EATING DISORDERS PROGRAM 06130 Revised 121123 Page 1 of 15 CONTENTS INTRODUCING…Homewood Health Centre’s Eating Disorders Program!! ♦ Who we are and what we believe ♦ Our clients ♦ Preadmission Assessment Process ♦ Preparing for Admission ♦ Day I Admission Day ♦ Week 1: Assessment Phase ♦ Treatment Process ♦ Treatment Team Members ♦ Treatment Opportunities ♦ Important Things to Know – House Rules! 48 Hour Therapeutic Pass and Program “NonNegotiables” ♦ Additional Information and Tour Information ♦ Local Accommodations Directory ♦ Typical Day’s Meal Menu ♦ Typical Program Schedule (partial week) only 06130 Revised 121123 Page 2 of 15 WHO WE ARE AND WHAT WE BELIEVE Homewood’s Eating Disorders Program is Canada’s largest inpatient treatment program specializing in the treatment of Anorexia Nervosa, Bulimia Nervosa and Eating Disorder Not Otherwise Specified (excluding Binge Eating Disorder), for women and men, 16 years of age and older. Homewood Health Centre is a fully accredited psychiatric hospital with over 100 years of history of patient care. We are situated on fifty acres of scenic property along the Speed River in Guelph, Ontario. The Homewood Health Centre’s Eating Disorders Program views eating disorders as constituting an extreme pole on the continuum of weight and size preoccupation prevalent in today’s society. An eating disorder is manifested by symptoms that may include food restriction or fasting, binge eating, purging, compulsive exercise and obsessive thinking. It can be perceived as a means of coping with psychological/familial/social distress in one’s life. The program has a voluntary, group-based, recovery-oriented approach, which encourages selfresponsibility and healthy coping right from the start of treatment. Patients are immediately able to access a supportive community of peers and multidisciplinary staff who fully understand the complexities of the illness and the healing process. Program participants are provided with opportunities to practice their newly acquired coping skills by having outings in the community (or at home, whenever practical), integrating their therapeutic experiences with those of “real life.” While the program does not constitute a “cure” for eating disorders, it provides a strong foundation upon which patients can build through outpatient follow-up services in their own communities. Wherever possible, Homewood partners with outpatient supports to ensure the best possible continuity of care. OUR CLIENTS The Homewood Eating Disorders Program offers treatment to those who meet the diagnostic criteria for Anorexia Nervosa, Bulimia Nervosa and Eating Disorder, Not Otherwise Specified (ED NOS) (not including Binge Eating Disorder). A general description of these disorders is as follows: ANOREXIA NERVOSA involves an intense pursuit of thinness, a fear of weight gain and an extreme preoccupation with food at a time when a person is emaciated. There is an inability to see one’s body size and shape accurately, which co-exists with body dissatisfaction. The disorder appears to be a means of coping with uncomfortable emotions and difficult life situations. It may serve a functional purpose in one’s life and thus is quite difficult to relinquish. Often low self esteem and feelings of being out of control in one’s environment are present. Body weight may be perceived as the only thing one can control. If your weight is very low and/or you are medically unstable, you may not be eligible for admission. In such cases, this decision will be made on a case-by-case basis. 06130 Revised 121123 Page 3 of 15 BULIMIA NERVOSA involves extreme preoccupation with food and weight issues, as well as various weight control practices, (i.e., dieting, fasting, laxative usage, self-induced vomiting, compulsive exercise, etc.). It also involves recurrent episodes of eating large amounts of food in a short period of time (binges), feeling “out of control” while binge eating, and often feeling shameful afterwards. EATING DISORDERS NOT OTHERWISE SPECIFIED includes Eating Disorders that do not meet the criteria for a specific Eating Disorder. At the present time, Homewood is not treating Binge Eating Disorder. PREADMISSION ASSESSMENT PROCESS Prior to admission, you and your physician and possibly outpatient therapist, will be asked to complete various preadmission forms outlining the history of your eating disorder, prior treatment efforts, your present and past lifestyle and medical state. You will also be asked to develop individualized treatment goals for your hospitalization. Once all the required documentation is returned to the admissions office, the treatment team will assess your paperwork. You will be notified of the assessment outcome. If you are accepted into the program, there will be a waiting period for admission during which time you will remain under the care of your own physician and