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In the middle of the country, on the bluffs overlooking
a gently flowing river, nestled against forested parkland,
is a treatment center unlike any other…




                                     St. Louis, Missouri
                                     636-386-6611 | 888-822-8938
                                     www.castlewoodtc.com
Castlewood Treatment Center

is a creative collaboration of the owners’

clinical experience and personal and

professional evolution. The result is

a residential treatment program for

eating disorders that allows for the unique

treatment of each individual with an

emphasis on compassion, respect and

empowerment.
Our vision required that the structure itself
be beautiful, unique, and natural, blending harmoniously
   with its surroundings. Most of all, it had to have the
     ambiance of a healing community, a sanctuary.


       After years of searching, we discovered this
secluded gem, high on a ridge, overlooking endless acres
   of state woodlands and the scenic Meramec River.
Men and women who                                   AN EATING DISORDER is both originated
                                                    and maintained by a constellation of factors.
come to Castlewood                                  For each client, every step of the way, we are
                                                    continually inquiring as a treatment team and
are not anorexic; they are                          in collaboration with the client: what are the
                                                    necessary and sufficient components of treat-
not bulimic; they are not                           ment needed to restore this person, not only to
                                                    decreased symptoms, but to a life that is both
compulsive overeaters.                              live-able and worth living?

At Castlewood we begin                              In addition to the eating disorder, some clients

with the premise that                               have psychiatric diagnoses; some have multiple
                                                    addictions and some have a history of severe

each person who walks                               childhood traumas. Some clients will see a
                                                    specialist for adjunctive therapy, such as seeing
through our doors defies                            our anxiety specialist if needed, in addition to
                                                    their primary therapist. Whatever is required
simple categorization.                              to help the client, we attempt to provide.


Though we naturally wish to restore our clients     When new clients arrive at Castlewood we
to health and functionality as efficiently as       never know how his/her treatment will end
possible, we do not place a 30 or 60-day time       up looking, because therapeutic strategies
limit on our residents’ stays. Our mission is not   evolve as we get to know them and identify the
merely to churn out weight-restored women           pertinent factors that are contributory to the
or men who look healthy to others, but whose        issues they present. Clients say this flexibility
internal wounds, if unaddressed, will readily       distinguishes Castlewood from prior treatments
result in relapse. Experience has taught us that    and often constitutes the difference that allows
the full measure of health rests upon more          their recovery efforts to at last succeed.
than a temporary absence of symptoms.

Castlewood therefore provides an individualized
treatment approach tailored to meet the precise
needs of each client. We understand that eating
disorder clients tend to be more different than
similar. This is why at Castlewood, each client’s
treatment plan is highly individualized.
Eating Disorders
eating
   disorders
 Eating Disorders
    Eating Disorders constitute the most
    life-threatening category of mental
    health issues.
Eating disorders often occur along with the compounding and
   further debilitating symptoms of depression, anxiety, addiction
(to drugs or alcohol), perfectionism, and stress response syndromes.

     Family and friends may find aspects of the eating disorder
perplexing in the tenacity of the hold it exerts on their loved one, the
sufferer’s lack of awareness of their degree of debilitation over time,
 and the deception that can begin to enter once-honest relationships.
WHAT CAUSES EATING DISORDER?
Eating Disorder can result                         Once the eating disorder takes hold as a
                                                   “survival strategy” of sorts, it can begin to take
as a symptom of many                               on a life of its own, as a recourse from, while
                                                   simultaneously a perpetuator of, anxiety and
different syndromes with many                      isolation. As the illness progresses, various types
                                                   of disequilibrium occur in mind and body,
developmental pathways.                            which cyclically, cause the individual to rely
                                                   more heavily on the eating disorder symptoms
For some clients, there is fear of growing up      to maintain an illusory sense of stability amidst
and assuming adult responsibilities. For others,   the increasing chaos. As the cycle of the eating
external functioning seems great while inside,     disorder continues, habituation results, as in
they are confused, distressed and need a           any addiction, and it takes more of the same
symptom to yell: help! Some become trapped         behavior to achieve the desired effect of feeling
in the role of pleasing others, perfectionism,     temporarily o.k. – more restriction, more food,
and being the “good child” For some clients,
                             .                     more binging and purging, diet pills, laxatives,
there was a major loss during childhood, such      exercise, etc.
as a mother with post-partum depression or
other experiences of separation from a key         When reliance on the eating disorder is discon-
loved one. Others have experienced tremen-         tinued, a client’s whole world can feel upside-
dous pain in their social interactions in school   down, out-of-control and initially, impossible to
or with peers that has led to an ongoing sense     manage. This unfortunate, yet understandable
of anxiety and isolation. Some clients’ families   predicament is what Castlewood exists to address.
are themselves disengaged, without sufficient      Our goal is to provide a container for the initial
emotional connections, or shame-based with         and inevitable distress, to provide the support of
many intergenerational secrets and/or layers       community, in lieu of that seemingly provided
of unresolved intergenerational trauma. Some       by the eating disorder, and to assist the client to
are enmeshed, without appropriate boundaries,      learn and re-learn the skills necessary to stabilize
resulting in overindulged children who get         and rebuild their lives.
things rather than parenting. Some clients have
perfect families, in appearance, and feel over-
whelmed because they cannot live up to the
parents’ perceived achievements or expectations.
Core Symptoms
• Weight loss or gain with endocrine
  or metabolic abnormalities
• Fat phobia/food phobia
• Rituals around body checking,
  exercise and food
• Purging (undoing and punishing) by
  fasting, vomiting, diuretics and exercise
• Dissociation/lack of autonomy from
  craving and rituals/addiction
• Body dissatisfaction, body image
  distortion
• Binge eating, secretive eating,
  hoarding and stealing food
• Chewing and spitting food as
  an attempt to control weight
• Taking in excessive amounts of fluid
  or restricting fluid intake
• Use or abuse of diet pills, herbal
  supplements or teas
• Increased isolation, spending less and
  less time with family and friends
• Refusing or avoiding eating with
  family and friends
treatment

                                             Treatment
 components
     Components
    Castlewood Treatment Center
    offers comprehensive and highly
    individualized treatment planning.

    The program is specifically designed
    to treat all types of eating disorders
    as well as co-existing disorders,
    including trauma, addictions, body
    dysmorphia, self-harm and other
    frequently co-occurring issues.
Our therapy begins with a solid individual relationship with
the primary therapist, psychiatrist and our nutritionist.

EACH CLIENT RECEIVES:
• A total of six sessions weekly with skilled
  and experienced clinicians.
• Daily work with Dr. Mark Schwartz, and
  Lori Galperin, each nationally known for their
  clinical expertise, workshops and publications on
  eating disorder, childhood trauma and addictions.
• Four individual sessions per week with
  the primary therapist.
• A weekly session with his/her nutritionist
  who eats meals with clients.                        Working with a qualified
• A weekly session with our psychiatrist.             nutritionist, who has a solid
• A small, well-chosen therapeutic community.         background in eating disorders is
• Levels of care that allow for increasing            the cornerstone of our program.
  autonomy with continuing support
                                                      Our residential nutritionist is a
• Excellent aftercare programming, including
  follow-up visits offered at Castlewood.             former eating disorder client
                                                      herself and understands the
Castlewood maintains a high staff-to-                 process as only someone who
patient ratio providing for greater                   has been through the recovery
individualized care. Many of our clients
have had treatment at other programs                  process can.
and have found recovery at Castlewood.
residential
   treatment
      residential



