Welcome to Walden’s Virtual Clinic!
Walden Behavioral Care is thrilled to offer Partial Hospitalization Programs (PHP) and Intensive Outpatient Programs
(IOP) via Zoom
virtually.
secure telehealth. Our programs have maintained their core components, and are now offered
Requirements: Laptop, Desktop or Smart Phone. Participants must be willing to appear on camera, identify/confirm
their current location, and have a private space in order to adhere to confidentiality laws for themselves and other
group members. Participants that stop their camera without letting the group leader know, or who are observed to
be interacting with anyone in the room may be removed from the group by the group leader due to confidentiality
laws.
We respect the courage you’ve shown by deciding to participate in this program, and look forward to working
collaboratively with you and your family in your journey toward recovery. Through your involvement in this program,
you will gain awareness and skills to assist you in your recovery process. This means not only finding a way to live
without your eating disorder, but creating a life you want to live.
Our mission is to provide the highest quality of care in an environment of respect and compassion. Because Walden
offers a full continuum of care, we are able to provide an environment that fosters change and promotes more
permanent positive results. We want you to get the most out of your treatment with us; therefore, we are providing
you with a set of guidelines.
Adolescent Programming Treatment Philosophy
We believe that eating disorders are complex, multi-dimensional conditions. Genetic, biological, socio-cultural and
psychological factors all influence the development and continuance of the disorder. Therefore, no one is at fault for
having an eating disorder, and a family cannot cause an eating disorder. Regardless of causality, we recognize that
eating disorder behaviors, while self-defeating and self-destructive, serve a very real purpose: to help the individual
cope with painful and distressing emotions.
Goals of Treatment
At Walden’s Adolescent Programming, we make every effort to teach, support, and encourage patients and their
families in establishing healthy and normalized eating patterns. It is our goal to help a patient stabilize medically,
supporting a patient at a healthy body weight, with stable lab work and vital signs, as well as reduce eating disorder
behaviors. In an effort to follow the guidelines of family based therapy, the staff will create a meal plan and serve all
meals for patients while they are in program. It is the expectation that your family will participate in family groups,
family meetings, and that the parents will prepare the child’s meals and snacks both in and out of program. During IOP,
the general goal will be to move away from using a meal plan or meal guidelines and away from using an outpatient
dietician, and empowering parents to fully have decision making around meals and snacks.
Walden Behavioral Care: Core Treatment Components
Family Based Treatment: The program incorporates key aspects of Family Based Treatment for Eating Disorders (FBT),
also known as “Maudsley” that has been extensively researched and shown to be the most effective treatment for
adolescents with eating disorders.
Family based treatment views families as an invaluable resource in treatment because they are uniquely positioned to
provide the support and supervision necessary to combat this life-threatening disease. Parents are temporarily put in
charge of eating behaviors in order to “combat” the eating disorder that is controlling their child’s behavior. The
treatment seeks to respect the adolescent’s opinions and experience, but refuses to let this devastating illness continue
to control their lives.
Family Meals: It is very likely that family meals have changed some since the onset of your loved one’s eating disorder.
Our supportive family meal environments are designed to support you while you observe, learn and test acquired
knowledge and skills that you will immediately use to support your child/adolescent toward their meal time goals.
Parent/caregiver presence and support during assigned family meal times are an essential part of our adolescent
program and your loved one’s recovery.
Dialectical Behavioral Therapy (DBT): Dialectic Behavior Therapy (DBT) teaches skills to tolerate and regulate distress.
Individuals learn concrete and effective coping skills to replace their self-destructive coping methods. This is done using
group instruction, discussion, and homework and focuses on the following four domains: Mindfulness, Distress
Tolerance, Emotion Regulation, and Interpersonal Effectiveness. During your family’s involvement, you and your child
will learn new ways to manage painful emotions and how to communicate more effectively during the difficult recovery
process.
Cognitive Behavioral Therapy (CBT): This group helps clients understand the connections between thoughts, feelings
and behaviors, and utilizes various exercises in order to modify maladaptive patterns of thinking. By changing the way a
person thinks about their self, body, food and relationships, they can become skilled at managing anxiety and
restructuring their thinking in a more effective manner.
Process Group/Weekend Review: These groups are less didactic than the other groups in order to provide a time for
clients to engage on topics and issues of their choice. Group leaders provide a safe environment for clients to discuss
personal issues that relate to their eating disorders. Group members and group leaders help each other problem solve
and provide support for recovery by targeting problem behaviors.
Expressive Therapies: A variety of modalities are used to support individuals in exploring the recovery process using
creative and mindful expression and movement.
Therapeutic Meal Groups: During therapeutic meals, clients, families (during family meals) and staff eat well-balanced
meals together. This provides clients with the opportunity to practice eating in front of others and work through specific
difficulties with the help of staff, their families, siblings, and other supports.
Updated 12/7/2020; 4/6/2021 - RD
Individual Meetings: Your assigned family clinician will meet with your child 1 time per week (PHP only). Sessions will
typically occur during the treatment day. You can expect your child’s clinician to enter the treatment group and have the
host send your child a private chat message that it is time to leave the group room, and enter their individual room, if
they are not present in the individual meeting room at their scheduled time.
Family Therapy: Your assigned clinician will schedule a Family Based Treatment (FBT) session with direct caregivers 1
time per week (PHP & IOP). Sessions will typically occur during the treatment day or at another time that is convenient
for your family/caregivers. IOP family sessions will occur before or after IOP programming. If your session occurs during
the treatment day, you can expect your clinician to enter the treatment group and have the host send your child a
private chat message that it is time to leave the group room and enter their individual/group room. Please see additional
specific information on FBT Methodology on page 10.
