Sheppard Pratt

My take on it: Describe the average day: Wake up at like 6 or so for weights and vitals, showers, then chill out until breakfast at 8. then menu planning, groups, supplements at around 10 or so if needed, groups, lunch at 12, groups, supplements at 3 if needed, group or free time until dinner at 5, free time, snack at 8:30, then at 9 go back get ready for bed.

What were meals like? Depended on if you were on rehab or stabilization, but overall it was a balanced meal containing a protein, starch, vegetable, etc…

What sorts of food were available or served? It actually wasn’t too bad, most of the things weren’t gross or greasy. Had a lot of vegetables and fresh fruit, sandwiches, hot meals, etc

Did they supplement? How did that system work? yes for weight gain or if you didn’t eat your meals

What privileges are allowed? phones, outside

Does it work on a level system? nah

What sort of groups do they have? CBT, body image, movement, OT task, art, relationships

What was your favorite group? Didn’t really have one

What did you like the most? They actually new what they were doing

Would you recommend this program? yes

What level of activity or exercise was allowed? Very little except for movement group

What did people do on weekends? there was a lot of visiting hours but if you didn’t have a visitor they had a group or two and people would often get together and play things such as pictionary or something

Do you get to know your weight? kind of…the scales did not give you your weight in pounds..but you did get to see it unless you wanted a blind weight

How fast is the weight gain process? .2 kg per day

What was the average length of stay? depended on person..some like a week….some for months if that’s what they need

What was the average age range? all ages pretty much…just not really young kids I guess

When were you there? July 23 – August 11, 2008 Describe the average day: Wake up between 5:30 and 6 for vitals, weight, and shower. Go out to the main area at 7 and either sleep on a couch or watch the Today Show until breakfast at 8:15. Then meal planning, various groups, lunch at 12:15, more groups, dinner at 5:15, free time until snack at 8:30, another half-hour of free time, then back for “vanity” and bed at 9:30. Adults can go back out to the dayroom at 10, until 11, but adolescents have to go right to bed at 10.

What were meals like? Not bad! The first three days, you get standard trays; after that, you choose your own. During your first 3 days, you’ll meet with a dietitian who will explain the menus & meal plan to you. The meal plans are based on the food pyramid, which I liked because it’s simple – no need to figure out exchanges, just servings. The meals for the first 3 days SUCK, but somehow after that, it tastes better.

What sorts of food were available or served? This is one of my menus (I kept some for reference): breakfast: 2 scrambled eggs, wheat toast w\ butter, yogurt, grape juice, coffee w\ creamer & sugar lunch: baked ham, dinner roll w\ butter, chicken noodle soup w\ crackers, garden salad w\ dressing, sherbet, lemonade dinner: honey mustard chicken breast sandwich, green beans, pretzels, banana, ginger ale

Did they supplement? How did that system work? Supplements were given for not gaining weight (up to 4 per day), and as meal replacements if you didn’t finish (1 or 2, depending on how much you ate).

What privileges are allowed? “fresh air break” – aka a chance to go outside – if there is adequate staff and you aren’t on restriction. Um… idk what else. Privileges are based on weight gain. If you don’t make weight, you can’t shower, make phone calls, or go outside on that day, and if you don’t finish a meal, you can’t make calls or go outside until the next day.

Does it work on a level system? Not really.

What sort of groups do they have? CBT, Self-Esteem, Motivation to Change, Art Therapy, Movement Therapy, Occupational Therapy, Interpersonal Relationships, Family Dynamics. Also specialty groups such as Healthy Sports Managements, Substance Abuse, and Male ED’s, that meet once or twice a week.

What was your favorite group? OT Task Group! We made jewelry, picture frames, stress balls, and other stuff. Well, there were those options… I just made jewelry at every group.