outpatient clinician(s). NOTE ON ALCOHOL/DRUG DEPENDENCY If you have a history of chemical dependency, you may be asked to provide documentation of abstinence for a minimal period of up to three months prior to hospitalization. Some combined programming is offered through Homewood’s Alcohol and Drug Services Program (HADS). A.A., N.A., C.A., AlAnon and Narc-Anon meetings are available in-house only. NOTE ON SUICIDALITY You will not be eligible for admission if you are actively suicidal or are so depressed that you would not be able to participate fully in the program. Your referral will be reconsidered when your depression and suicidality are adequately treated prior to entering the program. NOTE ON SELF-HARM BEHAVIOUR If you engage in self-harm behaviours, you will be asked to contract with the treatment team to not engage in such behaviours while in hospital. We reserve the right to discharge patients who continue to self-harm once admitted. PREPARING FOR ADMISSION Since Homewood is a “home away from home” for a period of several weeks, you are encouraged to bring small items to hospital. In order to make your stay more comfortable, former clients have suggested the following list of useful items to bring with you: ► ► ► ► radio/CD player, IPOD and music; DVDs; stationary and stamps; personal journal book; a “Hope Book” (a keepsake journal for other patients to write in for you); 06130 Revised 121123 Page 4 of 15 ► ► ► ► ► ► ► ► ► ► ► ► leisure activities, i.e., knitting, crafts, puzzles, etc.; binder with dividers; lined paper; pen and pencil; reading material – (NB - no fashion/glamour or exercise magazines); laundry soap and change for machines; alarm clock; small fan (in warm weather), extra clothes hangers; bathrobe and slippers; toiletries including shampoo; safety razor and sanitary products; **unscented products only please! caddy or tote to transport toiletries to washroom. photos to decorate your room; thumbtacks for corkboard use; bank card; personal coffee mug (important to bring). Casual attire including gym clothes and running shoes are required for recreational activities and groups. No hospital pants, crop-tops or logos re dieting, alcohol, drugs, etc. are permitted. No cameras, recording devices, or televisions please. Linens are provided (sheets, towels, blankets, etc) as is a full length mirror. Patients are expected to use bulletin boards provided in their rooms and to refrain from decorating wall surfaces. Cell phones are permitted although use is limited to non-program times. Telephone cards are available for purchase for Homewood telephones. Laptops are permitted however they cannot be used for work purposes (school or vocation) and excessive usage will be discouraged. DAY 1 – ADMISSION DAY Admissions take place in early morning (8:30-9:30 am). If you are travelling a considerable distance, you may wish to seek overnight accommodation nearby. A list of local lodgings is enclosed. Short-term metered parking is available on Delhi Street or in the parking lot across from the hospital ($8.00 on exit). Wherever possible, we will attempt to contact you a few days prior to admission. On the morning of your admission day, you will report to the Admitting Department. You will then be escorted to the Eating Disorders Program. When you arrive on the unit, you will undergo admission procedures with nursing staff and the Psychiatrist, in addition to having a unit tour. You may also visit the lab for blood work. Those accompanying you may only stay with you until your intake meeting with staff. We believe it is important to involve your family members in treatment as soon as possible for two reasons: first, so that they can better understand your illness and receive support for themselves; and second, so they can help ease your transition to home and provide support after discharge. For these reasons, we encourage you to ask key family members (parents, partner or spouse, a sibling, etc.) to join you for family therapy. For most patients, we will recommend weekly family therapy for the duration of your admission. If you are coming from a great distance and your family is unable to attend in person, we can make arrangements for a session by telephone. Videoconferencing/skype is also available. In addition to active participation in family therapy, we also recommend that family and friends attend our monthly Family Information and Support Group, which is held one Friday per month. 