                                             Residential
    Our Residential level of care is
    designed for stabilization and
    restoration of healthy eating habits.
    At the Residential level, we work to
    establish and foster a therapeutic
    community that can allow each
    client to feel supported and to work
    on building social connections while
    establishing a stronger sense of self.
The Residential program only has a maximum
of 10 clients. Each client sees his/her primary
therapist four times a week as well as having
weekly sessions with the dietician and the
psychiatrist. The program itself consists of
40 hours of group therapy. Staff is on site 24/7.
Each bedroom is attractive, uniquely decorated
and has its own en suite bathroom. There are
no more than two clients to a bedroom.
Community space is likewise comfortable and
inviting with inspiring views.
Residential Program Weekly Schedule
Monday                                                Thursday
7:30 – 8:00     Breakfast                             7:30 – 8:00     Breakfast
8:30 – 10:30    Core Group Weekend Check-in & Goals   8:15 – 9:15     Process Group
10:30 – 11:00   Snack                                 9:30 – 10:30    Core Group
11:00 – 12:15   Core Group II                         10:30 – 11:00   Snack
12:30 – 1:15    Lunch & Post Meal                     11:00 – 12:00   Core Group II
1:30 – 3:00     Eating Disorder Group                 12:30 – 1:30    Chef ’s Choice
3:00 – 3:30     Snack                                 1:30 – 2:30     Pilates
3:30 – 4:30     Yoga Group                            3:00 – 3:30     Snack
4:30 – 6:00     Individual Sessions/Free Time         3:30 – 4:30     Cognitive Group
6:15 – 7:00     Dinner & Post Meal                    4:30 – 6:00     Individual Sessions/Free Time
                Compulsory Play                       6:15 – 7:00     Dinner & Post Meal
9:00 – 9:30     Snack                                                 Free Time
                                                      9:00 – 9:30     Snack
Tuesday
7:30 – 8:00     Breakfast                             Friday
8:30 – 10:00    Core Group                            7:30 – 8:00     Breakfast
10:00 – 10:30   Snack                                 8:30 – 10:00    Core Group
10:30 – 12:00   Movement Group                        10:00 – 10:30   Snack
12:30 – 1:15    Lunch & Post Meal                     10:30 – 12:15   Eating Disorder Group
1:30 – 3:00     Expressive Therapy                    12:30 – 1:30    Lunch & Post Meal
3:00 – 3:30     Snack                                 1:30 – 2:30     Body Image
3:30 – 4:30     DBT Group                             2:30 – 3:00     Snack
4:30 – 6:00     Individual Sessions/Free Time         3:00 – 4:30     Art Therapy
6:15 – 7:00     Dinner & Post Meal                    5:30 – 6:15     Dinner & Post Meal
7:15 – 8:15     Pre-Contract                                          Movie Outing
9:00 – 9:30     Snack                                 9:00 – 9:30     Snack

Wednesday                                             Saturday
7:30 – 8:00     Breakfast                             7:30 – 8:00     Breakfast
8:15 – 9:15     Eating Disorder Expressive Group      8:15 – 9:30     Individual Sessions/Free Time
9:15 – 9:45     Menu Group                            9:30 – 10:30    Gender Sexuality Intimacy & Relationships
9:45 – 10:30    Nutrition Group                       10:30 – 11:00   Snack
11:00 – 12:00   Treatment Module                      11:00 – 12:00   Literary Interpretation/Shame Group
12:30 – 1:15    Lunch & Post Meal                     12:30 – 1:15    Lunch & Post Meal
1:30 – 2:30     Sexual Healing or Containment                         Outing & Visitors
2:30 – 3:00     Snack                                                 Free Time
3:00 – 4:00     Eating Disorder Group                 9:00 – 9:30     Snack
4:00 – 5:00     Relapse Prevention
5:00 – 6:00     Individual Sessions/Free Time         Sunday
6:15 – 7:00     Dinner & Post Meal
                Compulsory Play                       7:30 – 8:00     Breakfast
9:00 – 9:30     Snack                                 8:00 – 10:30    Individual Sessions/Free Time
                                                      10:30 – 11:00   Snack
                                                      11:00 – 12:15   Music Therapy
                                                      12:30 – 1:15    Lunch & Post Meal
                                                                      Visitors & Passes
                                                      5:00 – 6:00     Addictions Group
                                                      6:15 – 7:00     Restaurant Outing or Family Style Meal
                                                                      Free Time
                                                      9:00 – 9:30     Snack
‘‘   The people at Castlewood Treatment Center
     saved my life. But they did more than that.

     They opened up my eyes to what life is all about,
     to all that I have to look forward to.

     I came in closed off from the world.

     The people here helped me find my strength.

     They didn’t just give me wings, they helped me find
     my own, and let me realize that I had the power to
     fly inside me all the time.            ‘‘
     I’m not just alive today because of the people here,
     but I’m actually living life as well.

     – MB
stepdown
     stepdown
   Our Step Down program is usually
   a transition from residential care.




                                         Stepdown
The Stepdown program focuses less on stabili-          Again, this program is tailored to fit the indi-
zation and more on practice, with an emphasis          vidual’s situation. Some clients in Stepdown, will
on acquiring the necessary life skills to facilitate   begin to work a certain number of hours, some
long-term recovery. Coping skills and healthy          to attend academic courses or to volunteer with
eating habits learned in residential are built         local agencies or organizations. Learning
upon and tried out in circumstances more               to sustain a balanced lifestyle that includes:
closely resembling what clients will encounter         appropriate nutrition, work or school, supportive
post treatment. There is greater autonomy,             relationships, recreational activities and self-care
encouragement of self responsibility, yet with         simultaneously, is often a foreign concept con-
help, support, guidance and community.                 trasted with how clients were functioning prior to
                                                       treatment. The more opportunity to practice in
We understand that each new phase in a client’s        this manner, the greater the odds for a sustained
recovery process entails novel challenges. We          recovery post discharge.
endeavor to provide the feedback, opportunities,
support and skill-building necessary to navigate       During the Stepdown phase, a meal and exer-
each sequential hurdle. Our Stepdown nutritionist      cise plan is developed for the individual client
has successfully helped hundreds of clients nav-       by the nutritionist with client input and goals
igate the pitfalls of eating in “the real world.”      considered. Clients frequently say that our
                                                       dietician and nutritionist are the BEST they’ve
                                                       ever worked with. We consider this a supreme
                                                       compliment and a variable that makes the
                                                       process of recovery so much smoother!
day treatment
 treatment
 day
  Castlewood offers a full spectrum
  of care. Our Day Treatment program
  is open to clients living in or around
  the St. Louis area who require more
  than outpatient treatment but who
  may be able to meet his/her treatment
  goals without a residential stay.


                                           Day Treatment
Day Treatment
In order to achieve a level of stabilization and
symptom reduction, some clients require a level
of care beyond outpatient.

Our Day Treatment program is provided for
clients living in or around the St. Louis area
who can commute to treatment and for whom
an overnight stay is not a necessary treatment
component.

The program is available on either a 5- or 7-day
basis. Clients become part of the therapeutic
community and participate in all residential
groups and programming. Depending upon
whether in the 5 or 7 day version, clients
receive 3-4 individual sessions with the primary
therapist, one with the psychiatrist and one
with his/her dietician weekly.

Day Treatment is often the treatment of
choice when a program of intensive
outpatient care has not been adequate in
effectively assisting the client to reach and/or
maintain treatment goals.
Outpatient
                                               Intensive
intensive IOP
   outpatient
   (intensive outpatient program)
      Our IOP Program is for clients needing
      more structure than individual
      outpatient therapy alone can provide
      or for the client who is transitioning
      back to life, work or school after
      treatment at a higher level of care,
      such as Residential or Stepdown.
Castlewood’s IOP Program consists of both group
and individual therapy held four evenings each
week. A supervised meal also comprises one facet
of each evening’s programming.

For motivated and less severely compromised clients,
IOP may be the treatment of choice. There are
four types of groups offered in the program.




                                                       Castlewood Treatment Center
                                                       offers a complete menu of
                                                       outpatient services with expert
                                                       individual therapists for eating
                                                       disorders, nutritional counseling,
                                                       marital and relational therapy
                                                       and trauma-resolution therapy.

                                                       For more information please call:
                                                       1-888-822-8938.
SKILLS GROUP
The SKILLS GROUP is a structural psycho-
educational group that provides clients with
practical skills for coping with challenges and
helps create alternative strategies to reliance
on the eating disorder symptoms. Instead of
binging and purging, utilization of self-sooth-
ing, distraction, and problem solving. Instead
of restricting, patients examine unhealthy
thought processes, body image distortion and
underlying feelings and needs. Clients are
taught to use their voice rather than symptoms       Castlewood Program Coordinators (from left to right)
to communicate internal states and to facilitate     Amy Kayda – IOP Coordinator & Therapist
problem solving, communication and to devel-         Emily Williams – Step Down Coordinator & Therapist
op relationship skills and resources. The groups     Deanna James – Assistant Program Director & Therapist
focus on body acceptance, behavior therapy,
enhancing motivation, diminishing anxiety,
appropriate nutrition, mindfulness, spirituality     MEAL PROCESS GROUP
and self care.
                                                     In the MEAL PROCESS group, individuals
                                                     are helped to recognize hunger and fullness, to
GENERAL PROCESS GROUPS                               learn to prepare or portion satisfying meals with
                                                     variety, nutrition and in appropriate servings.
The PROCESS GROUP allows an opportunity              The therapists eat with the clients, and clients
to discuss emotions and underlying dynamics          are challenged and supported to confront their
that maintain eating-disorder symptoms. Feed-        anxiety incrementally.
back from group members, particularly those
farther along or those who have had similar
experiences is useful. Assignments are often given
                                                     EXPERIENTIAL GROUP
to lend focus and assist clients in identification   In EXPERIENTIAL GROUP, clients deal
and exploration of symptom-maintaining cir-          directly with circumstances or situations having
cumstances and issues.                               to do with body, movement and strong emotions.
                                                     Clients often say these types of groups are the
                                                     most challenging, but also the most useful.
                                                     Clients may role play difficult situations to pro-
                                                     vide insight and mastery. Through behavioral
                                                     rehearsals, clients lessen anxiety and increase
                                                     efficacy in dealing with new or challenging
                                                     situations they face.
The groups were…
SUPPORT GROUP                                      vital to my recovery.


