genders (ages 18+) with anorexia nervosa, bulimia nervosa, binge eating disorder, exercise compulsion, avoidant restrictive intake disorder, orthorexia, other specified eating or feeding disorder, and body image dissatisfaction. We understand that struggles with food and body are often intertwined with other mental health struggles including, but not limited to, anxiety, obsessive-compulsive disorder, and depression.

Individual psychotherapy, individual nutrition counseling, group therapy, and psychiatric care.

Experience

Weekend Process

Clients come together each Monday to check in and share experiences from the weekend in order to more attuned to each other as the week of treatment begins.

Re-Thinking Exercise + Sport Didactic​

This didactic group is teaching-focused. The group covers topics related to nutrition, weight and psychology as it relates to sports and exercise. Teaching resources are based in current scientific research.

Radically Open DBT Skills Class

This twice weekly class helps clients decrease emotional loneliness and targets the overcontrolled temperament

ACT Group

Acceptance and Commitment Therapy Group (ACT) helps clients understand how language and thoughts can interfere with their ability to live in accordance with their values.

Life Stories

Life Stories allows clients to increase interpersonal connectedness and group cohesion as well as heighten awareness of the impact of life experiences. 

Re-thinking Sport and Exercise Process

Increases self-awareness regarding beliefs, mindset and behaviors around sport, exercise and movement and helps identify areas for behavioral experimentation. 

Art of Pleasure and Non-Productivity

A skill in RO DBT, clients have space and time to not be productive!

Aftercare Planning

Provides therapeutic support and creative space for clients to plan for life after treatment.

Body Wisdom

Opportunity for clients to explore things that block having a full and caring relationship with their body, including systems of oppression, eating disorder behaviors, shame, and trauma. Clients can work towards regaining trust with their body’s wisdom, shifting away from disconnection, avoidance and/or invalidation.

Movement Group

Offers creative ways for clients to engage their bodies in exercise,
movement and sport. This group allows clients to practice new skills, increase flexibility, and connect to their bodies.

Process Group

Meets daily. Clients are given an opportunity to process emotion and practice interpersonal/relational skills in a semi-structured environment.

Self- Inquiry Group

A time to challenge our core
beliefs and learn from distress rather than automatically attempting to regulate, distract, change, deny or accept.

Art Therapy

Twice  a week  Art Therapy group is a time for clients to process  emotions and thoughts in a creative, non-verbal modality.

Yoga Therapy

Yoga Therapy Group is a place to practice body awareness, and knowledge and practice of
mindfulness- based skills. Classes are taught by certified yoga teachers.

Health at Every Size® Didactic

A didactic group where clients learn and discuss the tenants of Health at Every Size® (HAES). Includes psychoeducation and group process time.

Team Meetings

Clients and their providers meet as a team on a weekly basis to
discuss individualized treatment goals and progress towards recovery.

Take out Dinner

Clients and staff weekly order take out from a variety of local restaurants. 

Community Group

A group for all clients to connect and build Opal’s recovery community. 

Nutrition Education

A Dietitian-led group that offers education about food and nutrition, as well as process time to gain insight into one’s relationship with food.

Support System Programming

A weekly experience that allows loved one’s the opportunity to meet Opal staff and experience the space, food and treatment approach. Includes multi-family group, presentation night, and meals.

Culinary Group

Each week a client works 1:1 with a staff member to learn to plan, purchase, prepare, and serve food. The group makes the meal together, fostering connectedness. A time for clients to gain competency with cooking and baking.

Grocery Shopping Outing

Each Friday clients have a time to shop for needed grocery items with the support of other clients, milieu therapists, and a dietitian.

Facing Fears

A place to experiment with moving towards anxiety in order to learn to allow values to lead the way rather than avoidance of fear and anxiety.

Meals and Snacks

Breakfast, lunch, dinner and snacks are opportunities to eat in community and be exposed to a wide variety of foods while being therapeutically supported. 

Opal's Treatment Model

Individual Sessions

Clients have weekly meetings with their treatment team which includes a therapist, dietitian, and psychiatrist. This may also include exercise and culinary experientials.

Group Therapy and Meals Experience

Clients take part in weekly groups in community with fellow clients. They also eat all meals and snacks together during their treatment days.

Areas of Focus

Treatment at Opal has always been rooted in Health at Every Size. We also use Radically Open Dialectical Behavior Therapy and specialize in working with athletes in our Exercise and Sport Program.