06130 Revised 121123 Page 5 of 15 This group will help your family members learn more about eating disorders and the Homewood program. In addition, it offers them a unique opportunity to talk to other patients and family members about ways to cope with this illness and the process of recovery. We hope you will invite any friends or family members who are willing to participate. PHASE 1: ASSESSMENT PHASE Everyone entering the program engages in an assessment period during which time members of the treatment team will assess you. Following a mutual agreement that our program is appropriate for your needs, a collaborative treatment plan will be developed. The assessment period usually lasts up to two weeks. For patients of very low weight, there will be a period of bed rest which precedes the Assessment Phase. The program functions in a community milieu setting. Please accept other clients as part of your support team and feel free to ask questions to help you get comfortable with your new surroundings. SUPPORT PEOPLE Family or friend visits are limited to evenings 6:30-9:00 p.m. on weekdays and 9:00-12:00 noon, 1:30-4:45 p.m. and 6:30-9:00 p.m. on weekends. Visitors are not to visit during mealtimes and post-meal supervision periods, or during supervised snack times. Please leave only urgent messages at the nursing station (extension 2553). Individual patient mailboxes will accept incoming calls. The unit telephone accepts Homewood calling cards, available for purchase at Switchboard. Please avoid incoming calls during mealtimes and after 10:00 p.m. As patients become familiar with their program schedules, they may advise family and friends of the best times to call. Visitors are asked not to bring any food products, beverages, diet products, medications or exercise equipment into the hospital. OUTINGS AND PASSES HOME The opportunities to leave the hospital are indicated on your Collaborative Treatment Agreement that is provided at the end of the Assessment Phase. Depending on both your physical status and ability to manage eating disorder symptoms, the opportunity to leave the hospital is limited initially, sometimes for a number of weeks. Patients must remain on the unit between 10:00 pm and 6:00 am daily. Program outings are opportunities to practice recovery skills acquired in the program. Patients are responsible for funding occasional community outings (restaurant meals or activity-related events). Some in-hospital craft activities may also require funding (minimal). A bank machine is available on the premises. TREATMENT PROCESS Eating Disorders can involve serious medical and psychological complications such as heart arrhythmias, vomiting blood, osteoporosis, anaemia, memory and concentration impairment, depression, and even death by heart failure or suicide. Researchers are only beginning to understand how seriously eating disorders can affect every organ in the body, at times with irreversible or fatal consequences. Specialized hospital programs, such as that which Homewood offers, can be an important part in the overall treatment needs of the individual. Starvation and chaotic eating have such a profound effect on the body and mind that nutritional 06130 Revised 121123 Page 6 of 15 rehabilitation is an important part of healing. Our program includes a strict reduction in your activity level with a gradual increase in activity as progress occurs. The foremost goal of the program is to help you regain control of your life so that full functioning is restored. A multidisciplinary team will provide you with many opportunities to develop a better balance in your lifestyle, to learn how to express feelings in a healthier fashion, and to develop new thought patterns. Developing healthy trust in others and feeling effective in your life will take longer than a short-term hospitalization. The inpatient program commits itself to recognizing the vital importance of ongoing outpatient therapy and every attempt will be made to secure outpatient resources in your home community. During hospitalization, you will begin a journey of finding healthier ways of coping without resorting to self-defeating food and weight manipulation. If you suffer from Anorexia Nervosa, normal eating and weight gain will be an important part of your treatment. This part of the program will be coordinated by the dietitian/nutritionist. A “target weight range” will be recommended. Throughout your hospitalization, you will work toward this goal weight range. A weekly expected weight gain is 1-1.5 kg. As many persons with eating disorders have difficulty with excessive exercise, activity levels and healthy leisure, the recreation therapist will help regulate and normalize these areas. Bed rest and/or the inability to leave the unit may be applied in certain cases. If you suffer from Bulimia Nervosa, you may still need to gain weight to reach your body’s “set point” weight range. This is the weight range at which your body is most comfortable (natural weight), but the main emphasis will be on interrupting your eating disorder symptoms and relearning normal eating patterns. Binge eating, purging and restricting are not permitted in the program and will be initially controlled by supervision at mealtimes and the option of ongoing washroom/shower supervision. TREATMENT TEAM MEMBERS