                                              ‘‘
Castlewood sponsors a free weekly sup-
port group for people in recovery from
Anorexia Nervosa, Bulimia and Binge                From the very first day I was warmly
Eating Disorder. The group is open to              welcomed and though terrified I found
anyone regardless of stage of recovery.
The purpose of the group is to establish
                                                   support. The groups were extremely
a safe, reliable setting that emphasizes           difficult but vital to my recovery. I
positive aspects of recovery. The format           formed friendships on a level I had
offers time for participants to briefly
check in about the week, followed by an            never experienced before and found hope
open discussion that focuses on various            that had been covered by layers of fear.
issues or topics that are common during
                                                   I can’t begin to explain the care that
the recovery process. Examples include:
relapse prevention, negotiating boundaries,        the staff at Castlewood had for me. At
and utilizing healthy coping tools. Par-           times it was overwhelming to think that
ticipation in support group requires that
the individual be engaged in outpatient
                                                   anyone could care that much. From my
therapy, as the support group is not in-           relentless and kind therapist that helped
tended to replace on-going therapy or as a         me through my most difficult days, the
stand-alone form of support. Castlewood
welcomes inquiries by both clients and             psychiatrist that respected my every
therapists about appropriateness of the            boundary, the directors who’s intuition
Support Group for you or for your client.
                                                   still amazes me today, the staff who’s
Information about the Support Group
is available from Nancy Albus at                   safety I remember when I was strug-
636-386-6611.                                      gling the most, and let’s not forget the
                                                   dieticians that I would have never
                                                   imagined to be my biggest allies. With
                                                   all of that, the structure of filled days
                                                   of groups, the focus on the fear and

                                                                                 ‘‘
                                                   trauma that was fueling my behaviors,
                                                   and the many levels of step down I
                                                   found my path to recovery. And most
                                                   importantly I found myself.
trauma

                                     Resolution
                                      Trauma
     resolution
  trauma resolution
   therapies
      Clients need to return to
      the root of “what happened”…
With one foot in the present and one
foot in the past, the client re-examines the
memories, re-associates the emotions, and
changes the trauma-based or childhood
attributions used to make meaning of
the experience at the time to an adult
perspective of enhanced clarity, wisdom
and compassion. The event no longer
exerts the same influence over behavior,
choices and sense of self it did previously.
Unresolved experiences of child sexual abuse or rape, for example, will almost
always result in symptoms. Where traumatically-originating symptoms prevail or
complicate the individual’s ability to achieve a fuller recovery, therapies such as
EMDR, Attachment-based Psychotherapy or Internal Family Systems therapy
can be utilized to facilitate and speed up the necessary shifts in processing once
some degree of safety, containment and stabilization exist.


EMDR                                               Attachment-based
Clients who have suffered for years from anxiety
                                                   PSYCHOTHERAPY
or distressing memories, nightmares, insomnia,     When a client has experienced early attachment
abuse or other traumatic events can often          deficits with their caretakers in the first few years
gain relief from a revolutionary therapy called    of life due to sensory hyperactivity or parental
EMDR (Eye Movement Desensitization Repro-          unavailability, they will evidence attachment dis-
cessing). Research shows that EMDR is rapid,       orders later in life. They will become dismissive
safe and effective. EMDR does not involve          of, or preoccupied with, securing love. So often,
the use of drugs or hypnosis. It is a simple,      eating disorder results from a hunger for love,
non-invasive patient-therapist collaboration       and the person is either too afraid to seek love
in which healing can happen effectively. This      (dismissive) or approaches partners with a binge
powerful short-term therapy is highly effective    mentality (preoccupied), or both (disorganized).
for a wide range of disorders including chronic    Castlewood utilizes directive interventions to
pain, phobias, depression, panic attacks, eating   work with attachment difficulties.
disorders and poor self-image, stress, worry,
stage fright, performance anxiety, recovery
from sexual abuse and traumatic incidents.
INTERNAL FAMILY SYSTEMS
THERAPY
Internal Family Systems (IFS) therapy is a
therapy that is very applicable to clients who
have complex traumatic stress disorders and
allows for a reworking of those experiences with
one foot in the present, and one foot in the past.
IFS has in common with Ego State therapies
the idea that each individual has multiple selves
or self-states. IFS, like Ego State therapies, is
predicated on the notion that having self-states,
(generally referred to as “parts”) is not (solely)
a function of a dissociative process in need of
therapeutic correction, but rather the normative
state of all human beings. Working with these
parts can be a very efficient and potent method
of resolving past events and freeing the indi-
vidual to rely more fully on his/her own innate
capacities for change, growth and healing.




RICHARD C. SCHWARTz, Ph.D.,
the originator of Internal
Family Systems Therapy,
is integral to Castlewood in
both his training of our staff
and as a clinical consultant.
castlewoodstaff
 castlewood staff



                                             Staff
    The staff at Castlewood is passionate.
    Their skill and dedication are
    surpassed only by their compassion
    for the hard work involved in each
    client’s process of recovery.
Our therapists include highly trained                                     Lori Galperin
                                                                          M.S.W., L.C.S.W.
master- and doctoral-level professionals
                                                                          Clinical Co-Director
with numerous specialties who are
                                                                           Ms. Galperin initially
unequivocally committed to helping                                         earned her undergraduate
                                                                           degree in Psychology and
people heal. They understand the
                                                                           later completed her gradu-
obsessive, often labyrinthine thought                ate degree in Clinical Social Work at Tulane
                                                     University. She is an accomplished contributor
processes that create and maintain our
                                                     in the fields of marital and sexual dysfunction,
clients’ cognitive distortions.                      sexual compulsivity, sexual trauma, dissociative
                                                     and eating disorders, lecturing nationally and
                                                     internationally on these topics. She has au-
                                                     thored various journal articles and book
                                                     chapters, is trained in Clinical Hypnosis,
                    Mark Schwartz, Sc.D.             EMDR, Internal Family Systems, Expressive
                    Clinical Co-Director             and Attachment-based therapies. Over the
                      Mark earned his doctorate      past 22 years Ms. Galperin has treated several
                      in Psychology and Mental       thousand inpatients and trained more than
                      Health from Johns Hopkins      100,000 clinicians throughout the United
                      University. He is a licensed   States, Canada and Europe.
                      psychologist and an adjunct
professor in the departments of Psychiatry at                             Nancy Albus
St. Louis University School of Medicine. Over                             M.Ed., L.P.C.
the past 25 years, Dr. Schwartz has achieved                              Program Director
international recognition for his contribu-
                                                                           Nancy earned her Master
tions in a variety of clinical arenas including
                                                                           of Arts degree in Counsel-
the treatment of intimacy disorders, marital
                                                                           ing from the University of
and sexual dysfunction, sexual compulsivity,
                                                                           Missouri-St. Louis. She is
sexual trauma and eating disorders. He lectures
                                                     a licensed Professional Counselor and trained
nationally and internationally on these topics
                                                     in Internal Family Systems. In addition to her
and has authored numerous articles and book
                                                     interest in eating disorders, Nancy works with
chapters, as well as the books, Sexual Abuse
                                                     femininity and sexuality issues, including facili-
and Eating Disorders and Sexual Compulsive
                                                     tating the Femininity and Sexuality group in
Behavior, Sex and Gender. Dr. Schwartz is cur-
                                                     Residential Treatment. Nancy joined
rently on the Editorial Board of the Journal of
                                                     Castlewood in 2002 as a therapist and is also
Eating Disorders.
                                                     the program director for the treatment center.
Theresa Chesnut                                     Samantha Young
                     M.S.W., L.C.S.W.                                    M.Ed., L.P.C.
                     Therapist                                           Intake Coordinator/
                                                                         Therapist
                      Theresa initially earned
                      her undergraduate degree                           Samantha Young earned
                      in Family Life and Com-                            a Masters of Science
                      munity Services from                               Degree in Counseling
Kansas State University and later completed          from Missouri Baptist University. She is a
her graduate degree in Clinical Social Work at       Licensed Professional Counselor and is trained
the University of Kansas. Theresa has been           in Internal Family Systems, Dialectical Be-
on staff at Castlewood since 2000 and has held       havioral Therapy and EMDR. Samantha has
various positions: Primary Therapist, Program        worked at Castlewood Treatment Center since
Director and currently as the Marketing Direc-       2002 working with trauma and eating disorders.
tor. Theresa has also been on staff for the
Menninger Clinic and she has over 15 years                               Deborah Hinds, D.T.R.
experience in lecturing on college campuses                              Nutritionist
and to psychiatric professionals about the signs,
symptoms and prevention of eating disorders.                               Deborah earned her de-
Currently, her area of research, focus and                                 gree in Dietetic Technolo-
lecturing is on the recovery process and various                           gy with an emphasis in Nu-
intervention strategies as well as providing In-                           tritional Care at Florissant
services for elite athletes, coaches and trainers.                         Valley College in Missouri.
                                                     She is a registered and licensed Dietetic Tech-
                    James Gerber                     nician in the State of Missouri, and has experi-
                                                     ence in clinical nutrition, outpatient counseling,
                    M.A, A.T.R., Ph.D.
                                                     mental health, and facilitating groups on eating
                    Therapist
                                                     disorders and addiction. Deborah is trained
                     Dr. Gerber earned a             in the Internal Family Systems Model and has
                     Masters Degree in Art           exclusively treated individuals with eating dis-
                     Therapy/Counseling at           order for nearly 10 years. Deborah works with
                     Southern Illinois University,   residential, intensive outpatient, and outpatient
Edwardsville. He earned his Ph.D. at Saint           clients to develop custom meal plans and to
Louis University in Counseling and Family            provide grocery shopping assistance and nutri-
Therapy. Dr. Gerber has worked extensively           tional counseling.
with adults and adolescents in a variety of
clinical areas including sexual/marital dysfunc-
tion, family therapy, sexual abuse, trauma and
compulsivity. He has published and presented
papers on sexual aggression, sexual abuse and
trauma.
Anna M. Jurec, M.D.
                        Psychiatrist
                     Anna M. Jurec, M.D.
                     graduated from Medical Uni-
                     versity in Gdansk, Poland and
                     completed her Psychiatry
                     Residency Program at Saint
Louis University Department of Neurology and
Psychiatry. She has been a member of the Ameri-