What did you like the most? The staff. They are wonderful. I don’t know how long ago the people with negative experiences were there, but I just got back 2 days ago, and the current staff is amazing. They are so kind, and patient, and really seem to care about everyone. Everyone is assigned to a staff member every day – your “contact person,” who will check in with you at some point (well, they’re supposed to, but it doesn’t always happen; however, there is a list posted by the nurses’ station, so you can always find out who your contact is if you need them) to see how you’re doing, if you need to talk, etc. Your contact person is also who you go to if you have any questions or concerns, or just want to talk. I will agree with others that sometimes they are very focused on “the program,” which can be frustrating. I had issues because of this, but I was able to talk to my individual therapist about it, and she helped me work out my situation and find ways to help.

What did you like the least? That privileges are tied to weight gain. I didn’t need to gain, but I felt bad for those who did, and who ate 100% and followed all the rules, and were still restricted because of things beyond their control. I also think they tend to overmedicate. I was upset and crying one day, and a nurse asked me if I wanted a PRN. I said no, I don’t even have anything prescribed, and she offered to talk to my doctor and get something. I had to argue with her, and later with someone else, about why I didn’t want more meds. It struck me as very odd – I was trying to learn to experience emotions and deal with them, not drug them away. However, you have the right to refuse any medication. Also, I told my Doctor that I didn’t want my current med combination messed with, and other than one small change, she respected that.

Would you recommend this program? YES. However, I would more highly recommend it for someone who can do PHP as well as IP. The program is designed with the assumption that you’ll do both, and most people are only IP for 10-14 days. So the IP groups are super repetitive. The IP groups are veeerrrryyy basic CBT, mostly for education and motivation… you do a lot of identifying negative patterns, etc. Then in PHP groups you move on to actually changing things, and it’s more in-depth. I could only do IP because of my insurance, and sitting in the groups for 3 weeks, literally going over the same stuff EVERY time, got really old. Sometimes people who can’t do PHP are allowed to go to the PHP groups for their last week or so, but I couldn’t because my Doctor said I wasn’t ready. That was frustrating, because I felt like I wasn’t really being prepared to go home.

What level of activity or exercise was allowed? NONE. EVER. If you are standing up for too long, you’ll be told to sit down.

What did people do on weekends? There would be 2 groups, and the rest of the time everyone watches movies, plays games, sleeps, etc.

Do you get to know your weight? Yes, unless your Doctor doesn’t want you to.

How fast is the weight gain process? 0.2 kg/day.

What was the average length of stay? 10-14 days IP, then 2-3 weeks PHP.

What was the average age range? Probably late teens/early 20’s. The youngest when I was there was 12, and the oldest was in her 60’s, I think.


When were you there: October-December 2008

Describe the average day: wake up at 5:30/weights/vitals…showers if permitted, out in the milieu by 7, breakfast at 8, groups/school until lunch at 12, groups/free time until dinner at 5. free time until snack at 8. bedtime at 10 for minors and 11 for adults.

What were meals like? huge. no really. the meal plans are very un-individualized. there are only 2. basic and standard. basic is as follows: breakfast=dairy + 4 items lunch=sandwich + 3 items + caloric beverage dinner=protein+ 2 starchy side items + veggie + fruit or dessert + caloric bev. snack=1 item + caloric beverage standard: breakfast=dairy + 5 items lunch=sandwich + 4 items(one of the items is required to be a dessert) + caloric bev. dinner=protein + 2 starchy sides + veggie + dessert + extra item + caloric bev. snack=1 item + caloric bev. if you’re on basic and still gaining when you aren’t supposed to, they won’t change your meal plan. I’ve seen girls gain as much as 20 pounds over their ideal weight and they never adjusted it. the first day you don’t gain 1/2 pound, you’re bumped up to standard…and after that they just add ensures in between the meals.

What sorts of food were available or served? the food was really disgusting. typical hospital food. everything that was supposed to be hot was cold, juice was frozen, milk was expired half the time…it was bad.

Did they supplement? How did that system work? supplement was the same for meals regardless of what meal plan you were on…which really didn’t make sense. if you didn’t eat at all, you got 2 supplements, if you ate all of your sides but not your entree you still got 2 supplements, and if you ate the entree but not the sides, or just couldn’t finish all the sides in time, you got 1 supplement. they also used ensure plus on top on the regular meal plan for weight gain, if there was ever a day that you didn’t gain a 1/2 pound, they’d add another ensure plus, even if you’d gained like 2 pounds the day before.