Team members, from a variety of professional disciplines include: Program Coordinator The Program Coordinator facilitates program functioning, networks with the community and also functions as a clinical social worker on the treatment team. The program coordinator is involved in coordinating preadmission assessments, admissions and discharges. Psychiatrist The psychiatrist is consultant to the team and is a therapist in treatment groups. Individualized psychotherapy is not provided by the psychiatrist. If medication is needed at any time during your hospitalization, this will be discussed with you and your psychiatrist. Medications that can be used in the treatment of eating disorders include anxiety-reducing medication prior to meals, antidepressant medication and medications to decrease the sensation of being overly full. There are no medications that actually cure eating disorders but they can serve as a useful adjunct to the main medication: food itself. 06130 Revised 121123 Page 7 of 15 Nursing Staff You will be assigned to a Prime Nurse who will meet with you on a regular basis throughout your hospital stay and who will be responsible for coordinating your individual treatment plan. S/he will establish a therapeutic relationship with you, plan your care while in hospital, and assist you in goal development and continuously monitor/review your progress in conjunction with the rest of the treatment team. With your permission, your prime nurse may keep in contact with referral sources. When your Prime Nurse is on night shift or on vacation, an alternative nurse will be provided. Dietitian and Diet Technician After a nutritional assessment, the dietitian will discuss with you your nutritional needs to establish healthy eating. Most patients begin with 6500 kilojoules (1500 calories) per day. For patients with anorexia nervosa, energy intake is gradually increased until a weight gain of approximately 1.5-kg (3 lbs.) per week is attained. A weight goal range is set, based on your weight history and/or weight standards. For bulimic clients, emphasis is on re-learning normal eating habits and not on weight change (unless underweight). Nutrition education is provided throughout your hospital stay, both individually and in a nutrition group. The Homewood Health Centre’s Nutrition Services Department provides all foods. Patients will choose from a variety of foods from a selection of meat, fish, poultry and alternatives, fruits, vegetables, milk and milk products, grains, fats and desserts. Please refer to typical meal menu (attached). Completion of all food on the meal plan is required throughout the program. The Eating Disorders Program supports a “symptom-free” environment. We are unable to accommodate a vegan diet. Dietary restrictions (e.g., gluten-free diet) requires confirmation by a specialist/physician prior to admission. Psychologist The psychologist assists you and the treatment team with psychological assessments and psychotherapeutic treatment. Although you have acknowledged problems with eating, the psychologist assesses for additional problems that may complicate your recovery. Psychological assessment and treatment serves to generate awareness of psychological issues and offers strategies for problem resolution. Social Worker/Family Therapists The social worker/family therapists are available to provide consultation, education and/or family therapy as requested by the patient. Family involvement is strongly encouraged in order that the family members can support the recovery process in a healthy way. A family information/support session occurs monthly and is initially attended by patients and family members. Family members then meet together for the bulk of the day. There is a $15.00 per person charge to cover the cost of meals, handouts, etc. Attendees should be 16 years of age and older. Family concerns about treatment and/or progress in the hospital can be directed to the Prime Nurse or the Program Coordinator. Patients must provide permission to release information about their care. 06130 Revised 121123 Page 8 of 15 Recreation Therapist The recreation therapist will assist you in developing a healthier leisure lifestyle by increasing your awareness of leisure and its importance to recovery, health and the quality of one’s life. A recreation therapy assessment is conducted to determine leisure functioning, needs, interests, patterns and exercise involvement. The emphasis is on acquiring leisure concepts and skills that promote balance, structure and wellness. Patients are educated and experience exercise in moderation, incorporating it into part of a balanced lifestyle contributing to physical and psychological wellbeing. A healthy exercise program is developed and gradually reintroduced, helping you to experience and enjoy exercise without excess and preoccupation with weight control. During the