                                                              ‘‘
can Psychiatric Association since 2004. She is cur-
rently working as a full time psychiatrist at Castle-
wood Residential Treatment Center. She is also a
                                                                   We chose Castlewood very carefully.
consultant with Places for People – a non-profit
organization in St. Louis, treating severely and                   When my daughter started I had
persistently mentally ill patients.
                                                                   hope, bits of optimism, and of course
“I enjoy helping to bring out the potential of the human           some relief in seeing her downward
mind in those affected by mental illness. I strive to treat
the patient as an integral combination of body, mind and           spiral arrested. Almost a month later
spirit and to allow patients to choose the best individual
treatment based on scientific and clinical evidence.               I still felt those same things, but my
My particular professional interests are directed toward
                                                                   daughter was voicing some optimism
psychosomatic medicine (eating disorders in particular,)
as well as mood and anxiety disorders.”                            of her own. The degree to which the

                        Iness Panni, RN, MSN                       staff blend their roles/results/
                        Nurse Manager                              perspectives, etc. for each client,
                       Iness earned a Bachelor’s                   including my daughter, is what
                       Degree in nursing from
                       Avila University and a                      returned her to life, and life to her.
                       master’s degree in nursing
                       from University of Kansas.                  You were the reason she believed she
Iness Panni has worked with eating disorders
and addictions for over 25 years. She brings
a special sensitivity to the medical, physical,
emotional, psychological, social, and spiritual
aspects involved in the complexity of treating
                                                                   might, then could, then would make‘‘
                                                                   it: and the strength she “borrowed”
                                                                   when hers wasn’t quite there.
eating disorders. As Nurse Manager of
Castlewood Treatment Center since 2002,
Iness provides a holistic oversight of the care                                                          – DM
and well being of each client.
why castlewood
 castlewood
  why
    A small Residential community
    fosters greater participation
    and affords more individualized
    treatment planning and care within




                                                 Why Castlewood
    a strong, cohesive therapeutic milieu.
    Castlewood is located just 25 minutes
    from St. Louis Lambert International
    Airport. In addition to state-of-the-
    art care, our facility, set in a tranquil,
    secluded environment, is a testimonial
    to the healing inherent in nature’s
    ever-renewing beauty.
‘‘   Unlike so many treatment centers, Castlewood
     helps clients heal the pain that underlies their
     eating disorders rather than just manage the
     symptoms. The place is beautiful, not just in
     it’s physical setting, but also in the compassionate
     way the staff views and relates to the clients.
     I wish I could send them all my traumatized
     clients, not just those with eating disorders.
                                                         ‘‘
                                  – RiChaRd C. sChwaRtz, Ph.d.
                     Developer of the Internal Family Systems model.
WHY CHOOSE CASTLEWOOD TREATMENT CENTER?
1. we are small.                                          6. we provide a full continuum of care.
   Only ten clients in-house with 33 staff permits           We have found that almost all clients slip fol-
   highly individualized intensive treatment. We             lowing the support and safety of the in-house
   provide a great deal of support at the table and          program. To allow clients more freedom and
   have locked access to food.                               independence to practice recovery and rebound
                                                             from the inevitable slips we began a Stepdown
2. we individualize care.
                                                             Program. It is a supportive environment where
   Whether you have obsessive-compulsive disor-
                                                             clients receive support from peers, implement
   der, body dysmorphic disorder, social anxiety
                                                             relapse prevention plans and continue with his/
   disorder, major depression, multiple addictions
                                                             her individual therapy. We can further step a
   or dissociative disorder, we provide specific treat-
                                                             client down to Partial Hospitalization or the
   ment for the eating disorder as well as these
                                                             Intensive Outpatient Program to provide a full
   often concurrent issues.
                                                             spectrum of recovery experiences alongside
3. we specialize in                                          reintegration into daily life and activities.
   trauma-resolution therapies.
                                                          7. we encourage family involvement
   For clients with a history of childhood or adult
                                                             whenever appropriate and possible.
   trauma, we offer state of the art therapies for
                                                             We schedule family weekends every 6-8 weeks,
   resolution of experiences that were overwhelm-
                                                             which involves the clients inviting all interested
   ing. Trauma may consist of a one time incident
                                                             family members to 3 days of group and indi-
   that led to Post Traumatic Stress symptoms, or a
                                                             vidualized treatment. Additional individualized
   series of developmentally prevalent occurrences
                                                             family therapy and couples therapy with spouses
   that generated avoidance, constriction or reen-
                                                             or significant others are scheduled between
   actment phenomena.
                                                             Family Weekends as well, as it seems contribu-
4. we utilize internal Family systems                        tory to the client’s overall treatment goals.
   therapy.
                                                          8. we create a safe environment.
   All of our therapy staff have had training in
                                                             People with bulimia,binge eating disorder and/
   Internal Family Systems therapy which allows
                                                             or anorexia, are constantly punishing themselves
   us to work as a team to understand the contex-
                                                             internally with negative self talk. When working
   tual function of the individual’s eating disorder
                                                             towards recovery,one needs people who under-
   symptoms in order to help each client discover
                                                             stand this phenomenon and offer reflection with
   truly viable alternative survival strategies.
                                                             compassion rather than criticism.
5. our focus is more than simply
   re-feeding or control of symptoms.
   Our goal is to help launch a person in his/her
   development toward a full life. This includes
   support to transition to or re-enter college, job
   and relationship.
For the Professional
Castlewood utilizes an evidence-based approach with 1-year follow-up with
all clients. We have found that treatment effectiveness is highly dependent on:

1. Bringing the client from a premotivational        5. Keeping a strong focus on food-related behav-
   to a motivational state.                             ior and establishing control over out of control
                                                        behavior, but not as part of a “good girl” over-
2. Assessing psychiatric co-morbidity including
                                                        compliancy but rather with a “real self,” honest
   OCD, social anxiety, body dysmorphia,
                                                        and nonreactive stance toward relationships.
   co-addiction, post-traumatic stress disorder,
   and dissociaton.                                  6. Looking for the deeper function of the symp-
                                                        toms. There are good reasons each client de-
3. Working with pertinent family dynamics,
                                                        velops an eating disorder. We don’t “get rid of ”
   burdens the family carries intergenerationally
                                                        the eating disorder, but instead help integrate a
   that manifest in: over-control, over-indulgent
                                                        stronger self that no longer requires the illusion
   enmeshment, engulfment or other addictive
                                                        of control that comes from engagement in the
   and secretive dynamics. Often, we need to
                                                        eating disorder.
   have the entire family in for intensive work.
                                                     7. Integration. Our therapists and Treatment
4. Couples work. A spouse, if not brought on
                                                        Team will involve the referring therapist in the
   board to what will be necessary to continue the
                                                        treatment and recovery process. Let us know
   recovery process, can unravel a great deal of
                                                        how you would like to be kept updated on
   even the most effective in-residence work.
                                                        your clients treatment and progress and we
                                                        will provide you with the clinical information.

