Visit by Ron and Kristie Campbell, March 13, 2013

Pulling into the parking lot of Center for Change in Orem, UT, I wasn't sure we were in the right place. I knew that the center was a hospital for adolescent girls and women with moderate to severe eating disorders; however these buildings looked nothing like a hospital. Seeing the sign on the wall, we parked and went inside.

In the waiting room was a desk surrounded by glass, the only resemblance to a hospital I could see. We were early for our appointment, so we waited a few minutes for Tamara Noyes, Director of Business Development, to get out of her meeting and inform the direct care staff that we were there.

As we waited, we noticed staff coming and going; each one using a key card to get into the center. Center for Change is a staff-secure facility to ensure patient safety.

We went back to Tamara's office, where she talked to us about the history of the program, the tuition, the academics, and described the overall program to us. She also explained that this is a hospital; the Center offers all levels of care, including acute inpatient for severe eating disorders and residential care for those whose eating disorders are more moderate. On a personal note however, it didn't matter how mentally prepared we were to see the ladies; no amount of preparation could equip us for the emotional aspect of visiting a place like this.

We started our tour in the school, which is unique for a hospital. Center for Change has a fully accredited school component available to the girls so that they can continue their studies during treatment. Because the girls are there for treatment, however, the academics are secondary. Girls do intense treatment and groups in the mornings, then if they are ready, school in the afternoon.

We talked to the Academic Director of the school to learn more about the academic component. She designs each girl's academic plan and tailors it to her needs. The academics are set up so that girls focus on one class at a time to allow them to receive the most beneficial transfer credits. The school consists of one large classroom, with a couple smaller rooms around the edges to create a standard school feeling. The walls of the large room are lined with books of all sorts, and one of the rooms contained many sandboxes and shelves lined with all sorts of figurines for expression therapy. There is also a music therapy room where the girls can express themselves through music, and a yoga room nearby.

We continued our tour, leaving the school and entering the residential part of the facility. Walking through the lower level, we saw a few girls preparing for snack. Those we saw appeared very thin. They were joking around a little with staff and appeared to be in a good frame of mind. Although the girls we saw appeared thin, we later discussed that size doesn't define the eating disorder, that many people who struggle with eating disorders are often a normal size.

Meals and snacks can be very difficult for people suffering with eating disorders. To keep the girls from being able to engage in eating disorder behaviors, all bathrooms are locked and, in the beginning phases of treatment, girls must be accompanied by staff to use them. The seasoned staff has a routine around meal time; the girls use the bathroom while a staff member stands outside the door, which is slightly cracked open, so they can listen for possible eating disorder behaviors. Although this may sound extreme, like it is violating privacy, it is important to remember how extreme and life threatening anorexia and bulimia are. Staff is there to ensure patient safety.

We entered the young adult ward. The temperature was a bit warm for me, but the staff was well aware of how high it was, and was monitoring the women and their activities. Surrounding mealtime, girls must also rest to slow their metabolisms. We noticed girls sitting cozily on the couches in the main living area.

The rooms were neutral in color with light colored blankets. Nothing hollered out hospital to me. It wasn't the sterile white atmosphere as in typical hospitals. Instead, the environment at Center for Change was warm and inviting. Young women on this floor were talking with each other and hanging out. They had finished their morning groups and were lounging on sofas in the great room, waiting their turn to prepare for lunch.

After the young adult wing, we walked through the cafeteria on our way to the acute care wing. Each girl is on an individualized food plan dependent on her needs. The kitchen staff and dietitians are fully aware of these needs and prepare meals accordingly. Depending on the program phase for each patient, their food is either plated for them, or they are on "family style" or the "intuitive eating" phase of the dietary program. For those who may struggle to eat the necessary calories, they have the option to receive a liquid supplement called "boost," to give them life sustaining nutrients.

Mealtimes can sometimes be difficult for patients at the Center, a very different atmosphere from other programs I've visited. We witnessed a couple of girls in the cafeteria crying as they struggled to eat their snack.

After the cafeteria, we walked over to the inpatient wing. Rooms looked a little more typical of a residential treatment center and again I forgot I was in a hospital. That is until we walked through the acute ward. Here the girls are very sick. They are pale and weak with thinned out hair. Their eyes are sunken and sad. A couple had to use walkers because they were too weak to support themselves, though they had recently graduated from wheel chair to walker, indicating improvement. In this area, girls may have feeding tubes if necessary. Even with the condition of the girls in this ward, it was clear to us that the girls were comfortable with the staff as they interacted and even joked with them.

We returned to Tamara's office after touring the facility to address any questions we had or give any feedback. It was hard to go through this tour knowing there are girls out there who hurt so badly on the inside that they have created this acute sickness in their lives. It's most difficult for me to understand how someone so skinny can view themselves as overweight.

Reiterating what was said earlier, the facility at Center for Change was warm and inviting. As emotionally hard as it was for us to visit, the ladies are in a safe and healing environment, without distraction, where they can work therapeutically on their issues with compassionate support. Anorexia nervosa and bulimia are serious, life threatening conditions. If appropriate, Center for Change would be a viable option.