early stages of treatment, activity is very limited. Leisure and exercise education is provided throughout your hospitalization stay, both individually and in leisure education. This staff person is involved in programs focusing on body image and selfacceptance. Community re-integration, through a variety of community outings is coordinated by the recreation therapist. Horticultural Therapist The Horticultural Therapist utilizes plants and horticulture-related mediums to enhance or rehabilitate one’s physical, emotional and spiritual wellbeing. The greenhouse and garden offer a relaxing and non-threatening environment. Horticulture Therapy provides an opportunity to develop positive leisure and coping skills to aid in the recovery process; improves quality of time and alters negative lifestyles; engages you in intellectual and social stimulation through a new learning experience with plants and heightens self esteem and sense of self worth through creative skills. A wide variety of horticultural activities are offered in order to stimulate interest and encourage ongoing treatment. Occupational Therapist An occupational therapist is available on a referral basis to meet with an individual regarding concerns with the process of returning to work and/or issues negotiating a return to work plan (with workplace, insurance company or WSIB). Volunteers Trained volunteers assist the program with the supervision of daily meals. Students Clinical program staff supervises students from a variety of disciplines. They may carry a patient caseload and participate in and observe a variety of treatment opportunities during their academic placement. TREATMENT OPPORTUNITIES For the most part, therapy is provided through various group treatments. Treatment modalities include Cognitive Behaviour Therapy (CB) and Dialectical Behaviour Therapy (DBT). The family therapist/social workers provide family therapy. Please refer to the sample program schedule (attached) for types of program opportunities available. 06130 Revised 121123 Page 9 of 15 IMPORTANT THINGS TO KNOW…HOUSE RULES! ON SMOKING Homewood is a smoke-free facility. It is the policy of the Homewood Health Centre that in order to promote a safe and healthy environment, that there be no smoking allowed anywhere inside any building that is part of the Homewood Health Centre complex, or any place that could be considered the Homewood Health Centre workplace, or on the Homewood Grounds. A designated smoking patio is the only permissible location for smokers. Contravention of this policy by patients will be dealt with therapeutically by the treatment team. This includes a range of options that may include discharge. Nicotine Replacement Therapy (gum and patches) and a psychoeducational group and a support group are available to patients. There are no opportunities to smoke during Bed Rest, Assessment and Preparation Phases (minimum of three weeks). ON SCENTED PRODUCTS Please do not bring any scented products into hospital out of respect for those with allergies. ON CONFIDENTIALITY For reasons of privacy and confidentiality, no recording devices, cameras or taping equipment are allowed on the premises. You will be expected to maintain confidentiality of co-patients by not discussing others with family and friends. ON ENVIRONMENTAL RESPECT Patients are expected to maintain a clear and tidy environment. Building surfaces must not be defaced, e.g., tape on walls, nail holes, etc. Patients will be charged for damages to hospital property including repairing walls, repairing furniture, etc. For sanitary purposes, please do not bring in personal linens as these are provided. This includes comforters, sheets, and pillows. ON ALCOHOL AND DRUG USAGE Using alcohol or non-prescribed substances while in the program (outings and passes included) will not be permitted and may result in discharge. If you have a prior history of chemical dependency, you will be asked to sign a non-usage contract. Other supports such as in-house 12-step meetings and concurrent involvement in the Alcohol and Drug Program can be made available. 06130 Revised 121123 Page 10 of 15 Rationale for 48 Hour Therapeutic Pass Eating disorders are extremely complicated illnesses to overcome. In our experience, even patients who truly desire recovery, face periods of ambivalence, especially: • if they have been "strongly encouraged" by others to seek treatment, and feel unsure about whether they are ready for an intensive inpatient program; • after they pass through the "honeymoon" phase of eating regularly and realize they are going to have to continue eating, without any form of restricting or purging, every single day; • as they start to experience changes in body size; • after they have been in treatment for some time, and are beginning to deal with the uncomfortable feelings and experiences that led them to their eating disorders