Nutrition Therapy: Your assigned Dietician will meet with primary caregivers 1 time per week (PHP only). Additional
consults will be offered as needed. Sessions will typically occur during the treatment day, unless there is another time
that works better for you and your family. These sessions will not include your child/adolescent. IOP families will have
access to the clinic dietician on an as needed consult basis.
Walden Special Guest Star: The increased utility of platforms such as Zoom® has been one of the COVID pandemic
“silver linings” at Walden. We are thrilled about the opportunity we now have to offer more variety in programming
using senior level clinicians and specialty experts across the system, rather than being limited to their geographical
location. This technology allows us to deliver to our whole system our best people in their best subject. You will be
joined by your peers in CT, MA and GA as you participate in groups on:
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Foundations/Community Meeting – Why does Walden use FBT? Why does Walden use DBT? What have other
adolescents’ experiences been in this program? What is it like for parents to participate in FBT? All of these
questions and more will be answered by recovery speakers and Dr. Michael Chiumiento, our Clinical Director of
Adolescent Services. Michael brings passion for treating adolescents and families, as well as his expert level
knowledge and training in FBT to this group, allowing time to process and ask questions.
ACT – Clinical staff bring passion, humor and expertise in teaching Acceptance and Commitment therapy - an
evidence-based treatment modality that uses acceptance and mindfulness strategies mixed with commitment
and behavior-change strategies with the goal of combating the cognitive inflexibility often associated with eating
disorders.
ARFID: This group and snack time is for those families that are struggling with Avoidant-Restrictive Food Intake
Disorder. Run by a multidisciplinary team, attendees will have the opportunity to share individual challenges and
to learn how to work through food aversions in order to increase/improve variety and intake.
We look forward to working collaboratively with you and your family in your journey towards recovery.
Updated 12/7/2020; 4/6/2021 - RD
Connect to your telehealth meeting with Walden-
G-
GR@securetelehealth.com For PHP and Walden-AA-GR@securetelehealth.com for IOP(room name and meeting ID
may change)
Join from a Mac or Windows computer
1. Download and install the Zoom app from https://securetelehealth.com/downloads
2. At the scheduled time, open the app and Click “Join a meeting”
3. Type 261-397-1732 for PHP and 601-465-5803 for IOP for the meeting ID and click
“Join”(substitute different meeting ID if given)
4. When prompted, click “Join with Video” Stay there until your doctor lets you in.
5. When the provider lets you in, you should see yourself and your provider on camera.
6. Click the green button “Join audio conference by computer”
7. When you are done with the session, click “Leave Meeting” in the lower right corner, or just close the program.
*If you join before the doctor, you will get a different message that says, “Waiting for the Host to start the
meeting”. Wait there. Do not sign in. You will be brought into the meeting when the doctor joins.
Join using iPhone/iPad or Android
1. Go to the app store and search for and install “Zoom Cloud Meetings”
2. Tap the cloud next to “Zoom Cloud Meetings” and allow the app to install.
3. Open Zoom, then choose “Join a Meeting”
4. Type 261-397-1732 for PHP and 601-465-5803 for IOP (or given meeting ID) for the meeting
ID, enter your name, and tap Join
5. Allow Camera Access when prompted, and then click “Join with Video” This will put you in the waiting room.
Wait there until your doctor admits you into the meeting.
6. Allow the app to use your Microphone
7. You may choose “don’t allow” when asked if you want Zoom to send you notifications.
8. When the provider lets you in, you should see yourself and your provider on camera.
9. Be sure to allow the app join audio. Apple Users click “call using internet audio. Android users must tap the
white box “Call via device audio”
10. When you are done with the session, click “Leave Meeting” in the lower right corner, or just close the program.
*If you Join before the Doctor, you will get a different message that says, “Waiting for the Host to start the
meeting”. Wait there. Do not sign in. You will be brought into the meeting and prompted to follow all the steps
above when the doctor joins.
Optional use of URL
In either case, once the program or app is already installed, a user can click this URL and join the meeting:
For PHP https://securetelehealth.zoom.us/j/2613971732
For IOP
https://securetelehealth.zoom.us/j/6014655803
Help Line: Call 412 837 9320
Updated 12/7/2020; 4/6/2021 - RD
PHP Telehealth Schedule –
Your home clinic meeting ID is 261-397-1732
8:45-9:30am
9:30-10:30am
10:30-11am
11-11:15am
11:15am12:15pm
12:15-12:45pm
12:45-1:30pm
1:30-2:30pm
MONDAY
Therapeutic
Breakfast
Psycho-Ed
TUESDAY
Coached
Breakfast
Self Esteem
Break/prep
Therapeutic
Snack
Weekend
Review
Break/prep
Therapeutic
Snack
Community
Break/prep
Therapeutic
Lunch
Family
Dynamics
Break/prep
Therapeutic
Lunch
Foundations
WEDNESDAY
Therapeutic
Breakfast
Creative
Expression
Break/prep
Therapeutic
Snack
DBT Emotion
Regulation
Break/prep
Therapeutic
Lunch
CBT
Michael
THURSDAY
Therapeutic
Breakfast
CBT
Break/prep
Therapeutic
Snack
DBT Distress
Tolerance
Break/prep
Therapeutic
Lunch
Relapse
Prevention
FRIDAY
Coached
Breakfast
DBTMindfulness
Break/prep
Therapeutic
Snack
Weekend
Planning
Break/prep
Therapeutic
Lunch
