Parents ... Demand Transparency

“Asking the proper questions is the central action of transformation. Questions are the key that causes the secret doors of the psyche to swing open.”

            Clarissa Pinkola Estes, American poet and advocate

“Ask the right questions if you're to find the right answers.”

                  Vanessa Redgrave, Actress

Moms, Dads, Husbands, Wives … so your beloved is suffering from an eating disorder. You have seen the statistics. You have seen the death rate. You have seen so much chest bumping and claims made on Internet web sites, that you simply do not know which way to turn.

Your family doctor is recommending a residential treatment program for your loved one. You have read some good reviews and you have read reviews that frighten you. We have been there. You are not alone.

You are about to entrust your most, valued, beloved person to someone else’s care. You are entrusting your heart and your soul. You are so incredibly afraid. You  are confused and uncertain.

It is long past time to start to use that fear as an asset, to help you, instead of against you. Fear can be a tremendous ally when you control it. And you can start to control it by being up front and assertive with the questions you ask treatment providers before you entrust your child, your spouse, your loved one to their care.

You are entitled to complete transparency. You are entitled to integrity. You are entitled to honesty. If you receive anything less than those qualities from the person, the treatment provider who has been entrusted with the care of your beloved, you need to look elsewhere. They literally hold the life of your beloved in their hands. You must expect … no you are entitled to DEMAND complete transparency.

So, as are you interviewing a treatment provider, do not back down.  You should always speak to the person in charge of the medical program… the medical director, the chief clinical officer, whoever it may be.  End at the top and don’t accept anything less.  If they don’t make time for you before you trust them with your child’s life, what makes you think they will give you time during and after the treatment protocol? Yes, they will have intake personnel to first vet your initial information. That is understandable and prudent. And, cooperate with them. But, you must also talk to the top person. Your beloved person’s life may very well depend on that treatment center and that professional.

And so, the following questions may help as a guidepost for that journey to enlightenment and honesty:

1.             What type of treatment protocol do you use?

2.            When they say, “We use evidence-based treatment, (“EBT”) get the specifics of that EBT.

3.            Who conducted the research into that particular type of EBT? When was it done?

4.            Were control groups used?

5.            Does your center duplicate the testing parameters utilized by the initial researchers as closely as possible? If not, why not.

6.            What is the average time, percentage wise, per day and per week that this EBT is actually being used?

7.            What is being done the remaining amount of time? As for those activities, what studies indicate that those activities are effective for treating eating disorders?

8.            How do they individually tailor their treatment protocol to take into account the unique needs of your loved one?

9.            Ask about the credentials and background histories of the medical personnel and counselors who will primarily be assigned to your loved one’s care.

10.        What complaints have the treatment program had? How do they resolve those complaints?

11.       What are the greatest strengths of the treatment program and the treatment facility in general?

12.         What are the weaknesses of the treatment program and treatment facility in general?

13.         How do they insure the safety of the people attending the program, not only from outside influences but also from other people at the facility?

14.        Carefully review the Internet website of the treatment facility. If there are any items of concern, i.e., “satisfaction or success” rate or representations about their quality, ask about them.

15.      Do they collaborate with research doctors or universities on their program? If not, why not?

16.      Are they aware of the latest Center of Excellence proposal made by four research doctors? If not, why not?

17.         Do you start their discharge planning from the very first day your loved one is entrusted to them? If not, why not?

18.         Ask what their discharge planning consists of.

19.         Do they coordinate with your treatment providers at home?

20.        Do they do family counseling during the week and if you live out of town, whether they do that by Skype?

21.         Ask for their views on pharmaceutical drugs.

22.        Ask if they know what the prevailing views on the usage of pharmaceutical drugs to treat eating disorders are. If they do not know, ask why they do not know.

23.        Ask them how they measure their success rate.

24.        Ask what follow up care they do, i.e., phone calls to you, phone calls to your general practitioner.

25.        Ask if a private equity firm owns them in whole or in part. If they are, ask how much of their medical practice is owned by that PE firm.

26.        Ask what role the PE firm has in charting the course for their practice, that is, will certain aspects of the practice be emphasized over others.

27.        Ask the manner in which they conduct peer-to-peer reviews.

28.        Ask if during a peer-to-peer review, whether the insurance benefit’s “independent doctor” has ever made either direct or veiled threats that if the insurance provider’s decision is disregarded, that could jeopardize the treatment center’s contract.

29.        Ask how often the treatment center is successful in the peer-to-peer reviews conducted with your insurance provider.

30.        Ask about the financial costs of the program, both with and without insurance proceeds being applied.

31.         Ask how they treat co-current medical conditions, i.e., depression, trauma, addiction and whether they have staff who specializes in treating those conditions.

32.        Is spirituality part of their treatment protocol?

33.      Have any complaints been filed against the medical personnel or counselors? If so, what were those complaints about and what were the outcomes of those investigations.

34.      Has a federal, state or local board of medical examiners ever investigated the treatment center and if so, what were the specifics of those investigations and outcomes?

35.       How often will they update you on your loved ones condition and treatment?

36.        If your loved one is 18 years of age or older, will they require your loved one to sign a HIPAA release form authorizing them to speak with you at all times?

You have the power of the future in your hands. Without you, their treatment center does not exist, their livelihood goes away. They are dependent upon you for their professional existence. Act like it. Use that information to empower you.

Parents … be strong, be faithful to your head and your heart. Ask questions. Demand truthful answers. Accept nothing less. Knowledge is power. And understand that the future is yours to embrace.