in the first place. These feelings and experiences are likely to re-trigger urges but, unlike those with addictions, people with eating disorders can't avoid their "substance" and in fact, must face their urges head on at least four times every day! Not surprisingly then, a number of our patients begin to doubt whether or not they can and/or want to truly let go of their eating disorder. They can become pessimistic and self-critical, and they can begin giving in to their eating disordered urges even in the safe, symptom-free environment of the hospital. When this happens, other patients can become triggered (i.e., "if she/he's restricting/purging maybe I should too") and they can begin to isolate or exclude the patient or, alternatively, become overly responsible and caretaking - both of which detracts from the recovery of both patients. Of course, staff talk directly with the patient about treatment ambivalence and encourage her/him to practice healthier coping strategies, offer extra support, and remind the patient of his/her earlier motivation towards recovery. Sometimes these interventions are enough to help the patient re-engage in treatment, but sometimes not. At this point in many programs, the patient who can not or will not make changes would be discharged as not "treatment ready." However, we offer an alternative. Either the patient or staff can initiate a 48-Hour Therapeutic Pass, which offers ambivalent or symptomatic patients an opportunity to take a break from the intensity of the inpatient unit. Patients can return home, to a friend, or to a hotel, where they can rethink their commitment to recovery through the program. Patients are given clear feedback from staff about specific concerns (like the ones mentioned above) and are encouraged to think about changes which would help them benefit the most from the remainder of their hospital stay. During this pass, patients are permitted to contact nursing staff for support as needed, and upon return, patients meet with staff to explore the impact of this break. (Please give advance consideration as to where you would stay, financing the same, etc., should you take this therapeutic leave.) Admittedly, many of our patients who are given a 48-hour pass view it negatively at first. Their perfectionistic tendencies are triggered and they can express distress at "failing" or "messing up." They can also feel angry initially towards staff for "punishing" them when they feel unsure 06130 Revised 121123 Page 11 of 15 about recovery. However, many of these same patients tell us after the pass they found it extremely useful in recommitting to recovery. These patients say they were able to think clearly, consider the alternatives (i.e., what if I stay sick? can I really get better if I don't give up the symptoms, gain the weight, etc.?) and focus on goals for the remainder of treatment. More often than not, patients who take a 48-hour therapeutic pass go on to complete their admission, rather than taking an early discharge. Additionally, they often experience a resurgence of support from their peers for taking responsibility for their recovery and making positive changes. In fact, when another patient is given a 48-hour pass, these same patients often say, "I thought it was negative too, but it turned out to be the best thing for me!" In our experience, this option has proved far more successful than either tolerating the ambivalence (which can keep the patient stuck and waste weeks of their treatment) or prematurely discharging the patient (since many go on to use the remainder of their hospitalization well). It also sends the message to our patients that it is okay to admit all their thoughts and feelings (even pro-eating disorder ones); that mistakes are okay and don't mean failure; and that even patients who struggle can make changes and continue recovery. We think these messages are vitally important to our patients' well being and think this highly effective intervention helps patients in their battle to overcome eating disorders. Patients are responsible for funding their 48 hour pass (accommodations, meals, transportation, etc). Program Non-Negotiables • full meal completion • activity level as presented by program • no self-harm behaviour • no violent or abusive behaviour • no smoking in hospital or on the grounds – designated smoking area only • no alcohol or drug use • no intimate in-house relationships ADDITIONAL INFORMATION Direct referral to the Homewood Eating Disorders Program may be made by a medical doctor or therapist contacting the Admitting Department at 519-824-1010 extension 2551 or through e-mail at [email protected]. General enquiries about the program may be directed to April Gates, MSW, Program Coordinator at extension 2292. Combined hospital and unit tours may be arranged by calling extension 2415. Tour requests of the Eating Disorders Unit can only may through April Gates. 