What privileges are allowed? all privileges are tied to weight gain. if you don’t “make weight”, you can’t shower, talk on the phone, do laundry, have visitors, shave etc. if you DO gain 1/2 pound…you can. it has nothing to do with how well you are complying with the program though. if you are eating 100% of your meals and you happen to not gain 1/2 pound on any given day-you automatically lose all privileges. but if you gain the 1/2 pound even if you aren’t complying with the program, you still have privileges. it was really frustrating.

Does it work on a level system? no.

What sort of groups do they have? a LOT of CBT and DBT.

What was your favorite group? I didn’t find any of them helpful.

What did you like the most? nothing.

What did you like the least? there are so many things I hated about Sheppard Pratt. first off, they told me point-blank that I would never recover. they told me that I could go into “remission” but that I would have an eating disorder for the rest of my life, and I had to accept that this was a chronic illness. secondly, the meal plan is ridiculous. it’s not based on food groups, calories, or exchanges, but “items”…which is such a loose program it’s basically as if you aren’t on a meal plan at all, and it feels very uncontrolled. like, with their system, an apple or a huge slice of banana cream pie are the same thing=1 item. depending on the person’s eating disorder, this system could really be abused. there was one girl there while I was inpatient who was a compulsive overeater, and she would order 4 donuts and a chocolate milk for breakfast every morning-and they were okay with that! it was really kind of crazy. third, the showering rule. it’s inhumane. and it’s NOT about exercising like everyone will try and tell you. …because if you try to wash your hair in the sink all hell with let loose. it’s a punishment. there’s really no way around that. fourth, the staff is incredibly rude. they make it very clear that they’re there for the money and then to get out. I was even told by a nurse when sitting with a supplement after a meal, “I don’t give a sh*t whether you eat or not, I just want my d*mn shift to be over so I can go home.” I’ve been in programs where the staff really does care, and it makes a HUGE difference.

Would you recommend this program? never.

What level of activity or exercise was allowed? they weren’t that strict on it. people could walk around, stand…there were even girls who would do laps up and down the hallways and never get caught. basically, you could do whatever you wanted…it was all about whether or not you wanted to shower the next day.

What did people do on weekends? nothing. the weekends were really boring.


t’s been about a year since I’ve been in SP, however I have been there a few times in the past two-three years. My most recent trip there was difficult. I was hospitalized because I was in the midst of a severe manic episode, I just happened to have a history of an ED. The CED focused primarily on my eating disorder and not my manic episode, which was what really should have been addressed. Once they did manage to get my mania under control, I was able to eat, sit still and attend groups (which I was initially banned from because my hyperactivity was so disruptive). So if you have a comorbid disorder, think about what issues are most disruptive to your life. The CED did help with my eating disorder but it was difficult to get the comprehensive treatment I needed. I would suggest advocating for your needs. After all, you are your own best expert. With the exception of a few staff members, most were extremely caring and helpful. As an employee of SP I know that the staff at CED far exceed what the employee expectations are on other units and I am grateful for them going beyond what is expected of them. Other units do not hesitate to medicate patients and the CED is one of the only units in the entire SP health system that will talk you through your problems. The staff are truly there to help you. As a mental health worker I can tell you that absolutely no one is in it for the money, they do it because they care.

his goes on and on the whole day long. If staff sees a patient moving something, this gets fast attention. Moving a chair from one room to another gets a reprimand:
please don’t move the furniture, ask a staff member for help
you’re not supposed to move furniture
I don’t want you moving furniture, you’re supposed to ask someone for help

Shorthand and abbreviations at SP
ALP – activity limitation protocol. If a patient is suspected of exercising, excessive walking or is not gaining weight, a doctor may assign extra observation. On ALP, a patient is observed more carefully and told to sit more frequently. Officially, they are supposed to be seated at least 50 minutes per hour.
Zoning – if a patient is not gaining weight, their doctor might assign them to a specific seat in the milieu. This means that they must return to the same seat each time, instead of choosing any available chair.
On camera – a patient is monitored on a camera in their room which a nurse watches. If a patient is suspected of exercising, their doctor might put them ‘on camera’ so that nurses can catch them in the act.
Open door – if a patient is suspected of purging in the bathroom, a nurse will follow them and keep the bathroom door open while they use the bathroom. This is an extra level of observation, since every toilet requires a key to flush.
One-on-one – if a patient is found to be a risk to themselves or suspected of exercising during the day, a nurse will be assigned to follow them around all day wherever they go. If a patient is put on one-on-one, they usually have ‘open door’ bathroom breaks.