DBT
Interpersonal
Effectiveness
Program Key
Rotating Topics – Family Dynamics, Relapse
Prevention, Communication, Self-Esteem, Guided
Journaling, Expressive Therapies, Grief&Loss, Anger
Awareness, Relationships, Self-Esteem, Self-Care,
Process, My Story
Meeting ID: Home Clinic
System Wide “Walden Special Guest Star” Groups –
Foundations & ACT
Meeting ID: 446-487-4937
Clinician
Dietician
Nurse Practitioner
Program Director
Assistant VP
Updated 12/7/2020; 4/6/2021 - RD
Your Treatment Team
Name
Meeting ID/email
Miranda Mitchell
Jenna Montanez
Rebekah Dowekyo
mmitchell@waldenbehavioralcare.com
jmontanez@waldenbehavioralcare.com
rdoweyko@waldenbehavioralcare.com
Adolescent Telehealth IOP Schedule
Telehealth room code: 601-465-5803
Monday
Wednesday
Thursday
3:00-3:45
Family Therapy
Appointments
Family Therapy
Appointments
Family Therapy
Appointments
3:45-4:05
Snack
Snack
Snack
4:05-4:50
Weekend Review/Process
DBT I
DBT II
4:50-5:15
Creative Expression
Creative Expression
Creative Expression
5:15-6:00
Middle Path
CBT
Weekend Planning
6:00-6:45
Family Dinner
Family Dinner
Family Dinner
6:45-7:30
Family Therapy
Appointments
Family Therapy
Appointments
Family Therapy
Appointments
Your Treatment Team
Name
Clinician
Program Director
Assistant VP
Updated 12/7/2020; 4/6/2021 - RD
Meeting ID/email
Parent, Caregivers, and Siblings Support Group Schedule
PHP – Attend Two per Week (Parent Skills & Support and Nutrition)
IOP – Attend Three per Week (Parent Support and Parent DBT)
Monday
4:00-5:30 PM
Parent Support
(DBT Skills & Open
Topic Discussion)
(Michael )
Room E
Meeting ID: 238351-3747
WBC ADOLESCENT PHP & IOP Parent & Family Group Schedule
Tuesday
Wednesday
Thursday
9:30-10:30 AM
Parent Skills &
Support
(General Support,
Skills, Open
Discussion)
(Susan)
Room T
Meeting ID:410236-5914
10:00-11:00 AM
Parent Skills &
Support
(General Support,
Skills, Open
Discussion)
(Hannah)
Room W
Meeting ID: 946234-7158
4:00-5:00PM
Parent Nutrition
Education
*PHP Parents*
(Marissa)
Room CC
Meeting ID: 682224-5275
4:00- 5:30PM
Parent DBT Skills
(Parent Guidance)
(Michael)
Room U
Meeting ID: 756268-7683
Updated 12/7/2020; 4/6/2021 - RD
Friday
9:30-10:30 AM
Parent Nutrition
Education Group
*PHP Parents*
(Amanda)
Room BB
Meeting ID: 217546-3650
4:00-5:30 PM
Parent Support
(General Support,
Open Topic Group
Discussion)
(Michael)
Room U
Meeting ID: 756268-7683
12:30-2:00 PM
Parent DBT Skills
(Parent Guidance)
(Michael)
Room U
Meeting ID:756268-7683
Adolescent IOP: The Treatment Team
The IOP treatment team consists of clinicians and clinical leadership. Upon admission to the program, you will be
assigned a clinician. This individual coordinates your treatment, meets regularly with you and your child/adolescent,
and assists with aftercare planning. As your treatment team, we are committed to providing excellent care and assure
you that we will do our best to meet your treatment needs.
Please note that the IOP team does not include medical or psychiatric staff on-site. Dietary consults may be available on
a case-by-case basis and provided when needed. Patients are also encouraged to have these treatment providers
(dietician only for parent resource) as part of their existing outpatient team, and your IOP clinician will work
collaboratively with these treaters to provide the best possible care. If you do not already have outpatient treatment
providers, your clinician will assist you with recommendations.
Adolescent PHP: The Treatment Team
The PHP treatment team consists of clinicians, registered dieticians and psychiatric nurse practitioners. Upon admission
to the program, you will be assigned a clinician. This individual coordinates your treatment, meets regularly with your
loved one and your family, and assists with aftercare planning. Dietician involvement is specifically focused around
consults and nutrition psychoeducation, as directed by and with the parents. Dietary consults rarely involve the
child/adolescent. Patients can expect collaboration between the PHP staff and existing outpatient providers to provide
the best possible care. If you do not already have outpatient treatment providers, your clinician will assist you with
recommendations.
As your treatment team, we are committed to providing excellent care and assure you that we will do our best to meet
your treatment needs.
Outpatient Treatment Providers and Medications
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Patients agree to medical monitoring as recommended by your Pediatrician/Primary Care Physician (PCP). If you
have not seen your PCP within three months, you will be asked to schedule an appointment as soon as possible.
Your PCP, in conjunction with the treatment team, will determine the frequency of further appointments.
If you do not currently reside in CT, MA or GA, we may not be able to prescribe medications. We will however,
collaborate with your local physician for any medical or medication needs.
Participants should take all prescribed and over-the-counter medications at home before or after the program, or
not within view of computer/mobile phone cameras. Upon initial evaluation, the Walden treatment team should be
provided with a medication list. The attending psychiatrist or psychiatric nurse practitioner will meet with each
adolescent weekly (PHP only) and consult with you if any medication changes are recommended. If new
medications are ordered or prescription refills are needed during the time the child is in treatment, the program
psychiatric nurse practitioner can provide the prescriptions. Every child/adolescent will meet with our psychiatrist or
nurse practitioner weekly for psychiatric evaluations, even if there are no currently prescribed medications.
