Therapist Krista Crotty is establishing a new temperament-based treatment program for eating disorders in Spokane.
The program, to be called Brain Based Therapy Northwest, will focus on a five-day treatment with support program and will start in January. Although primarily used to help treat anorexia, the program can be used to help treat other types of eating disorders.
“This specific form of treatment is really the first of its kind that’s intersecting eating disorder research, literature from the field, and research on the brain,” Crotty says. “It’s understanding temperament and biology that’s just genetic.”
Crotty will hold the new program at Harmony Woods Retreat Center, at 11507 S. Keeney Road, south of Spokane, until a more permanent location is secured.
She operates her established practice, Climb Clinic, at 705 W. Seventh, on Spokane’s lower South Hill. Through Climb Clinic, she has specialized in treating adults and adolescents with eating disorders, such as anorexia and bulimia.
She was introduced to temperament-based treatment with support in 2016, when she discovered the research of psychologist Laura Hill and her colleagues, who were establishing the grounds for the new treatment.
Developed by Hill and researchers at the University of California San Diego, temperament-based treatment with support incorporates a family member or support person into treatment for an intensive program and considers how neurobiology and brain processes effect those with eating disorders. Crotty began working directly with Hill in 2017 to figure out how to integrate this treatment into patient care.
Temperament-based treatment with support programs currently run regularly in Norway and Australia. Brain Based Therapy Northwest will be the second to run in the U.S., according to Crotty.
“Historically, eating disorder treat–ment and mental health treatment has excluded family members or support people from caring for their loved one while in treatment,” she says.
Crotty has worked in the mental health arena since 2003 and opened The Emily Program, a Minnesota-based treatment center for eating disorders, in Spokane in 2011. After establishing the program in Spokane and working in an administrative leadership role, Crotty founded her private practice in 2017 with the desire to get back into clinical work.
Programs for adults will run in January, March, and May, and both adult and adolescent programs will run in June, July, and August. For each week of the program, a space will be rented out with the hopes of establishing a permanent location for the program in the future.
“Not that my private practice is going away, but this other piece is a much larger and more significant piece of how I hope to do eating disorder treatment moving forward,” says Crotty.
Crotty hopes to train and bring in five to 10 other providers to help run the program monthly. Participants will arrive on Sunday, check-in with their medical clearance, and over the next five days they will spend 45 hours in treatment with their support people. Support people can be a caregiver, a parent, a sibling, or a friend.
The total cost to participate in the program will be $6,500 before insurance. Crotty says she is working with insurance companies to figure out how to have the best insurance reimbursement.
Patients and their support people will eat breakfast and lunch with the providers during the program but will supply their own food.
“Unlike traditional treatment where often the facility or dietician picks the food, there is sort of a shift in belief that we are going to support the family food culture and whatever they’re willing to eat right now,” says Crotty.
Patients will select their food based on their home dietician’s meal plan. If patients don’t have a home dietician, they will be able to work with one of the program’s dieticians.
The treatment focuses on activities that educate patients’ support people on what it’s like to live with an eating disorder. One activity called “brainwaves” involves flashcards that go through the neurobiological process of the brain when eating, comparing the process for a typical eater to someone with an eating disorder.
“It’s less talk about our troubles and feelings. It’s very educational and very structured,” says Crotty. “It’s giving the client the ability to explain what it feels like to have this illness and explain what’s helpful for them.”
The expectation is that with the education from the program, patients won’t go back to the same home environment because the support people are better equipped and educated to help their loved one recover. Crotty describes the program as a lightbulb moment for family members and friends.
“It’s this ‘aha’ of, I get how it feels now, and I know that it’s not that they’re choosing anything,” says Crotty.
The program isn’t meant to replace partial hospitalization programs or intensive outpatient programs for eating disorders. Rather, it’s intended to be an additional resource to make those treatments more successful.
“This has proven, especially when we look at the studies coming out of Norway, that it can be a way to interrupt and reduce symptoms,” says Crotty.
Although many treatment options for eating disorders have been developed in Spokane since Crotty started The Emily Program, people still need treatment options, especially with the COVID-19 pandemic’s lingering effects on mental health.
“Eating disorders, as a general statement, are on the rise, so there is more need than 10 years ago,” says Crotty. “The thing that is amazing to me is how sick people are by the time they ask for help, and that’s the difference.”
Crotty hopes that the five-day program model can help patients jumpstart their treatment if they are unable to see a provider elsewhere.
“There’s a long waitlist; that’s the other piece,” says Crotty. “It’s great that people are accessing care but there aren’t enough providers.”
Crotty also hopes that the program will be a cost-effective option, with clients only having to miss one week of work, rather than an extended period that is typical in other programs.
“The thing for me is, in a sense, this is the secret key,” says Crotty. “The more I learn about the brain and see the way the brain is firing differently and the way we provide better psycho education, I think it motivates people to see their care differently.”
After launching the temperament-based treatment with support program under Brain Based Therapy Northwest, Crotty hopes to establish more mental health care for adolescents under the Climb Clinic umbrella.