Your typical day at SP as an inpatient:
530-7 wake up around 530 for vitals and weigh-in, take a shower if you’ve gained at least 0.2kg
7-8 hang around in milieu
8-915 have blood drawn for lab tests if scheduled
915 bathroom break
930 water break and supplements
10 therapeutic group
11 therapeutic group
12 lunch
1 therapeutic group
215 bathroom break
230 water break and supplements
3 therapeutic group
4 therapeutic group
5 dinner
6-830 hang around in milieu
830 snack, supplements and water
930 evening bathroom
10 bedtime for minors
11 bedtime for adults

blood tests – Inpatients have daily tests for the first week, and weekly tests on Mondays afterward. PHP patients have daily tests for the first three days, and then weekly tests on Mondays. Doctors can also request other tests if they suspect eating disorder behavior since exercise and purging affect blood electrolyte concentrations.

water and nutritional supplements – during these breaks, all patients can drink an 8 oz cup of water along with any prescribed supplements. If patients do not gain weight by eating foods from the meal plan, their doctor will prescribe a supplement (ensure plus) each day. Each day a patient does not gain weight, their doctor can add a half supplement to their daily nutrition plan. Patients usually end up drinking 2-3 supplements daily, divided among the two breaks during the day and evening snack.

bedtime – minors (under 18) need to be in their bedrooms at 10pm. Adults can return to the milieu to read or watch TV until 11pm.

therapeutic groups – these can be any of CBT (cognitive behavioral therapy), DBT (dialectical behavioral therapy), IPT (interpersonal therapy), relapse prevention, mindfulness or nutritional education. Sometimes patients are taken for class to have individual therapy, family therapy or for a short daily meeting with their doctor.

medicines – SP provides all the medications patients are prescribed. There is a medication nurse who dispenses medications throughout the day. After talking with many patients, I found that seroquel was one of the most commonly prescribed drugs. It seems to relieve some of the patients’ anxiety, but they complain of drowsiness and fatigue through the day. It was frustrating to engage some patients in conversation, since they had trouble maintaining focus and would drift off.


Sheppard Pratt is a hospital just north of Baltimore MD for treating eating disorders. I went through a course of treatment starting as an inpatient and later PHP (partial hospitalization program). During my stay, I experienced what it’s like to be a patient. Looking back, I would give a mixed review of their program. If your are considering an eating disorder program, learn as much as you can before signing up.

Each meal was well prepared, including the buffet-style ‘therapeutic lunch’ each Wednesday. While some of the items were better than others, I have no complaints about the general quality of the food. Nurses were also flexible with patients in replacing any item that appeared undercooked or spoiled.

While the meals were usually tasteful and reasonably portioned, they had to be selected at least one day in advance. Once a patient submitted a menu with their selected items, they were only allowed to eat those items. Although patients were stuck with what they selected, it did prevent surprises during meals.

Mealtime rules seemed complicated and rigid to me. One of the major prohibition was making mixtures or combinations of foods. For example, dipping bread into a sauce or dipping a grilled cheese sandwich in tomato soup were not allowed. Combining two types of cereal in a single bowl was also forbidden. There were more prohibited combinations, such as:
adding salad greens to a sandwich
using salad dressing in place of mayonnaise on a sandwich
adding ketchup to any sandwich
dipping french fries in mustard
dipping cookies in milk during a snack
adding chocolate milk to cereal
While these rules were intended to ‘normalize’ eating behaviors, they felt restrictive and arbitrary.