Physical Activity/Medical Monitoring
Updated 12/7/2020; 4/6/2021 - RD
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
The treatment team may request random drug and
alcohol
toxicology screens. If there are medical issues that require additional attention, the team will communicate with
you and coordinate care with your child/adolescent’s PCP, and/or the local urgent care center or emergency room.
The treatment team will discuss considerations for physical activity and exercise with you, your primary care doctor
and your child on an individualized basis.
Risk Management
In the event of concerns for increased risk factors and/or changes to baseline functioning, WBC would like to offer some
useful reminders and guidelines to you as you work to increase protective factors and secure access to common
strategies for coping- including additional resources you may utilize in the event of increased concern. This information
can also be shared with any outside supports, including your friends or family members and outpatient team members.
This information will be offered throughout treatment, and will be useful to review with you when recent assessments
of risk factors and risk management protocols have been initiated by WBC staff as a result of common clinical indicators,
individualized warning signs, or decreased protective factors.
In the face of increased stressors and decreased supports, it is important to utilize the resources, and coping skills
learned and practiced in treatment. It may be helpful to reference DBT Distress Tolerance & Emotion Regulation Skills
that have been effective in the past. This may also be an opportunity to review any other strategies discussed with your
treatment team, such as plans for coping ahead; individualized safety plans; ways of asking for help; or methods of
using distractions and self-care- as well as any expressive, spiritual, or meditative practices that are familiar to you.
During both routine and follow-up assessments of risk and protective factors, your treatment providers at WBC were
careful to review the skills and strategies most likely to assist you during this time.
All clients in our treatment are urged to keep both professional and personal support persons informed of any changes
to individual needs, and any barriers to previous methods of coping. Parents, guardians, friends, partners, and other
family members have been encouraged to offer increased support, close monitoring, and additional supervision as
needed, and should act immediately on any raise to concern, by contacting available providers and emergency services
in response.
If you find that you are experiencing any new or worsening symptoms of suicidal thoughts, we recommend strongly that
you utilize emergency services. Additional options for urgent assistance that may not warrant immediate emergency
services are also offered below.
When changes affecting mood and behavior result in elevated risk factors, it can be difficult to keep protective factors
and longer-term life-worth-living goals in mind. However, it is even more important to do so at these times. Protective
factors known to assist and offer reassurance at times of difficulty include things such as:
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Remaining connected to family, friends, and treatment providers
Utilizing your identified DBT & other individualized coping skills & cope-ahead plans
A sense of responsibility for the care or well-being of others, including siblings, friends, co-workers, fellow
students, and pets (animal friends)
Longer-term hope and plans for the future, despite more immediate, shorter-term stressors
A strong working alliance with a therapist, treatment program, or other therapeutic provider (doctor, dietician,
peer advocate, coach, mentor, etc.)
Remaining active and goal-focused
Updated 12/7/2020; 4/6/2021 - RD
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
Utilizing creative self-expression and self-care
Using the help of support persons, as outlined below
strategies
As your team at WBC meets with you assist with additional ideas for coping, and reminders of your individual protective
factors, you are advised to utilize any or all of the following trusted contacts and other available resources in moments
of increased need for assistance:

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
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On-call or after-hours, mobile crisis or counseling services
(Your local crisis team or mobile crisis evaluation services can be found easily when searching for these by city or
town)
Therapists, psychiatrists, and doctors who offer after-hours coaching or consultation
Urgent care services
Virtual support groups and peer supports
Below are some of the most accessible, well-known, and most effective local and national hotlines for you to use either
when the individuals and groups listed above are not available, or in addition to the above-mentioned supports:
National Suicide Prevention Hotline -- 1-800-273-8255
Samaritans 24-Hour Crisis Hotline (212) 673-3000
Crisis Text Line -- Text Hello to 741741
Youth Line -- Text teen2teen to 839863, or call 1-877-968-8491
The Trevor Project -- 1-866-488-7386 or text START to 678678
For prompt, non-urgent assistance with mental health resources and community support services, dial 211
*For immediate access to urgent mental health & emergency services, dial 911
As part of your orientation process, staff at Walden Behavioral Care will initiate a comprehensive assessment of risk and
protective factors, document those assessments, and contact the appropriate providers and administrators to report
any immediate safety concerns. We encourage you to utilize the identified coping skills and support resources indicated,
and have provided and reviewed this information with you in effort to assist you during this difficult time. We are
dedicated to helping you through this difficult time, and plan to guide you through this process and toward the hope we
know is there for you!
Crisis Management
Updated 12/7/2020; 4/6/2021 - RD



While Present in Program: In the event of a medical or
psychiatric
emergency that occurs during a live telehealth session, emergency services will be contacted by a Walden staff
member and sent to your home at the address you provided. The emergency contact listed in your child’s file
will also be contacted regarding the nature of the emergency and crisis plan. Walden will work to follow up with
emergency care providers to ensure continuity of care when possible and appropriate.
After Program Hours: In the event of a medical or psychiatric emergency that occurs before or after program
hours, Walden staff will not be available to assist as staff are not currently in a clinic, nor readily accessible via
telephone or email. Should you require emergency assistance, please call 911 or 211.
Non-Suicidal Self-Injurious Behavior: Patients with a history of Self Injurious Behaviors (SIB) and/or urges to
engage in SIB may be asked to work with a member of their support system or their clinical/medical teams to
complete regular body checks to ensure prior wounds are healing and no new wounds requiring medical
attention are present.