                                                     8. Addressing body image difficulties in both
                                                        group therapy and in individual therapy through
                                                        sensory exercises and experiential therapy.
                                                        Clinicians help clients move toward connecting
                                                        with his/her body and help them learn how to
                                                        tolerate the connection.

                                                     9. Finally, a powerful relationship with the
                                                        primary therapist and nutritionist, that
                                                        allows for sufficient trust to incrementally
                                                        let go of the eating disorder.
We invite you to compare program quality and costs and to call us
for a telephone or in-person assessment and tour. Our intake coordinator,
Samantha Young, can be reached at 1-888-822-8938.




                                   800 Holland Road
                                   St. Louis, MO 63021

                                   636-386-6611 phone
                                   636-386-6622 fax
                                   888-822-8938 toll-free

                                   www.castlewoodtc.com
800 Holland Road
  St. Louis, MO 63021

  phone 636.386.6611
toll-free 888-822-8938
      fax 636-386-6622

www.castlewoodtc.com

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Eating Disorder Treatment

  • 1. In the middle of the country, on the bluffs overlooking a gently flowing river, nestled against forested parkland, is a treatment center unlike any other… St. Louis, Missouri 636-386-6611 | 888-822-8938 www.castlewoodtc.com
  • 2. Castlewood Treatment Center is a creative collaboration of the owners’ clinical experience and personal and professional evolution. The result is a residential treatment program for eating disorders that allows for the unique treatment of each individual with an emphasis on compassion, respect and empowerment.
  • 3. Our vision required that the structure itself be beautiful, unique, and natural, blending harmoniously with its surroundings. Most of all, it had to have the ambiance of a healing community, a sanctuary. After years of searching, we discovered this secluded gem, high on a ridge, overlooking endless acres of state woodlands and the scenic Meramec River.
  • 4. Men and women who AN EATING DISORDER is both originated and maintained by a constellation of factors. come to Castlewood For each client, every step of the way, we are continually inquiring as a treatment team and are not anorexic; they are in collaboration with the client: what are the necessary and sufficient components of treat- not bulimic; they are not ment needed to restore this person, not only to decreased symptoms, but to a life that is both compulsive overeaters. live-able and worth living? At Castlewood we begin In addition to the eating disorder, some clients with the premise that have psychiatric diagnoses; some have multiple addictions and some have a history of severe each person who walks childhood traumas. Some clients will see a specialist for adjunctive therapy, such as seeing through our doors defies our anxiety specialist if needed, in addition to their primary therapist. Whatever is required simple categorization. to help the client, we attempt to provide. Though we naturally wish to restore our clients When new clients arrive at Castlewood we to health and functionality as efficiently as never know how his/her treatment will end possible, we do not place a 30 or 60-day time up looking, because therapeutic strategies limit on our residents’ stays. Our mission is not evolve as we get to know them and identify the merely to churn out weight-restored women pertinent factors that are contributory to the or men who look healthy to others, but whose issues they present. Clients say this flexibility internal wounds, if unaddressed, will readily distinguishes Castlewood from prior treatments result in relapse. Experience has taught us that and often constitutes the difference that allows the full measure of health rests upon more their recovery efforts to at last succeed. than a temporary absence of symptoms. Castlewood therefore provides an individualized treatment approach tailored to meet the precise needs of each client. We understand that eating disorder clients tend to be more different than similar. This is why at Castlewood, each client’s treatment plan is highly individualized.
  • 5. Eating Disorders eating disorders Eating Disorders Eating Disorders constitute the most life-threatening category of mental health issues.
  • 6. Eating disorders often occur along with the compounding and further debilitating symptoms of depression, anxiety, addiction (to drugs or alcohol), perfectionism, and stress response syndromes. Family and friends may find aspects of the eating disorder perplexing in the tenacity of the hold it exerts on their loved one, the sufferer’s lack of awareness of their degree of debilitation over time, and the deception that can begin to enter once-honest relationships.
  • 7. WHAT CAUSES EATING DISORDER? Eating Disorder can result Once the eating disorder takes hold as a “survival strategy” of sorts, it can begin to take as a symptom of many on a life of its own, as a recourse from, while simultaneously a perpetuator of, anxiety and different syndromes with many isolation. As the illness progresses, various types of disequilibrium occur in mind and body, developmental pathways. which cyclically, cause the individual to rely more heavily on the eating disorder symptoms For some clients, there is fear of growing up to maintain an illusory sense of stability amidst and assuming adult responsibilities. For others, the increasing chaos. As the cycle of the eating external functioning seems great while inside, disorder continues, habituation results, as in they are confused, distressed and need a any addiction, and it takes more of the same symptom to yell: help! Some become trapped behavior to achieve the desired effect of feeling in the role of pleasing others, perfectionism, temporarily o.k. – more restriction, more food, and being the “good child” For some clients, . more binging and purging, diet pills, laxatives, there was a major loss during childhood, such exercise, etc. as a mother with post-partum depression or other experiences of separation from a key When reliance on the eating disorder is discon- loved one. Others have experienced tremen- tinued, a client’s whole world can feel upside- dous pain in their social interactions in school down, out-of-control and initially, impossible to or with peers that has led to an ongoing sense manage. This unfortunate, yet understandable of anxiety and isolation. Some clients’ families predicament is what Castlewood exists to address. are themselves disengaged, without sufficient Our goal is to provide a container for the initial emotional connections, or shame-based with and inevitable distress, to provide the support of many intergenerational secrets and/or layers community, in lieu of that seemingly provided of unresolved intergenerational trauma. Some by the eating disorder, and to assist the client to are enmeshed, without appropriate boundaries, learn and re-learn the skills necessary to stabilize resulting in overindulged children who get and rebuild their lives. things rather than parenting. Some clients have perfect families, in appearance, and feel over- whelmed because they cannot live up to the parents’ perceived achievements or expectations.
  • 8. Core Symptoms • Weight loss or gain with endocrine or metabolic abnormalities • Fat phobia/food phobia • Rituals around body checking, exercise and food • Purging (undoing and punishing) by fasting, vomiting, diuretics and exercise • Dissociation/lack of autonomy from craving and rituals/addiction • Body dissatisfaction, body image distortion • Binge eating, secretive eating, hoarding and stealing food • Chewing and spitting food as an attempt to control weight • Taking in excessive amounts of fluid or restricting fluid intake • Use or abuse of diet pills, herbal supplements or teas • Increased isolation, spending less and less time with family and friends • Refusing or avoiding eating with family and friends
  • 9. treatment Treatment components Components Castlewood Treatment Center offers comprehensive and highly individualized treatment planning. The program is specifically designed to treat all types of eating disorders as well as co-existing disorders, including trauma, addictions, body dysmorphia, self-harm and other frequently co-occurring issues.
  • 10. Our therapy begins with a solid individual relationship with the primary therapist, psychiatrist and our nutritionist. EACH CLIENT RECEIVES: • A total of six sessions weekly with skilled and experienced clinicians. • Daily work with Dr. Mark Schwartz, and Lori Galperin, each nationally known for their clinical expertise, workshops and publications on eating disorder, childhood trauma and addictions. • Four individual sessions per week with the primary therapist. • A weekly session with his/her nutritionist who eats meals with clients. Working with a qualified • A weekly session with our psychiatrist. nutritionist, who has a solid • A small, well-chosen therapeutic community. background in eating disorders is • Levels of care that allow for increasing the cornerstone of our program. autonomy with continuing support Our residential nutritionist is a • Excellent aftercare programming, including follow-up visits offered at Castlewood. former eating disorder client herself and understands the Castlewood maintains a high staff-to- process as only someone who patient ratio providing for greater has been through the recovery individualized care. Many of our clients have had treatment at other programs process can. and have found recovery at Castlewood.