On my first day at SP, the biggest change was the amount of water I could drink. Ever since I can remember, I always drank large amounts of water both during and between meals. At SP, patients are limited to water only at three break times throughout the day. We are allowed up to two 8 oz drinks with each of our meals, but additional water requires a doctor’s order.

Besides having limited water to drink, the air on the unit was usually very dry. My lips and skin dried out quickly, and I wanted to use chapstick and hand lotion. However, both of these need to be dispensed by the medication nurse, only at specific times. Like extra water, they required a doctor’s order. Even later in PHP, patients needed to first turn these in to the medication nurse who would later allow patients to use it when requested.

SP gives incentives to patients who gain weight, by allowing them privileges like phone and computer access. Each morning, patients wear a hospital gown and are weighed. Values are given in kg, to discourage anxiety about weight gain. Patients were expected to gain 0.2kg or more each day, and were put on ‘restriction’ otherwise. This meant that phone and computer privileges were revoked until the next day they gained 0.2kg.

Something that really irritated me were the times when staff enforced a rule, and then tried to comfort the patient. For example, they might tell a patient to stop talking on the phone if they were on restriction (from not gaining at least 0.2kg). The patient might have been in the middle of a conversation with one of their family members, a friend or their boss. Even so, they would disconnnect the phone with a switch in the back office and the patient would become visibly upset. Then the staff member would see them in a bad mood later, and ask if they ‘wanted to talk about it.’

Another bad mark on their report card would be the way they described their program at the outset. They say that the average stay for a patient is about two weeks as an inpatient, and then two or three weeks in PHP. However, you might end up staying longer if they judge your progress as insufficient. It can be tricky to leave SP when you want to, since they have ways of keeping you longer than you expected or would want to. All of the patients at SP are there voluntarily, since they sign a notice of signing up for voluntary treatment. In order to leave the treatment without a doctor’s consent, a patient can sign a 72 hour notice. However, your doctor might choose to commit you if they judge you a risk to yourself. The main reasons that they threaten involuntary commitment are:
being a risk to yourself (i.e. suicidal thoughts or self harm)
being under 75% of your ideal body weight (one of the criteria for anorexia nervosa is an inability or refusal to maintain 85% of ideal body weight)
not progressing in treatment (i.e. saying that you don’t want to recover)

Ending up in involuntary treatment is not fun. You get sent to a different part of the hospital for general psychiatric disorders, instead of the voluntary unit for eating disorders. This happens rarely, since most patients eventually withdraw their notice before 72 hours after talking with their parents or doctor.

SP prohibits physical exercise to help patients gain weight for therapy. However, it seems like they try to stop any mental activity also. Between classes, patients are expected to spend time in the ‘milieu,’ or community room. There are chairs and a few low tables, plus a television. Since many patients are in the milieu at the same time, it can get noisy. Patients and nurses are constantly talking, and at least one patient is being ‘redirected’ for doing something. Whenever someone vomits or breaks a rule in a major way, the group is called to a ‘community meeting.’ it’s hard to focus on anything when you’re in a noisy room full of constant motion.

Imagine trying to focus in an airport concourse or inside a moving bus. There are people all around you talking, television blaring, and information being announced. There is no surface to write on, and everything you have needs to be screened by security. They’ve taken away you scissors, glue, spiral bound notebook, three ring binder, headphones, computer and your cell phone too. I could tolerate these conditions for a few minutes while waiting for my flight. I would wait for my plane to arrive and get ready for departure. I would arrive at my destination and do something new.

This doesn’t happen at SP. If you change your seat, someone will tell you to sit down. If you try to stretch too much, someone will tell you to stop. This happens all day, with nurses watching what you are doing.

‘Caloric conservation’ is one of the major headaches I went through at SP. The protocol or rules are to prevent patients from moving in any unnecessary way, and to have them remain as sedentary as possible. Walking for any unnecessary distance will get you ‘redirected’ by nurses. Even standing for what they judge to be an excessive time will get you requests to sit down. Their voices still echo in my head:
could you please have a seat?
I need you to sit down now
please sit down, you’ve been standing for a while
you need to sit down now
I’d like you to find a seat now
I need everybody to sit down
if you aren’t waiting in line for the bathroom, you need to have a seat


Before you check in to Sheppard-Pratt, consider whether it matches your needs.