*Please note confidentiality section referring to policies regarding risk of harm to self or others
Additional 24/7 Hotlines for Support and Assistance
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National Suicide Prevention Lifeline: 1-800-273-TALK (8255)
National Hopeline Network: 1-800-784-2433 (1-800-SUICIDE)
Suicide Prevention For LGBTQ Youth: 1-866-488-7386 (1-866-4.U.TREVOR)
Crisis Text Line : Text HOME to 741741
National Domestic Violence Hotline: 1- 800-799-7233
National Eating Disorder Association (NEDA) HelpLine: 1-800-931-2237 or text NEDA to 741741
National Association of Anorexia Nervosa and Associated Disorders(ANAD) : 1-630-577-1330
National Runaway Safeline: 1-800-RUNAWAY (chat available on website)
Teenline: 310-855-4673 or text TEEN to 839863 (teens helping teens)
TransLifeLine: 877-565-8860
Walden FBT Treatment Methods
Updated 12/7/2020; 4/6/2021 - RD
CBT= Cognitive Behavioral Therapy; DBT= Dialectical
Therapy
Behavioral
General Components of PHP
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Family Sessions: Each family has a weekly 45 minute family session (not shown on program schedule). During
these sessions, the adolescent’s weight and/or behaviors is discussed in order to monitor progress in restoration
(when this is part of the individualized treatment plan) and to better understand factors that may be inhibiting
the recovery process. Families problem solve around issues that arose during the week with eating disorder
symptoms/behaviors and re-feeding.
Parent Group: Parents are strongly recommended to attend the weekly parent and nutrition groups. This group
will focus on providing support group for parents, as going through eating disorder treatment can be a
challenging time for caregivers. The second component of this group includes Dialectical Behavioral Therapy
(DBT) techniques to help parents more effectively tolerate distress, manage their emotions, and interact with
their child during this difficult time of illness. Parents are also recommended to attend the weekly Parent
Nutrition group for further support and psycho-education.
Adolescent DBT/CBT Groups: Adolescents attend multiple group therapy sessions weekly. These groups are
designed to help patients cope with the recovery process (eating normally), try new skills and techniques to
challenge their eating disordered thinking, and help them plan more effective ways to tolerate their emotional
distress.
Adolescent Individual Meetings: Each adolescent meets with their assigned clinician to discuss progress as
needed. Adolescents are encouraged to introduce issues they would like to have discussed in family sessions.
Family Meal: There are 2 coached meals per week that family members are encouraged to attend. These
breakfasts are held during program hours with the goal of providing additional support to both parents and the
adolescent, and to coach families on how to manage behavioral difficulties at meal times. Parents may also be
encouraged to join additional meals when indicated as necessary by the treatment team.
General Components of IOP

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Family Sessions: Each family has a weekly 45 minute family session (not shown on program schedule), either
directly before or after program. During these sessions, the adolescent’s weight is overtly discussed in order to
monitor progress in restoration and to better understand factors that may be inhibiting the recovery process.
Families problem solve around issues that arose during the week with eating disorder symptoms and re-feeding.
Parent Groups: Parents attend 3 groups a week. One group focuses on Dialectical Behavioral Therapy (DBT)
techniques to help parents more effectively tolerate distress, manage their emotions, and interact with their
child during this difficult time of illness. The second group will focus on providing support group for parents, as
going through eating disorder treatment can be an extremely challenging time for caregivers. The third group
includes both parents and adolescents and focuses on building a better understanding of eating disorders and
the recovery process.
Adolescent DBT/CBT Groups: Adolescents attend 4 group therapy sessions weekly. These groups are designed
to help your child cope with the recovery (eating normally) process, try new skills and techniques to challenge
their eating disordered thinking, and help them plan more effective ways to tolerate their emotional distress.
Adolescent Individual Meetings: Each adolescent meets with their assigned clinician to discuss progress as
needed. Adolescents are encouraged to introduce issues they would like to have discussed in family sessions.
Updated 12/7/2020; 4/6/2021 - RD

Family Dinners: There are 3 required family dinners a
week. These
dinners are held during program hours with the goal of providing additional support to both parents and the
adolescent, and to coach families on how to manage behavioral difficulties at meal times.
*See program specific schedule for further guidance and information on how the daily schedule is set up.
For Adolescent IOP-You will have one weekly family therapy appointment, at either 3:00-3:45 or 6:45-7:30, on one of the
three program days. Scheduling will depend on both clinician and family availability. Regular program hours are 3:456:45.
Updated 12/7/2020; 4/6/2021 - RD
Meal and Snack Guidelines
With the goal of moving towards health and healing, Walden aims to create a safe space for your loved one
and your family to practice normal eating, decrease eating disordered behaviors, and develop and implement
healthy coping skills. Parents/guardians are to construct and prepare their child’s meals for each treatment
day (in PHP this is breakfast, lunch and a snack; in IOP this is snack and dinner). These meals should follow the
Rules of Three (see description and example below); if you are working with an outpatient dietitian, please
continue to use the same plan.
MEALS
SNACKS
BREAKFAST:
MORNING SNACK
Starches
Starch or Fruit
Protein
Fat or Protein
Fat
Milk or Juice
Fruit
Milk or Juice
LUNCH:
AFTERNOON SNACK
Starches
Starches
Proteins
Fat or Protein
Fat
Milk or Juice
Fruit or Vegetable
Milk or Juice
DINNER:
EVENING SNACK
Starches
Starch
Proteins
Fat
Fats
Milk or Juice
Vegetable
Milk or Juice
Updated 12/7/2020; 4/6/2021 - RD
Rules of Three:
1. Three balanced meals each day.
2. Three snacks each day.
3. No more than 3-4 hours between meals and snacks.
Meals Should Include:
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Starches
Proteins
Fats
Fruits or Vegetables
Snacks Should Include:
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Two food groups
Fun Foods or Desserts:
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Include in one meal or snack daily
Other Goals:
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Include 1-2 animal proteins each day (eggs and/or seafood) to support intake of zinc, vitamin D, and B12.