  • 11. residential treatment residential Residential Our Residential level of care is designed for stabilization and restoration of healthy eating habits. At the Residential level, we work to establish and foster a therapeutic community that can allow each client to feel supported and to work on building social connections while establishing a stronger sense of self.
  • 12. The Residential program only has a maximum of 10 clients. Each client sees his/her primary therapist four times a week as well as having weekly sessions with the dietician and the psychiatrist. The program itself consists of 40 hours of group therapy. Staff is on site 24/7. Each bedroom is attractive, uniquely decorated and has its own en suite bathroom. There are no more than two clients to a bedroom. Community space is likewise comfortable and inviting with inspiring views.
  • 13. Residential Program Weekly Schedule Monday Thursday 7:30 – 8:00 Breakfast 7:30 – 8:00 Breakfast 8:30 – 10:30 Core Group Weekend Check-in & Goals 8:15 – 9:15 Process Group 10:30 – 11:00 Snack 9:30 – 10:30 Core Group 11:00 – 12:15 Core Group II 10:30 – 11:00 Snack 12:30 – 1:15 Lunch & Post Meal 11:00 – 12:00 Core Group II 1:30 – 3:00 Eating Disorder Group 12:30 – 1:30 Chef ’s Choice 3:00 – 3:30 Snack 1:30 – 2:30 Pilates 3:30 – 4:30 Yoga Group 3:00 – 3:30 Snack 4:30 – 6:00 Individual Sessions/Free Time 3:30 – 4:30 Cognitive Group 6:15 – 7:00 Dinner & Post Meal 4:30 – 6:00 Individual Sessions/Free Time Compulsory Play 6:15 – 7:00 Dinner & Post Meal 9:00 – 9:30 Snack Free Time 9:00 – 9:30 Snack Tuesday 7:30 – 8:00 Breakfast Friday 8:30 – 10:00 Core Group 7:30 – 8:00 Breakfast 10:00 – 10:30 Snack 8:30 – 10:00 Core Group 10:30 – 12:00 Movement Group 10:00 – 10:30 Snack 12:30 – 1:15 Lunch & Post Meal 10:30 – 12:15 Eating Disorder Group 1:30 – 3:00 Expressive Therapy 12:30 – 1:30 Lunch & Post Meal 3:00 – 3:30 Snack 1:30 – 2:30 Body Image 3:30 – 4:30 DBT Group 2:30 – 3:00 Snack 4:30 – 6:00 Individual Sessions/Free Time 3:00 – 4:30 Art Therapy 6:15 – 7:00 Dinner & Post Meal 5:30 – 6:15 Dinner & Post Meal 7:15 – 8:15 Pre-Contract Movie Outing 9:00 – 9:30 Snack 9:00 – 9:30 Snack Wednesday Saturday 7:30 – 8:00 Breakfast 7:30 – 8:00 Breakfast 8:15 – 9:15 Eating Disorder Expressive Group 8:15 – 9:30 Individual Sessions/Free Time 9:15 – 9:45 Menu Group 9:30 – 10:30 Gender Sexuality Intimacy & Relationships 9:45 – 10:30 Nutrition Group 10:30 – 11:00 Snack 11:00 – 12:00 Treatment Module 11:00 – 12:00 Literary Interpretation/Shame Group 12:30 – 1:15 Lunch & Post Meal 12:30 – 1:15 Lunch & Post Meal 1:30 – 2:30 Sexual Healing or Containment Outing & Visitors 2:30 – 3:00 Snack Free Time 3:00 – 4:00 Eating Disorder Group 9:00 – 9:30 Snack 4:00 – 5:00 Relapse Prevention 5:00 – 6:00 Individual Sessions/Free Time Sunday 6:15 – 7:00 Dinner & Post Meal Compulsory Play 7:30 – 8:00 Breakfast 9:00 – 9:30 Snack 8:00 – 10:30 Individual Sessions/Free Time 10:30 – 11:00 Snack 11:00 – 12:15 Music Therapy 12:30 – 1:15 Lunch & Post Meal Visitors & Passes 5:00 – 6:00 Addictions Group 6:15 – 7:00 Restaurant Outing or Family Style Meal Free Time 9:00 – 9:30 Snack
  • 14. ‘‘ The people at Castlewood Treatment Center saved my life. But they did more than that. They opened up my eyes to what life is all about, to all that I have to look forward to. I came in closed off from the world. The people here helped me find my strength. They didn’t just give me wings, they helped me find my own, and let me realize that I had the power to fly inside me all the time. ‘‘ I’m not just alive today because of the people here, but I’m actually living life as well. – MB
  • 15. stepdown stepdown Our Step Down program is usually a transition from residential care. Stepdown
  • 16. The Stepdown program focuses less on stabili- Again, this program is tailored to fit the indi- zation and more on practice, with an emphasis vidual’s situation. Some clients in Stepdown, will on acquiring the necessary life skills to facilitate begin to work a certain number of hours, some long-term recovery. Coping skills and healthy to attend academic courses or to volunteer with eating habits learned in residential are built local agencies or organizations. Learning upon and tried out in circumstances more to sustain a balanced lifestyle that includes: closely resembling what clients will encounter appropriate nutrition, work or school, supportive post treatment. There is greater autonomy, relationships, recreational activities and self-care encouragement of self responsibility, yet with simultaneously, is often a foreign concept con- help, support, guidance and community. trasted with how clients were functioning prior to treatment. The more opportunity to practice in We understand that each new phase in a client’s this manner, the greater the odds for a sustained recovery process entails novel challenges. We recovery post discharge. endeavor to provide the feedback, opportunities, support and skill-building necessary to navigate During the Stepdown phase, a meal and exer- each sequential hurdle. Our Stepdown nutritionist cise plan is developed for the individual client has successfully helped hundreds of clients nav- by the nutritionist with client input and goals igate the pitfalls of eating in “the real world.” considered. Clients frequently say that our dietician and nutritionist are the BEST they’ve ever worked with. We consider this a supreme compliment and a variable that makes the process of recovery so much smoother!
  • 17. day treatment treatment day Castlewood offers a full spectrum of care. Our Day Treatment program is open to clients living in or around the St. Louis area who require more than outpatient treatment but who may be able to meet his/her treatment goals without a residential stay. Day Treatment
  • 18. Day Treatment In order to achieve a level of stabilization and symptom reduction, some clients require a level of care beyond outpatient. Our Day Treatment program is provided for clients living in or around the St. Louis area who can commute to treatment and for whom an overnight stay is not a necessary treatment component. The program is available on either a 5- or 7-day basis. Clients become part of the therapeutic community and participate in all residential groups and programming. Depending upon whether in the 5 or 7 day version, clients receive 3-4 individual sessions with the primary therapist, one with the psychiatrist and one with his/her dietician weekly. Day Treatment is often the treatment of choice when a program of intensive outpatient care has not been adequate in effectively assisting the client to reach and/or maintain treatment goals.
  • 19. Outpatient Intensive intensive IOP outpatient (intensive outpatient program) Our IOP Program is for clients needing more structure than individual outpatient therapy alone can provide or for the client who is transitioning back to life, work or school after treatment at a higher level of care, such as Residential or Stepdown.
  • 20. Castlewood’s IOP Program consists of both group and individual therapy held four evenings each week. A supervised meal also comprises one facet of each evening’s programming. For motivated and less severely compromised clients, IOP may be the treatment of choice. There are four types of groups offered in the program. Castlewood Treatment Center offers a complete menu of outpatient services with expert individual therapists for eating disorders, nutritional counseling, marital and relational therapy and trauma-resolution therapy. For more information please call: 1-888-822-8938.
  • 21. SKILLS GROUP The SKILLS GROUP is a structural psycho- educational group that provides clients with practical skills for coping with challenges and helps create alternative strategies to reliance on the eating disorder symptoms. Instead of binging and purging, utilization of self-sooth- ing, distraction, and problem solving. Instead of restricting, patients examine unhealthy thought processes, body image distortion and underlying feelings and needs. Clients are taught to use their voice rather than symptoms Castlewood Program Coordinators (from left to right) to communicate internal states and to facilitate Amy Kayda – IOP Coordinator & Therapist problem solving, communication and to devel- Emily Williams – Step Down Coordinator & Therapist op relationship skills and resources. The groups Deanna James – Assistant Program Director & Therapist focus on body acceptance, behavior therapy, enhancing motivation, diminishing anxiety, appropriate nutrition, mindfulness, spirituality MEAL PROCESS GROUP and self care. In the MEAL PROCESS group, individuals are helped to recognize hunger and fullness, to GENERAL PROCESS GROUPS learn to prepare or portion satisfying meals with variety, nutrition and in appropriate servings. The PROCESS GROUP allows an opportunity The therapists eat with the clients, and clients to discuss emotions and underlying dynamics are challenged and supported to confront their that maintain eating-disorder symptoms. Feed- anxiety incrementally. back from group members, particularly those farther along or those who have had similar experiences is useful. Assignments are often given EXPERIENTIAL GROUP to lend focus and assist clients in identification In EXPERIENTIAL GROUP, clients deal and exploration of symptom-maintaining cir- directly with circumstances or situations having cumstances and issues. to do with body, movement and strong emotions. Clients often say these types of groups are the most challenging, but also the most useful. Clients may role play difficult situations to pro- vide insight and mastery. Through behavioral rehearsals, clients lessen anxiety and increase efficacy in dealing with new or challenging situations they face.