Sheppard-Pratt has two main programs: inpatient and outpatient. Inpatient focuses on gaining weight and introduces patients to cognitive therapy techniques. PHP, or partial hospitalization program, continues after patients have reached at least 75-85% of their goal weight. Cognitive behavioral therapy, dialectical behavioral therapy and family dynamics are the main therapies in both programs.

SP takes safety very seriously. patients cannot leave the locked unit without approval, and visitors are monitored. nurses watch the patients 24 hours a day, and log their location every 15 minutes. since some patients self-harm, the rules are obsessive towards safety. any items that might be used to harm (this includes staples and paperclips) are prohibited.

Since some patients have a habit of hiding foods or purging, any items that could hide foods are also banned. plastic bags and even envelopes were banned during my stay. There must have been some clever patients before my stay, since adhesive tape is also banned. Their explanation was that some patients like to hide things by taping them to the undersides of furniture.

The unit was also very clean, even with 30 people sharing the common spaces like dining room and living room AKA “milieu.” the dining rooms were used for classes too, but a visitor would have never known that a meal for thirty people had been served only hours before.
during my stay, most of the patients

the obsessive rules are my biggest complaint. it felt like living in a hostile environment since several nurses would supervise me during the entire day. Their main job is to remind us to sit down, since all inpatients are on ‘caloric conservation.’ This means that any activities that might burn any calories are prohibited. We were reminded to sit if standing for more than a minute or so. Some nurses even tried to remind patients to stop stretching.

Since more than half of the patients are minors, the nurses also monitor patients to ‘change the topic’ if conversation shifts to anything about food or a non-PC topic. The rules had to cater to minors too. This meant that movies rated above PG were prohibited, all CD’s needed to be screened before they could be played during meals or leisure, and magazines advertising articles unsuitable for minors were prohibited.

While therapy groups were divided by age, all other activities were communal. everyone would gather in the same living room for the times between classes, and meals were not divided by age. I understand that the rules were in place to protect safety and keep bad influences away from minors, but it felt like I was back in elementary school for my entire stay.

it took me a while to get used to the meal routines at SP. Among some of the many rules for this central event, we were expected to:
eat items separately and not combine foods
spread butter evenly across the entire surface of bread
add enough milk to cereal to keep it covered
wear only a single layer of clothing

Many of the patients had problems with the rules. One meal was an open face sandwich. While rules for this entree were not published or discussed before the meal, they were enforced. I watched staff members hover around several patients during a meal.

When one patient was seen eating the meat separately from the bread, the nurses took away her first sandwich and replaced it with another. They did the same after seeing another patient tearing portions with a fork instead of separating the portions with a knife. During the same meal, they replaced a third sandwich for another patient, saying that it must be cut with fork and knife, then eaten so that each forkful contains at least a portion of both meat and bread. Apparently, all of these rules are intended to ‘normalize’ eating behavior.

chronic disorganization was a big problem. at least one staff had to be in any room for every 5 patients. the staff were usually spending their time ‘supervising.’ the problem here is that if a patient had a request, the staff who were watching them could use the excuse that they were busy supervising patients and would not respond to the request.

it was hard to get a good night’s sleep here. every 15 minutes around the clock, a staff member has to record the location of a patient for security. while the staff can do this unobtrusively during the day and during classes, it made it hard to stay asleep. every 15 minutes, a staff member would open the door of my room and peer inside to make sure that i was still there and breathing. Plus, we had to wake up around 530.