Be mindful about energy expenditure. If your child had a more active day, consider larger portions.
Include 8 oz of a caloric beverage (milk, juice, lemonade) at two meals or snacks each day.
PHP Meal Guidelines:
The adolescent will be provided with 30 minutes for meals; 15 minutes for snacks; and 15 minutes for opportunities to
“make-up” any missed components from the meals/snacks, all with staff support and supervision. Any component of a
meal or snack that is not completed will be carried over to the following meal/snack and the adolescent will be provided
with an opportunity to complete the missed component. If there are still components of the meals/snacks leftover at
the end of the program day parents will be notified of what will carry over into the remainder of the day.
Updated 12/7/2020; 4/6/2021 - RD
Coached Breakfast (PHP): What’s the Point
The purpose of Coached Breakfast is for parents and kids to share a meal in a supportive setting, where immediate
feedback and assistance is available from the PHP staff. This also presents opportunities to practice eating in their home
setting, use coping skills to tolerate distressing thoughts and emotions, and rehearse healthy/ normal eating habits.
There is not a precise formula which meals need to follow. They should be representative of a typical meal at your
house. We do request that no diet, low-cal, or fat-free foods be used for Coached Breakfast or any family meals. All
family members that attend, including the child, are expected to eat the same meal. All parents and patients who attend
coached meals are expected to complete 100% of their meals.
If an Eating Disorder behavior is noted by staff, your child/adolescent will be meal coached during the meal, with a
reminder to refrain from use of these behaviors during the meal. This may include being provided food to supplement
your meal. We understand that this feedback can be difficult to hear. We expect your child/adolescent to struggle with
re-learning healthy eating behaviors. Our commitment to your family’s recovery means we will provide guidance,
feedback and support in a non-judgmental manner.
Coached Family Breakfast (PHP): How It Works
1) Any family members that would like to participate are invited. At minimum, a parent or other involved adult
needs to attend.
2) All present are given 30 minutes to complete their meal.
3) Parents are encouraged to provide support and feedback to their child, as well as utilize PHP staff to address
problematic behaviors (listed below are behaviors that are not allowed during meals/snacks).
4) During the meal, friendly conversation is the goal. Please refrain from talking about food, weight, appearance,
diet, etc. (see below for further info.).
5) At the end of the meal, PHP staff will check the patient’s plate to ensure completion via private chat message.
6) Unless otherwise directed, please remain at the table until everyone has finished their meal.
Family Dinner (IOP): What’s the Point
The purpose of Family Dinner is for parents and kids to share a meal in a supportive environment, where immediate
feedback and assistance is available from the IOP staff. This also presents opportunities to practice eating in their home
setting, use coping skills to tolerate distressing thoughts and emotions, and rehearse healthy/ normal eating habits.
There is not a precise formula which meals need to follow. They should be representative of a typical meal at your
house. We do request that no diet, low-cal, or fat-free foods be brought in for Family Dinners. All family
members that attend, including the child, are expected to eat the same meal. All parents and patients who attend
coached meals are expected to complete 100% of their meals.
Updated 12/7/2020; 4/6/2021 - RD
If an Eating Disorder behavior is noted by staff, you and your
child/adolescent will receive a prompt from the meal leader and/or a private chat message during or after the meal and
redirected. This may include being encouraged to supplement your meal. We understand that this feedback can be
difficult to hear. We expect you to struggle with re-learning healthy eating behaviors. Our commitment to your
recovery means we will provide guidance, feedback and support in a non-judgmental manner.
The Family Dinner (IOP): How It Works
1. Any family members that would like to participate are invited. At minimum, a parent or other involved adult
needs to attend.
2. The family prepares dinner for 6:00 pm and sits down to eat with their child/adolescent.
3. All present are given approximately 45 minutes to complete their meal.
4. Parents are encouraged to provide support and feedback to their child, as well as utilize IOP staff to address
problematic behaviors (listed below are behaviors that are not allowed during meals and snacks).
5. During the meal, friendly conversation is the goal. Please refrain from talking about food, weight, appearance,
diet, etc. (see below for further info.).
6. At the end of the meal, IOP staff will check the patient’s plate to ensure completion via private chat message.
7. Unless otherwise directed, please remain at the table until everyone has finished their meal.
Snack (IOP): How It Works
1. Adolescents will be presented with a snack provided by their parents.
2. Adolescents are provided 20 minutes of supported time to complete snack. Snacks that are not completed are
re-presented in addition to dinner when more intensive coaching can be provided.
Meals and Snacks: What Is OK
1.
2.
3.
4.
5.
Having a hard time at meals and feeling conflicted about eating. This is normal and expected.
Letting people know when you’re struggling and asking for support.
Asking someone if they want help if you see them struggling.
Talking about movies, school, hobbies, sports, weekend plans, pets, current events, music, and vacation plans.
Enjoying the conversation.
Meals and Snacks: What’s Not OK
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2.
3.
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7.
NO DIET, LOW-CAL, OR FAT-FREE FOODS.
Mixing foods and making inappropriate combinations.
Excessive stirring.
Over-preparation of foods, like repeatedly rearranging items on your plate.
Taking tiny bites or cutting food into tiny pieces.
Blotting foods with your napkin.
Hiding food.
Updated 12/7/2020; 4/6/2021 - RD
8. Ritualistic eating habits such as deconstructing a
sandwich, not
letting silverware touch your lips, or excessive crumbling.
9. Excessive movement, like leg-bouncing or standing while eating
10. Label reading.
11. Talking about calories, weight, diet, appearance, or making excessive comments about another person’s meal or
snack.