06130 Revised 121123 Page 12 of 15 GUELPH ACCOMMODATIONS LIST Comfort Inn 519-763-1900 480 Silvercreek Pkwy. North ac Care Rate offered for Homewood visitors Guelph Holiday Inn 519-836-0231 601 Scottsdale Drive dr,ac,ip,s,mg,wp Homewood visitor rate offered Travel Lodge 519-836-1331 106 Carden Street dr,ac,hkg Corporate rate offered Days Inn 519-822-9112 785 Gordon Street dr,ac,p,wp Corporate rate offered Delta 519-780-3700 50 Stone Road dr,ac,p,hkg Corporate rate offered Super 8 836-5850 281 Woodlawn Road East Guelph, Ont. Hampton Suites 519-821-2144 725 Imperial Road North Holiday Inn Express 1-877-660-8550 540 Silvercreek Parkway North Best Western Royal Brock Hotel & Conference Centre (519) 836-1240 | 716 Gordon Street, Guelph, Ontario N1G 1Y6 Red Car Limousine Service (to and from Toronto airport) 519-824-9344 BED & BREAKFASTS (519) 824-6874 London House Bed & Breakfast - 80 London Rd. W., Guelph. Slate gables and Gothic windows rise above mature maples at the corner of London Road and Park Avenue. This gracious Victorian home overlooks one of Guelph's oldest parks making it an attractive setting for the discriminating traveller looking for a comfortable retreat. After a restful night, enjoy your choice of English or Continental breakfast in our dining room. London House is in the heart of Guelph, close to downtown, shopping, theatres, Macdonald Stewart Art Centre, the University of Guelph and public transit and walking distance to Homewood. (519)767-1095 Norfolk Guest House Bed & Breakfast - 102 Eramosa Rd., Guelph. Attractive and convenient location just blocks from the Homewood. Homewood visitor rates offered upon registration (please indicate that you are a Homewood visitor), rooms with private bath available. (519)658-5313 Eagle Crest Bed & Breakfast - Eagle Lane, R.R. #22 Cambridge. Relax in the tranquil setting of a lakefront home. The home has been designed to resemble a seaside Nantucket residence, furnished with many local Canadiana antiques. Open all year round and situated minutes from the 401, 20-30 minutes to Guelph. Deluxe rooms, each with a private bath. Call ahead for reservations. Non-smoking. 06130 Revised 121123 Page 13 of 15 SAMPLE MENU – EATING DISORDERS PROGRAM Monday – Breakfast Fruit ___ Raisins ___ Fruit Cup ___ Prune Juice ___ Prunces ___ Bottle Juice Protein ___ Cheese ___ Boiled Egg ___ Cream Cheese ___ Peanut Butter Grains ___ Corn Flakes ___ Bagel ___ Muffin ___ Bread ___ Oatmeal ___ All Bran Milk ___ Yogurt ___ Chocolate Milk ___ 1% Milk Beverages ___ Coffee ___ Herbal Tea ___ Decaf Coffee ___ Tea Extras ___ Margarine ____Sugar ___ Butter ___ Creamer ___ Milkette ___ Salt ___ Pepper ___ Brown Sugar 06130 Revised 121123 Page 14 of 15 Monday-Lunch Monday-Dinner ___Cream of Mushroom ___ Crackers Select One Meal Option: ____ Baked Chicken served with parslied potatoes, beets and a tossed salad Select One Meal Option: ___ Macaroni and Cheese served with tossed salad ___ Ham Sandwich served with a tossed salad _____ Vegetable Chili served with a tossed salad and whole wheat dinner roll Beverages ___ 1% milk 250 ml ___ Choc. Milk 250 ml ___ Juice Bottle ___ Herbal Tea ___ Coffee ___ Decaf Coffee ___ Tea Select One Dessert Option: ____Pear ____ Banana ____Orange ____ Apple ____ Fruit Yogurt ____ TCBY ____ Jello Beverages ____ 1% Milk 250 ml ____ Choc. Milk 250 ml ____ Juice Bottle ____ Herbal Tea ____ Coffee ____ Decaf. Coffee ____ Herbal Tea Extras ___ Margarine ___ Butter ___ Creamer ___ Milkette ___ Salt ___ Pepper ___ Sugar ___ Cream Cheese Extras ____ Margarine ____ Butter ____ Creamer ____ Milkette ____ Salt ____ Pepper ____ Sugar ____ Cream Cheese Select One Dessert Option: ___ Grapes____Orange ___ Banana ___ Fruit Yogurt ___ Jelly Roll ___ Ice Cream EATING DISORDERS TYPICAL SCHEDULE – 3 day sample only (not actual program schedule) MONDAY TUESDAY WEDNESDAY M 7:00-7:30 Weigh In O 7:30 Breakfast 7:30 Breakfast 7:30 Breakfast R 9:00-10:00 Dialectical Behaviour Therapy (DBT) 8:45-9:30 Menu Planning 9:00-10:00 Community Outing 9:30-10:15 Community Meeting 10:15-10:30 Snack 10:15 Snack 10:30-11:30 Body Esteem Group N 10:15-10:30 Snack I 10:45-11:30 Nutrition Group N 10:30-11:30 Finding Meaning G 11:45 Lunch (Main Dining Room) 12:00 (Lunch (E.D.Dining Room) 11:45 Lunch (Main Dining Room) 12:00 (Lunch (E.D.Dining Room 11:45 Lunch (Main Dining Room) 12:00 Lunch (E.D.Dining Room) 1:15-2:15 Self-Expression Art Therapy 12:30-1:00 Post Meal Support Group 1:00-2:15 Interpersonal Effectiveness Training 1:10-2:10 Horticulture Therapy 2:15-2:30 Snack 2:15-2:30 Snack 2:15-2:30 Snack 2:30-3:45 Leisure Education 2:30-4:00 Interpersonal Process Group 3:00-4:15 Mindfulness 5:00 Dinner 5:00 Dinner 5:00 Dinner 8:30-8:45 Evening Snack 8:30-8:45 Evening Snack 8:30-8:45 Evening Snack 06130 Revised 121123 Page 15 of 15
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