The Montrose Model (Three Phase Residential Programme)
Montrose Manor provides comprehensive treatment programmes that address the biological, psychological, relational and spiritual aspects of Eating Disorders, including;
- Anorexia Nervosa
- Bulimia Nervosa
- Binge Eating Disorder
- Eating Disorders not otherwise specified
- Treatment for obesity
Our objective in providing structured extended care treatment is to address the deep-seated psychological issues that underlie Eating Disorders, using evidence-based therapies.
Where present, concurrent psychiatric disorders are managed in close association with a consultant psychiatrist, who prescribes medication when necessary. All treatment is offered in a safe, gentle and supportive environment.
Clients receive one-on-one counselling at least twice a week. This counsellor serves as the point of co-ordination for the client’s care plan as s/he moves through the various phases of treatment (please see below). The individual counsellor provides regular progress reports to referrers (with the client’s consent) and compiles a detailed discharge report with future treatment plans at the time of discharge.
Examples of concurrent disorders, which are commonly managed within Montrose Manor include:
- Bipolar Disorder
- Obsessive-Compulsive Disorder
- Other Anxiety Disorders
- Major Depressive Disorder
- Post Traumatic Stress Disorder
- Addiction
The Montrose Manor treatment programme integrates traditional and innovative psychotherapeutic modalities, employing a wide spectrum of group-based activities, and a minimum of twice-weekly individual consultations.
Life-skills components are used in addition throughout the various phases of treatment, facilitating enhanced physical, spiritual and social development. A comprehensive family programme is offered to address the crucial relational dimension of eating disorders.
On admission each client is individually and comprehensively evaluated by the clinical team. The therapeutic programme is then tailored to meet each client’s specific treatment goals and needs.
PHASE ONE
- Individual counselling and therapy.
- Group counselling and therapy including Dialectical Behavioural Therapy.
- Body Image groups.
- Special focus groups exploring a variety of topics including gender, bereavement, trauma, sexuality, spirituality and co-dependency.
- Life skills groups focusing on a variety of topics including relationships, communication skills, assertiveness, conflict and anger management, co-dependency, understanding and coping with criticism, handling stress and anxiety and self-esteem and self- concept enhancement.
- Workshops exploring emotions and boundary setting.
- Art therapy.
- Experiential therapy; psychodrama, role play and outdoor activities.
- An exploration of the 12-Step recovery principles as applied to eating disorders, including workshops on coping with fear, guilt and shame
- Individual weekly sessions with the dietician
- Psycho-educational lectures
- Attendance of self-help meetings/external support groups
During Phase One, the client does not have access to the kitchen. All meals are plated and freedom of movement over weekends is limited.
PHASE TWO
In addition to the activities and groups offered in Phase One, Phase Two offers:
- Restaurant outings.
- Groups exploring trauma and family of origin issues.
- Self-directed reading and reflection to encourage personal growth.
- Writing and presenting a lifestory.
- An individualised Wellness Programme based on recommendation and supervision of the biokineticist.
- Supervised self service of meals.
- Graded freedom of movement over weekends.
- Family work which includes conjoint family sessions and time spent with family.
PHASE THREE
Phase Three of treatment at Montrose Manor aims to assist clients in their transition from the structure of an in-patient treatment to living a healthy life in recovery in the community. Critical to this goal is the development of an ethos of work/employment/study balanced with meaningful free-time and social activities.
- Self service of meals and unsupervised kitchen access
- Assist in preparation of meals
- Continue to attend weekly fellowship meetings/support groups, have a sponsor and meet with him/her at least once a week
- Continue to attend a certain number of therapeutic/programme groups
- Do voluntary community service, or follow a course or skills training.
- Advanced Exposure Therapy
- Relapse prevention
- Pre-discharge planning
Clients gain clarity of their self-destructive behaviors, develop alternative behaviors and consolidate these changes in a supportive environment. In short, they develop and practice ‘relapse prevention tools’ to prepare them for re-integration into their home, work and social environments.
The Wellness Programme
This aspect of the programme helps each client develop a healthy relationship with exercise. Towards the end of Phase One, each client’s current relationship with exercise is explored, and a goal is defined as to how s/he would like that relationship to develop. Montrose Manor’s wellness facilities include walking, a swimming pool, yoga and Pilates classes. Examples of specific work done here are core stability, correction of posture, muscle alignment and strength, injuries, and weight appropriate exercises.