Ultimately, treatment should meet each individual where they are in recovery. Therefore, the most appropriate level and method of care for your client is one that takes various factors — such as medical stability, symptom severity, client motivation and your clinical insight — into account.

Does My Client Need a Higher Level of Care?

Most eating disorder recovery work takes place in the outpatient setting. However, outpatient care has limits, and recognizing when it’s no longer enough for a particular client is a critical aspect of responsible, responsive treatment.

Sometimes eating disorder symptoms emerge in clients who are receiving care for other mental health concerns. In these cases, providers may recommend a higher level of care as early intervention to keep symptoms contained before they escalate.

Sometimes specialized outpatient eating disorder care is effective for a time but becomes insufficient when a client’s circumstances, symptoms, or stressors change. 

It’s important for providers and clients alike to know that moving to a higher level of care is not a sign that a client or outpatient provider has failed. Treatment should not be viewed as a step backwards but as a necessary step forward — a step that many clients don’t take without support and encouragement from their OP team.

A higher level of eating disorder care may be advised if your client:

• is experiencing ongoing or rapid weight loss
• struggles to maintain adequate nutritional intake
• struggles to adhere to treatment recommendations
• has frequent medical complications or hospital visits
• is experiencing more severe eating disorder symptoms or engaging in new, harmful behaviors
• expresses suicidal thoughts or engages in self-harm
• is having difficulty managing co-occurring symptoms to the extent that they interfere with recovery progress
• shows signs of being at risk for relapse
• shows a decline in functioning at school, work, or in relationships
• is becoming increasingly rigid around food or socially withdrawn
• lacks a supportive or structured home environment
• requires supervised meals, behavior interruption, or medical monitoring
• has stalled or regressed in recovery despite participating in outpatient care

Levels of Eating Disorder Care

A continuum of care is available to support clients with eating disorders who are struggling to thrive or progress in the outpatient setting. These specialized programs offer treatment interventions that are not possible in an outpatient environment and help clients restore nutritional stability, interrupt entrenched behaviors, and safely address underlying emotional and cognitive factors contributing to the eating disorder.

Inpatient Eating Disorder Care

Inpatient care is the most intensive level of eating disorder treatment, intended for individuals experiencing severe or life-threatening symptoms. Treatment takes place in a hospital setting and focuses on medical stabilization, nutritional restoration, and short-term crisis management.

Inpatient treatment is often a precursor to lower levels of care, such as residential eating disorder treatment, once the client is medically stable.

Residential Treatment

Residential treatment provides 24-hour support in a home-like setting for clients experiencing severe eating disorder symptoms that cannot be safely or effectively managed in outpatient care. It is designed for individuals who are medically stable but require intensive therapeutic intervention to interrupt disordered behaviors and build a foundation for recovery.

Clients receive highly structured, full-day programming—including individual therapy, group sessions, nutrition counseling, and supervised meals—while residing at the treatment facility. Residential treatment also addresses co-occurring conditions and supports clients in exploring the emotional, cognitive, and behavioral patterns driving their eating disorder. 

Partial Hospitalization Program (PHP) 

Also referred to as Day Treatment, PHP often serves as a bridge between inpatient and outpatient care. Programming typically takes place five to seven days a week for several hours during the day—similar to the time commitment of a full-time job or class schedule.

PHP offers supportive, structured treatment for clients who are ready to pursue their recovery goals without overnight supervision. This allows clients to live at home, providing a transitional step that supports more seamless reintegration into daily life, routines, and relationships.

Intensive Outpatient Program (IOP)

IOP is appropriate for clients with mild to moderate symptoms who are ready to continue recovery with more autonomy. Programming typically occurs three to five days per week for a few hours per day, and can often be scheduled around school or work commitments.

Treatment at the IOP level of care is often a client’s next step once they’ve completed PHP and focuses on relapse prevention, skill-building, and preparing clients to reintegrate smoothly. IOP can also serve as a proactive step for individuals in the early stages of an eating disorder, offering targeted, early intervention before symptoms worsen. Clients who admit to this level of care may also step-up if it becomes clear that additional structure and support are needed.

Methods-of-Care Considerations: In-person vs. Remote (Virtual) ED Care

The availability of virtual eating disorder services has grown significantly in recent years, making treatment more accessible for more people than ever before. Not only that, but offering virtual treatment to clients who can truly benefit from this method of care creates more space in in-person programs throughout the country for clients who require the structure and support they can only get through more traditional treatment approaches.

The flexibility of virtual programs can make them more appealing to some individuals considering treatment. However, client preference is not the only factor to consider. While both traditional (in-person) and virtual eating disorder care have shown comparable clinical outcomes for clients recovering from eating disorders, these options may not be equally effective or appropriate for every individual. For example, virtual care may not be suitable for clients:

• who require behavior interruption
• whose symptoms escalate quickly or involve medical risk
• who struggle to stay engaged without in-person accountability
• whose home environment is chaotic, triggering, or lacking in support
• who have limited privacy or space to participate in sessions
• who tend to minimize or hide symptoms, making observation more difficult remotely

At Alsana, Outpatient Providers’ Level-of-Care Recommendations Are Honored 

Level- and method-of-care-decisions are complex and help shape the trajectory of clients’ recovery. At Alsana, we believe these determinations should be guided by clinical judgment and thoughtful collaboration between members of a client’s outpatient and treatment teams—not dictated by intake assessment alone. 

When outpatient and treatment teams collaborate on initial level of care decisions, they help ensure treatment is not only clinically appropriate but also minimally disruptive—building on the therapeutic work already underway. 

Our team is committed to engaging with outpatient providers as true partners in their clients’ care and to collaborating with them before, during and even after treatment. When you refer to Alsana, you can be assured that not only will your level-of-care recommendation be honored, but your clinical insight will remain instrumental throughout your client’s time in treatment.

If you’re ready to make a referral or have questions for our admissions team, call 866-376-0888.