Updated 12/7/2020; 4/6/2021 - RD
Program Policies and Guidelines
Confidentiality Policy
1. Confidentiality by patients, family members and staff members is absolutely essential as it protects
treatment for everyone involved. Therefore, while participating in ANY of Walden Behavioral Care Programs,
each patient will be required to maintain strict confidentiality. You may only participate in our virtual
programming from a private location where outside parties are not able to hear you or group participants.
We recommend using noise machines for folks that are cohabitating. Patients agree not to disclose any
information that is shared in the treatment groups to anyone outside of the group. This includes family
members and significant others, who may, out of genuine interest and concern, ask questions about
treatment. We encourage patients to respond to such questions by commenting only on their own
experience and progress while in treatment and abstaining from discussing other patients’ treatment.
Clients will be required to find a private space in which to participate in virtual sessions. Noise machines are
encouraged.
2. Outside of group, verbal contacts BETWEEN PATIENTS may be acceptable in some cases. Examples of
appropriate contacts would include: utilizing one another for support, coaching one another or practicing
skills learned while in treatment and accessing community resources. Private relationships, which cannot
be discussed in group, are not acceptable. Difficulties may arise when a relationship cannot be discussed, as
this could result in a group member finding it very uncomfortable to participate in and use groups to the
extent needed.
3. All information discussed during treatment sessions will remain confidential and will not be revealed
without your written permission, unless one of the following conditions applies:
o If your child/adolescent is determined to be suicidal or homicidal, your clinician will be obligated to take
special precautions in order to ensure no harm is done. If your child/adolescent threatens to harm
another person, your clinician is obligated to inform the police and attempt to warn the intended victim.
o If a reasonable suspicion of child or elder abuse exists, the clinician is mandated by law to inform the
local protection agencies in order to protect the individual.
o If you or your child/adolescent’s psychological status becomes an issue in a court of law, or your
child/adolescent’s evaluation has been ordered by a court of law, your clinician may be legally obligated
to disclose aspects of their assessment and therapy to the court (such as diagnosis and number of
sessions; specific details are rarely relevant to court proceedings).
o Certain basic information may be released to your insurance company as is required by them to pay
your insurance claims. This information is not released to your employer as a matter of course.
o In the event of a medical emergency, disclosure may be made to medical personnel.
o If the clinician that you are working with is an intern, they will be under the close supervision of a
licensed professional with whom your treatment will be discussed. Both supervisors and interns adhere
to the rules and limits of confidentiality discussed above.
o Violation of confidentiality laws may result in immediate discharge.
Updated 12/7/2020; 4/6/2021 - RD
Attendance Policy
Walden Behavioral Care Partial Hospitalization Program is 30 hours each week, Monday through Friday. The Intensive
Outpatient Program is a minimum of 9 hours per week (three, 3 hour days).
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Patients are expected to be on time, attend all scheduled sessions, and to actively participate in all modalities of
treatment. If you must miss appointments, please inform your clinician at least 24 hours in advance.
If a patient has three consecutive unexcused absences from program, the treatment team will work with you and
your family to determine if remaining in program is indicated.
Poor attendance can potentially result in insurance coverage issues.
Gift Giving Policy
We know that society encourages “gestures of good will.” However, to maintain the ethical standards that our staff and
clinicians adhere to, we cannot accept gifts and favors from clients. We are here to serve you in your recovery. The
biggest “thank you” that you could give us would be to use the skills that we have taught you. We also ask that you
refrain from giving gifts to your fellow clients during treatment. This is believed to be therapy interfering.
Electronic Devices Policy
Please put away and turn off or silence all electronic devices when in session. This includes all cell phones and tablets.
Participants that stop their camera without letting the group leader know, who are observed to be using their phone’s
camera, or interacting with anyone in the room, may be removed from the group by the group leader due to
confidentiality laws. Violation of confidentiality laws may result in immediate discharge.
Guidelines for Dress
The expectations for dress below have been created to maintain a comfortable, safe environment for everyone so
people do not feel triggered around body image related issues.
 Visible Shorts/Skirts must reach at least mid-thigh.
 Please do not wear strapless or backless shirts.
 Tank top straps must be at least the two inches thick.
 Please do not wear extremely tight fitting clothing.
 Please do not wear shirts that show your mid-drift
 Please do not wear any shirts that promote drugs or alcohol.
 Please make sure that shirt neck lines are not too low.
**If you are unsure if your clothing is appropriate for program, we encourage selecting different attire.
If we notice that your attire is not within these expectations, we may privately ask you to change.
Updated 12/7/2020; 4/6/2021 - RD
Inclement Weather Policy
Program will run despite outdoor weather conditions. Should weather result in wide-spread power outages, you will be
notified of cancellation via email.
Adolescent Group Therapy Behavioral Guidelines
1. Full attendance is expected unless your child/adolescent is pulled from group for an individual or family meeting
with a member of your treatment team. Absences may result in missing individual and/or family meetings.
These will not be rescheduled unless the absence was due to illness or emergency.
2. Please be on time. Groups will start and end on time.
3. If called out of a group by staff, please return to group if it is still in session.
4. If you need to leave the group for any reason, we ask that you inform the group leader prior to leaving the
group.
5. Patients and families are expected to respect the confidentiality and privacy of each other. Disclosure of
information by a patient about any other group member will not be tolerated (see the Confidentiality Policy).
6. The Walden treatment team respects the confidentiality of the groups and the individual; however, if an
adolescent under the age of 18 discloses they are engaging in life threatening behavior, confidentiality will be
broken and caregivers will be immediately informed. (see the Confidentiality Policy).