Opal's Approach to Eating Disorder Treatment

The treatment of eating disorders is individualized. We take a holistic approach to treatment that allows for healing to be done in community and in individual sessions. We believe eating disorders develop to serve a function for an individual.  Opal’s staff come alongside our clients to better understand those “whys” and find new ways to cope and live life without an eating disorder.  We offer three levels of care at our Seattle clinic. Overall, our treatment model includes: 

  • Individual therapy, nutrition counseling, psychiatry, exercise experientials and family therapy available at the PHP and IOP levels of care. 
  • Health at Every Size, weight-neutral treatment approach (link to HAES page)
  • Non-diet approach to food. Meals and snacks provided offer a wide variety of foods (highly processed, fresh, organic, non-organic, home-cooked, frozen, easy to prepare, etc.) 
  • Eating at meals and snacks are done with other clients and staff, as a community.
  • A belief that adequate food intake is a foundational step in recovery. 
  • Exercise + Sport programming, which addresses exercise bulimia, exercise avoidance, and other exercise concerns
  • Radically Open Dialectical Behavioral Therapy as a foundational treatment 
  • Group therapy including body wisdom group, movement group, self-inquiry, process groups, facing fears and more. 
  • Teaching/Didactic groups including Radically Open Dialectical Therapy, Acceptance and Commitment Therapy, Exercise + Sport Didactic, Health at Every Size Didactic, etc.
  • Free, non-clinical lodging for PHP clients to use while in treatment, as space available. 
  • Outpatient groups 

We believe in the model of attuned eating and hold it as a goal for our clients. The aim of attuned eating is to learn to trust that our bodies work! This means trusting that our bodies know what to do with the foods we put in it, that our bodies will tell us when we’re hungry and when we’re full, and that we can distinguish between our physical and emotional feelings. Intuitive eating also aims to separate self-worth from diet and weight, allowing us to make peace with food and our bodies. We recognize that intuitive eating does not come easily to many of us and can even be quite frightening to consider – this is why we take care to meet each client where they are in this journey and work at a pace that is appropriate for each person.ption or absorption of food and that significantly impairs physical health or psychosocial functioning. (DSM V, p. 329)

A meal plan is a document created by each client and their dietitian that depicts the client’s daily intake requirements. It includes breakfast, morning snack, lunch, afternoon snack, dinner, and pm snack (if applicable). The dietitian assesses each client’s nutritional needs in conjunction with recovery goals and they create the meal plan together. It is common for the meal plan to change as a client progresses through treatment. The idea behind meal plans is to give clients, who have developed abnormal patterns of eating, a guide to retrain their bodies on what is “normal eating” in terms of quantity, variety, and frequency of meals. The ultimate goal is to move away from needing meal plans, but that clients can use the skills they have developed to eat in a more attuned manner.

This refers to eating choices that are distinct from disordered eating, such as vegetarianism, veganism, or choices to eating locally-sourced foods, for example. Food values are an important part of each person’s general food choices, yet can become intermingled with disordered eating as well. We work to honor each person’s unique values while also paying special attention to how a food value could be part of one’s eating disorder

Yes. Opal intake and nutrition teams together assess these needs on a case-by-case basis. Typically, we ask for medical documentation of food allergies before approving accommodations in a meal plan. Regarding food values, clients can begin treatment with their food values honored and will further discuss in individual nutrition sessions. Clients will work to more clearly understand how these food values may/may not serve eating disorder recovery.

We have found that for the best care, clients at the PHP and IOP level will see an Opal therapist and dietitian, we take great care to communicate and collaborate with those clinicians who have referred their clients to us. 

The simple premise that the best way to improve health is to honor your body. It supports people in adopting health habits for the sake of health and well-being (rather than weight control)

Radically Open Dialectical Behavior Therapy (RO-DBT) is a new treatment that targets over-controlled behavior. It has been used to treat some of the rigid responses and emotional inhibition thought to underlie many treatment-resistant conditions. RO-DBT has been informed by over 20 years of clinical and experimental research, and is a talk therapy that involves weekly individual and group sessions.  The RO-DBT treatment typically involves a 1-hour weekly individual session and a 2.5-hour weekly group session.
Opal offers this in Partial Hospitalization and Intensive Outpatient Program.

While Opal is not affiliated with a specific religion or spiritual practice, we do invite clients to incorporate their own traditions and practices into their recovery and help to facilitate that part of their experience.

Getting Started