  • 22. The groups were… SUPPORT GROUP vital to my recovery. ‘‘ Castlewood sponsors a free weekly sup- port group for people in recovery from Anorexia Nervosa, Bulimia and Binge From the very first day I was warmly Eating Disorder. The group is open to welcomed and though terrified I found anyone regardless of stage of recovery. The purpose of the group is to establish support. The groups were extremely a safe, reliable setting that emphasizes difficult but vital to my recovery. I positive aspects of recovery. The format formed friendships on a level I had offers time for participants to briefly check in about the week, followed by an never experienced before and found hope open discussion that focuses on various that had been covered by layers of fear. issues or topics that are common during I can’t begin to explain the care that the recovery process. Examples include: relapse prevention, negotiating boundaries, the staff at Castlewood had for me. At and utilizing healthy coping tools. Par- times it was overwhelming to think that ticipation in support group requires that the individual be engaged in outpatient anyone could care that much. From my therapy, as the support group is not in- relentless and kind therapist that helped tended to replace on-going therapy or as a me through my most difficult days, the stand-alone form of support. Castlewood welcomes inquiries by both clients and psychiatrist that respected my every therapists about appropriateness of the boundary, the directors who’s intuition Support Group for you or for your client. still amazes me today, the staff who’s Information about the Support Group is available from Nancy Albus at safety I remember when I was strug- 636-386-6611. gling the most, and let’s not forget the dieticians that I would have never imagined to be my biggest allies. With all of that, the structure of filled days of groups, the focus on the fear and ‘‘ trauma that was fueling my behaviors, and the many levels of step down I found my path to recovery. And most importantly I found myself.
  • 23. trauma Resolution Trauma resolution trauma resolution therapies Clients need to return to the root of “what happened”…
  • 24. With one foot in the present and one foot in the past, the client re-examines the memories, re-associates the emotions, and changes the trauma-based or childhood attributions used to make meaning of the experience at the time to an adult perspective of enhanced clarity, wisdom and compassion. The event no longer exerts the same influence over behavior, choices and sense of self it did previously.
  • 25. Unresolved experiences of child sexual abuse or rape, for example, will almost always result in symptoms. Where traumatically-originating symptoms prevail or complicate the individual’s ability to achieve a fuller recovery, therapies such as EMDR, Attachment-based Psychotherapy or Internal Family Systems therapy can be utilized to facilitate and speed up the necessary shifts in processing once some degree of safety, containment and stabilization exist. EMDR Attachment-based Clients who have suffered for years from anxiety PSYCHOTHERAPY or distressing memories, nightmares, insomnia, When a client has experienced early attachment abuse or other traumatic events can often deficits with their caretakers in the first few years gain relief from a revolutionary therapy called of life due to sensory hyperactivity or parental EMDR (Eye Movement Desensitization Repro- unavailability, they will evidence attachment dis- cessing). Research shows that EMDR is rapid, orders later in life. They will become dismissive safe and effective. EMDR does not involve of, or preoccupied with, securing love. So often, the use of drugs or hypnosis. It is a simple, eating disorder results from a hunger for love, non-invasive patient-therapist collaboration and the person is either too afraid to seek love in which healing can happen effectively. This (dismissive) or approaches partners with a binge powerful short-term therapy is highly effective mentality (preoccupied), or both (disorganized). for a wide range of disorders including chronic Castlewood utilizes directive interventions to pain, phobias, depression, panic attacks, eating work with attachment difficulties. disorders and poor self-image, stress, worry, stage fright, performance anxiety, recovery from sexual abuse and traumatic incidents.
  • 26. INTERNAL FAMILY SYSTEMS THERAPY Internal Family Systems (IFS) therapy is a therapy that is very applicable to clients who have complex traumatic stress disorders and allows for a reworking of those experiences with one foot in the present, and one foot in the past. IFS has in common with Ego State therapies the idea that each individual has multiple selves or self-states. IFS, like Ego State therapies, is predicated on the notion that having self-states, (generally referred to as “parts”) is not (solely) a function of a dissociative process in need of therapeutic correction, but rather the normative state of all human beings. Working with these parts can be a very efficient and potent method of resolving past events and freeing the indi- vidual to rely more fully on his/her own innate capacities for change, growth and healing. RICHARD C. SCHWARTz, Ph.D., the originator of Internal Family Systems Therapy, is integral to Castlewood in both his training of our staff and as a clinical consultant.
  • 27. castlewoodstaff castlewood staff Staff The staff at Castlewood is passionate. Their skill and dedication are surpassed only by their compassion for the hard work involved in each client’s process of recovery.
  • 28. Our therapists include highly trained Lori Galperin M.S.W., L.C.S.W. master- and doctoral-level professionals Clinical Co-Director with numerous specialties who are Ms. Galperin initially unequivocally committed to helping earned her undergraduate degree in Psychology and people heal. They understand the later completed her gradu- obsessive, often labyrinthine thought ate degree in Clinical Social Work at Tulane University. She is an accomplished contributor processes that create and maintain our in the fields of marital and sexual dysfunction, clients’ cognitive distortions. sexual compulsivity, sexual trauma, dissociative and eating disorders, lecturing nationally and internationally on these topics. She has au- thored various journal articles and book chapters, is trained in Clinical Hypnosis, Mark Schwartz, Sc.D. EMDR, Internal Family Systems, Expressive Clinical Co-Director and Attachment-based therapies. Over the Mark earned his doctorate past 22 years Ms. Galperin has treated several in Psychology and Mental thousand inpatients and trained more than Health from Johns Hopkins 100,000 clinicians throughout the United University. He is a licensed States, Canada and Europe. psychologist and an adjunct professor in the departments of Psychiatry at Nancy Albus St. Louis University School of Medicine. Over M.Ed., L.P.C. the past 25 years, Dr. Schwartz has achieved Program Director international recognition for his contribu- Nancy earned her Master tions in a variety of clinical arenas including of Arts degree in Counsel- the treatment of intimacy disorders, marital ing from the University of and sexual dysfunction, sexual compulsivity, Missouri-St. Louis. She is sexual trauma and eating disorders. He lectures a licensed Professional Counselor and trained nationally and internationally on these topics in Internal Family Systems. In addition to her and has authored numerous articles and book interest in eating disorders, Nancy works with chapters, as well as the books, Sexual Abuse femininity and sexuality issues, including facili- and Eating Disorders and Sexual Compulsive tating the Femininity and Sexuality group in Behavior, Sex and Gender. Dr. Schwartz is cur- Residential Treatment. Nancy joined rently on the Editorial Board of the Journal of Castlewood in 2002 as a therapist and is also Eating Disorders. the program director for the treatment center.