7. Patients will be redirected to use appropriate language to communicate their thoughts and feelings. Verbal
abuse or name calling directed toward staff, family members or other patients is not permitted.
8. Patients are strongly encouraged to give feedback to each other. Using “I” statements are more effective that
“you” statements.
9. Please be mindful of sharing specific details related to eating disorder behaviors (such as numbers, specific
foods, and clothing sizes), self-injurious behaviors or personal trauma. We strive to create an environment of
safety and honesty, and want everyone to feel free to discuss their current issues. Please ask a staff member if
you have any questions.
10. If group therapy sessions become too intense or difficult for an individual to handle, one can self-impose a “time
out” in order to regroup. However, clients are encouraged to remain and share their feelings with the group. If a
time out is needed, the client will be asked to address this issue with their clinician. Staff may also impose a time
out for a client if the client is acting inappropriately and is not responding to redirection.
Updated 12/7/2020; 4/6/2021 - RD
Behavioral Expectations and Protocols
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Patients who are not responding to the current level of treatment (i.e., no decrease in symptoms) may be referred
to a more appropriate level of care.
The use of alcohol and other mind/mood altering substances is prohibited prior to or during treatment sessions.
Weapons are not allowed to be displayed at any time.
If your child/adolescent is experiencing difficulty with self-injurious behaviors and/or substance abuse, we will work
closely with you and your providers to assist you in interrupting this behavioral pattern. Depending on severity, we
may need to consider a higher level of care to ensure your safety.
Treatment center romances are discouraged as romantic relationships between clients can interfere with treatment.
In the event that your child/adolescent become medically or psychiatrically unstable, we will work closely with you
and your outpatient team to determine the most appropriate treatment, one of which may be a transition to an
alternate level of care.
If your child/adolescent becomes medically or psychiatrically unstable outside of program hours, you agree to
contact your medical and/or psychiatric providers, call 911 or 211 or go to a local Emergency Room.
Clients agree to medical monitoring as recommended by your PCP/NP for the duration of the program. This will
include checking weight, vitals and blood work as indicated.
Clients agree to authorize releases so that we may communicate with outpatient providers.
Use of bathrooms is encouraged to be done during assigned break times that occur prior to meal time.
Clients are expected to attend and complete all meals, snacks and groups.
If a client has three unexcused absences or three consecutive no call/no shows from program, the treatment team
will work with you to determine if remaining in the current level of care is appropriate.
As way of helping patients to take full responsibility for addressing these behaviors, patients may be directed to
immediately complete a BEHAVIORAL CHAIN ANALYSIS. Patients will be oriented to this process by staff when
therapy interfering behaviors occur.
Parents are encouraged to monitor all bathroom breaks by remaining outside the door, and checking the toilet
before flushing when behaviorally indicated.
Outside of group, verbal contacts BETWEEN PATIENTS may be acceptable in some cases, and also as permitted and
allowed by caregivers. Examples of appropriate contacts would include: utilizing one another for support, coaching
one another or practicing skills learned while in treatment, and accessing community resources. Private
relationships, including romantic relationships, which cannot be discussed in group, are not acceptable.
Updated 12/7/2020; 4/6/2021 - RD
Recovery Record
Walden utilizes the option for parents to use Recovery Record as a tool to support logging food intake, emotion and
mood for electronic correspondence with your treatment team. * Walden staff has access during regular program hours
only.
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HIPAA compliant to keep your information secure, even when shared with your treatment team.
Not a replacement for in-person communication. Your treatment team is not expected to be aware of, nor
respond to, events reported in your app, except in session or as your clinician chooses.
Here to provide information, not medical, legal or psychological advice, diagnoses, or treatment.
Recovery Record is not intended to diagnose or treat any illness and does not guarantee improvement in your
condition.
Recovery Record app should not be used to report emergencies. If you are experiencing an emergency or are at
risk of harming yourself or others, call 911 or your local crisis hotline.
Your clinician is not expected to be aware of, nor respond to, events or changes that are reported in your app,
except in session or as your clinician chooses during normal business hours.
Recovery Record does not make treatment recommendations. Any decisions based on this information are
made at the discretion of you and/or your clinician.
Recovery Record is NOT a tool to be used to report absences to program. Absences must be called directly into
program.
If you do not own a smart phone, or have access to a private computer system, you may be asked to keep a
paper diary care for self-monitoring purposes.
INSTALL If you have an iPhone, Android or iPad go to the App Store and search for 'Recovery Record’. Tap Install.
EXPLORE Log some meals and check out the ’’More’’ section to find skills, goals and log questions that are just right for
you.
LINK Ask your clinician for their Link Code and type it into the Clinician Connect section of your app for connected care
that meets you where you are.
Insurance/Financial Responsibility
We will work diligently on your behalf and attempt to secure full coverage for your healthcare services at Walden
Behavior Care through your insurance company. You will be asked to sign off on our “Financial Responsibility
Agreement” form prior to admission. Ultimately, it is your responsibility to verify with your insurance company what copays and deductibles you will incur. Walden Behavior Care will also verify and communicate your co-pay and deductible
if applicable under your health plan. Also, it is imperative that you inform your clinician of any insurance changes in
order to prevent an interruption in coverage or self-pay responsibilities.
Furthermore, during your PHP/IOP stay, you may require a higher level of care such as Inpatient or Residential
treatment. Your clinician will make every effort to obtain authorization for the higher level of care and confirm with
your health plan that Inpatient or Residential level of care is a covered benefit under your plan. You will be informed
when any changes in level of care are considered.
Updated 12/7/2020; 4/6/2021 - RD
Updated 12/7/2020; 4/6/2021 - RD