The Adaptive Care Model: Treating the Whole Person, Not Just the Eating Disorder
Eating disorders are dangerous, life-threatening conditions that affect all aspects of the individual. In the past, many treatment models focused solely on the psychological, medical and nutritional components of the eating disorder itself rather than treating the complete, individual person. Now there is a model that builds off the traditional methods to focus on healing all dimensions of the whole person. To do this, clinicians must understand the biological underpinnings that cause eating disorders and the behaviors that help maintain them long-term, and work together in multi-disciplinary teams to achieve total health.
The Adaptive Care Model
The Adaptive Care Model was developed by a group of industry experts at Alsana, an eating disorder recovery community, working together to create a comprehensive, integrated model for eating disorder treatment centered on total health for each client. This model is built on the belief that full recovery is possible when an individual is approached collaboratively with compassion, and has the opportunity to receive evidence-based treatment. The model treats the whole person, addressing five dimensions through an integrated approach:
- Therapeutic: The therapy program is centered on an understanding of the complexity of eating disorders and their underlying biological, behavioral and environmental influences. Therapy is provided with compassion and acceptance to create an environment in which clients stabilize symptoms, process underlying issues, and integrate changes to create a life worth living based on values and a sense of purpose.
- Nutritional: The nutrition program integrates the balance of nourishment and pleasure within a real-world environment to restore a nurturing relationship with both food and body. This dimension is focused on helping clients learn to experience food, meals, cooking and even shopping with joy.
- Medical: The medical program is based on building health resilience to provide a physical foundation of recovery. Clinicians treat the nuanced medical, physical, and psychiatric complications of eating disorders with a comprehensive plan, consistent methods, precise interventions and compassion.
- Movement: The movement program is built on evidence-based treatment that integrates progressive levels of movement as healing for both body and mind. Clients learn how to enjoy and relish everyday activity and exercise in a healthy way.
- Relational: The relational program provides guidance and support for clients to explore and grow their own sense of purpose as part of the recovery process. Individuals recover in relationship with others, themselves and in connection with a deep sense of purpose.
Data-driven and innovative treatment methods support recovery by targeting areas of the brain specifically affected by eating disorders. When combined with ongoing assessments and feedback from the client, interventions are tailored to meet the specific needs of the individual. The Adaptive Care Model is not based on a specific method or intervention style, but rather encompasses all the appropriate methods available, and determines how best to apply them to each client based on his/her unique situation, assessments, feedback and personality. At the heart of the Adaptive Care Model is compassion and understanding. By viewing the individual as a person and treating all dimensions of that person, the model is better able to adapt to each client’s needs to achieve total health.
Treating the Root Cause of Eating Disorders
The Adaptive Care Model builds off of a neurodevelopment model of etiology for the eating disorder, and addresses the eating disorder in its development and maintenance phases. Eating disorders develop in individuals with a biological diathesis that is triggered by a behavioral activator – typically dieting behavior. This biological diathesis is the result of a genetic predisposition and interpersonal neurobiological development within the individual. Eating disorder symptoms are then maintained based on the emotional, relational and neurological adaptive function they have taken on.
The Adaptive Care Model takes into account the biology, genetic predisposition and neurochemistry that result from early attachment patterns. It leverages the interpersonal neurobiological model that describes human development and functioning as a product of the interaction between the body, mind and relationship, understanding how the brain and mind are developed and how they function based on the interplay of genes in the context of relationships.
The model recognizes the predisposing, precipitating and perpetuating factors that contribute to the disorder’s development and maintenance over time, allowing clinicians to target interventions to specifically address these factors:
The heritability of eating disorders is estimated to be as high as 70 percent, while children of individuals with eating disorders are up to 11.3 times more likely to develop one themselves than the general population. Common temperamental factors associated with eating disorders include harm avoidance, novelty-seeking, perfectionism and persistence, while specific neurochemical and neurobiological findings have also been identified including problems in reward system, decision-making, perseveration, interoception and perception of body size.