  • 29. Theresa Chesnut Samantha Young M.S.W., L.C.S.W. M.Ed., L.P.C. Therapist Intake Coordinator/ Therapist Theresa initially earned her undergraduate degree Samantha Young earned in Family Life and Com- a Masters of Science munity Services from Degree in Counseling Kansas State University and later completed from Missouri Baptist University. She is a her graduate degree in Clinical Social Work at Licensed Professional Counselor and is trained the University of Kansas. Theresa has been in Internal Family Systems, Dialectical Be- on staff at Castlewood since 2000 and has held havioral Therapy and EMDR. Samantha has various positions: Primary Therapist, Program worked at Castlewood Treatment Center since Director and currently as the Marketing Direc- 2002 working with trauma and eating disorders. tor. Theresa has also been on staff for the Menninger Clinic and she has over 15 years Deborah Hinds, D.T.R. experience in lecturing on college campuses Nutritionist and to psychiatric professionals about the signs, symptoms and prevention of eating disorders. Deborah earned her de- Currently, her area of research, focus and gree in Dietetic Technolo- lecturing is on the recovery process and various gy with an emphasis in Nu- intervention strategies as well as providing In- tritional Care at Florissant services for elite athletes, coaches and trainers. Valley College in Missouri. She is a registered and licensed Dietetic Tech- James Gerber nician in the State of Missouri, and has experi- ence in clinical nutrition, outpatient counseling, M.A, A.T.R., Ph.D. mental health, and facilitating groups on eating Therapist disorders and addiction. Deborah is trained Dr. Gerber earned a in the Internal Family Systems Model and has Masters Degree in Art exclusively treated individuals with eating dis- Therapy/Counseling at order for nearly 10 years. Deborah works with Southern Illinois University, residential, intensive outpatient, and outpatient Edwardsville. He earned his Ph.D. at Saint clients to develop custom meal plans and to Louis University in Counseling and Family provide grocery shopping assistance and nutri- Therapy. Dr. Gerber has worked extensively tional counseling. with adults and adolescents in a variety of clinical areas including sexual/marital dysfunc- tion, family therapy, sexual abuse, trauma and compulsivity. He has published and presented papers on sexual aggression, sexual abuse and trauma.
  • 30. Anna M. Jurec, M.D. Psychiatrist Anna M. Jurec, M.D. graduated from Medical Uni- versity in Gdansk, Poland and completed her Psychiatry Residency Program at Saint Louis University Department of Neurology and Psychiatry. She has been a member of the Ameri- ‘‘ can Psychiatric Association since 2004. She is cur- rently working as a full time psychiatrist at Castle- wood Residential Treatment Center. She is also a We chose Castlewood very carefully. consultant with Places for People – a non-profit organization in St. Louis, treating severely and When my daughter started I had persistently mentally ill patients. hope, bits of optimism, and of course “I enjoy helping to bring out the potential of the human some relief in seeing her downward mind in those affected by mental illness. I strive to treat the patient as an integral combination of body, mind and spiral arrested. Almost a month later spirit and to allow patients to choose the best individual treatment based on scientific and clinical evidence. I still felt those same things, but my My particular professional interests are directed toward daughter was voicing some optimism psychosomatic medicine (eating disorders in particular,) as well as mood and anxiety disorders.” of her own. The degree to which the Iness Panni, RN, MSN staff blend their roles/results/ Nurse Manager perspectives, etc. for each client, Iness earned a Bachelor’s including my daughter, is what Degree in nursing from Avila University and a returned her to life, and life to her. master’s degree in nursing from University of Kansas. You were the reason she believed she Iness Panni has worked with eating disorders and addictions for over 25 years. She brings a special sensitivity to the medical, physical, emotional, psychological, social, and spiritual aspects involved in the complexity of treating might, then could, then would make‘‘ it: and the strength she “borrowed” when hers wasn’t quite there. eating disorders. As Nurse Manager of Castlewood Treatment Center since 2002, Iness provides a holistic oversight of the care – DM and well being of each client.
  • 31. why castlewood castlewood why A small Residential community fosters greater participation and affords more individualized treatment planning and care within Why Castlewood a strong, cohesive therapeutic milieu. Castlewood is located just 25 minutes from St. Louis Lambert International Airport. In addition to state-of-the- art care, our facility, set in a tranquil, secluded environment, is a testimonial to the healing inherent in nature’s ever-renewing beauty.
  • 32. ‘‘ Unlike so many treatment centers, Castlewood helps clients heal the pain that underlies their eating disorders rather than just manage the symptoms. The place is beautiful, not just in it’s physical setting, but also in the compassionate way the staff views and relates to the clients. I wish I could send them all my traumatized clients, not just those with eating disorders. ‘‘ – RiChaRd C. sChwaRtz, Ph.d. Developer of the Internal Family Systems model.
  • 33. WHY CHOOSE CASTLEWOOD TREATMENT CENTER? 1. we are small. 6. we provide a full continuum of care. Only ten clients in-house with 33 staff permits We have found that almost all clients slip fol- highly individualized intensive treatment. We lowing the support and safety of the in-house provide a great deal of support at the table and program. To allow clients more freedom and have locked access to food. independence to practice recovery and rebound from the inevitable slips we began a Stepdown 2. we individualize care. Program. It is a supportive environment where Whether you have obsessive-compulsive disor- clients receive support from peers, implement der, body dysmorphic disorder, social anxiety relapse prevention plans and continue with his/ disorder, major depression, multiple addictions her individual therapy. We can further step a or dissociative disorder, we provide specific treat- client down to Partial Hospitalization or the ment for the eating disorder as well as these Intensive Outpatient Program to provide a full often concurrent issues. spectrum of recovery experiences alongside 3. we specialize in reintegration into daily life and activities. trauma-resolution therapies. 7. we encourage family involvement For clients with a history of childhood or adult whenever appropriate and possible. trauma, we offer state of the art therapies for We schedule family weekends every 6-8 weeks, resolution of experiences that were overwhelm- which involves the clients inviting all interested ing. Trauma may consist of a one time incident family members to 3 days of group and indi- that led to Post Traumatic Stress symptoms, or a vidualized treatment. Additional individualized series of developmentally prevalent occurrences family therapy and couples therapy with spouses that generated avoidance, constriction or reen- or significant others are scheduled between actment phenomena. Family Weekends as well, as it seems contribu- 4. we utilize internal Family systems tory to the client’s overall treatment goals. therapy. 8. we create a safe environment. All of our therapy staff have had training in People with bulimia,binge eating disorder and/ Internal Family Systems therapy which allows or anorexia, are constantly punishing themselves us to work as a team to understand the contex- internally with negative self talk. When working tual function of the individual’s eating disorder towards recovery,one needs people who under- symptoms in order to help each client discover stand this phenomenon and offer reflection with truly viable alternative survival strategies. compassion rather than criticism. 5. our focus is more than simply re-feeding or control of symptoms. Our goal is to help launch a person in his/her development toward a full life. This includes support to transition to or re-enter college, job and relationship.
  • 34. For the Professional Castlewood utilizes an evidence-based approach with 1-year follow-up with all clients. We have found that treatment effectiveness is highly dependent on: 1. Bringing the client from a premotivational 5. Keeping a strong focus on food-related behav- to a motivational state. ior and establishing control over out of control behavior, but not as part of a “good girl” over- 2. Assessing psychiatric co-morbidity including compliancy but rather with a “real self,” honest OCD, social anxiety, body dysmorphia, and nonreactive stance toward relationships. co-addiction, post-traumatic stress disorder, and dissociaton. 6. Looking for the deeper function of the symp- toms. There are good reasons each client de- 3. Working with pertinent family dynamics, velops an eating disorder. We don’t “get rid of ” burdens the family carries intergenerationally the eating disorder, but instead help integrate a that manifest in: over-control, over-indulgent stronger self that no longer requires the illusion enmeshment, engulfment or other addictive of control that comes from engagement in the and secretive dynamics. Often, we need to eating disorder. have the entire family in for intensive work. 7. Integration. Our therapists and Treatment 4. Couples work. A spouse, if not brought on Team will involve the referring therapist in the board to what will be necessary to continue the treatment and recovery process. Let us know recovery process, can unravel a great deal of how you would like to be kept updated on even the most effective in-residence work. your clients treatment and progress and we will provide you with the clinical information. 8. Addressing body image difficulties in both group therapy and in individual therapy through sensory exercises and experiential therapy. Clinicians help clients move toward connecting with his/her body and help them learn how to tolerate the connection. 9. Finally, a powerful relationship with the primary therapist and nutritionist, that allows for sufficient trust to incrementally let go of the eating disorder.
  • 35. We invite you to compare program quality and costs and to call us for a telephone or in-person assessment and tour. Our intake coordinator, Samantha Young, can be reached at 1-888-822-8938. 800 Holland Road St. Louis, MO 63021 636-386-6611 phone 636-386-6622 fax 888-822-8938 toll-free www.castlewoodtc.com
  • 36. 800 Holland Road St. Louis, MO 63021 phone 636.386.6611 toll-free 888-822-8938 fax 636-386-6622 www.castlewoodtc.com