Besides having a hard time sleeping at night, we were not allowed to take naps during the day. the staff justified the no-naps rule by saying that there were not enough couch spaces for people to recline without taking a seat from someone else. since everyone needs to remain seated instead of standing for long periods, they could say that napping would prevent someone else from sitting. even at times when there were spaces enough for people to recline and sit, the staff would tell us that we should spend the time between classes socializing, since this was another part of the therapy.

drinking enough water was another challenge. we were limited to 16 ounces of liquid during any meal, and had to get a doctor’s order to get an additional 8 ounces of water with a meal. aside from beverages at mealtimes, we were offered water during 3 breaks throughout the day. eight cups of water are recommended as a healthy intake. this means water, not water included in other beverages or food. doing the math, a patient with a doctor’s order for additional water who also took advantage of each water break would only get 6 cups: 3 during breakfast, lunch and dinner, plus the 3 breaks.

I wouldn’t recommend an eating disorder to anyone. this seems like a lifelong condition that I will need to deal with. I’ve only been to one inpatient treatment center in my lifetime, and can only offer my limited perspective. If you’re looking for a treatment center and considering SP, see if it matches your needs before signing up.


I was in SP inpatient in June 2011. It is hard core disciplined, there are no exceptions for acting on symptoms, and excuses are heard but not tolerated. It is the most restrictive eating disorder recovery environment I’ve been in. If you are interested in saving your life and can tolerate that this inpatient program is in the business of life saving and is less hard core therapy but rather hard core behavior modification, you will get a lot out of the program. I moved to a different program for PHP/IOP management as I don’t live in Maryland, but the experience. The program is “cookie cutter” but I do think that is based on the likelyhood that if you are sick enough to be inpatient that you need to have some serious intervention. I hated every second but I liked the outcome. It’s like taking a nasty tasting medicine that works; it’s worth it if you REALLY want recovery. Don’t waste your time if you aren’t ready.



I have been here for a while now.

I fully believe the program is productive and good as long as YOU are willing to do the work. If you want a treatment that is comfortable/plush and where you can get away with behaviors without consequences – you will despise SP. If you want a program where behaviors are not tolerated, this is a good place. Yes, some aspects really honestly suck. Privilegeds are based upon weight gain, and while acting on your ED gain cause you to not make weight, sometimes you honestly do everything you are suppose to and do not make weight. However, this makes weight gain more of a positive thing. Additionally, many of the treatment team are very skilled. Some of the nurses suck ass, do not know anything about ED’s, and deserve to be fired… but some are simply amazing and I would love for them to adopt me. I am making progress in this treatment. They do not have gorgeous rooms or equine therapy, but they do provide you with abundant opportunities to not utilize your ED, learn new coping skills, and process what is going on. I would return here.


When were you there?
i’ve been there several times but my last admission was this march-august (2010)

Describe the average day?
weights/vitals at 5:30, breakfast at 8, groups from 10-12, lunch at 12, groups from 1:30-5, dinner at 5:30, visiting hours from 7-8:30, snack at 8:30, lights out at 11.

What were meals like?
they have two dining rooms (one for PHP and one for inpatients) you sit at the tables and get called up by staff to prepare your tray. after you prepare your tray, you have 45 minutes to complete it. (they’ll usually give you extra time if you need it though) staff walk around the table and monitor and at the end of the meal, they check your tray to make sure you’ve completed everything.

What sorts of food were available or served?
a sample day on the basic meal plan:
breakfast- 2 servings of cheerios, 1 c. milk, 1 c. juice
lunch- pbj sandwich, pretzels, apple, ice cream, iced tea
dinner- baked fish, rice, vegetables, roll with butter, fruit cup, iced tea
snack- granola bar, apple juice

it’s pretty basic stuff. cereals, yogurts, juices, fruits, toast, scrambled eggs, bagels, muffins etc. at breakfast…you have a lot of options. they tell you how many items you need and you can pick whichever ones you want. lunch is usually sandwiches and you get to choose the amount of sides you need for your meal plan from a selection of things like chips, pretzels, soups, fresh fruit or canned fruit, desserts, side salads etc. there are always three options for both lunch and dinner entrees, and you get to choose all of your sides.

Did they supplement? How did that system work?
if you eat less than 50% of your meal you get 2 supplements, more than 50% you get 1.
if you aren’t making weight, they’ll add permanent supplements to your meal plan (9:45 am, 2:45pm, and 9:00pm) you can get up to 4 permanent supplements.

What privileges are allowed?
if you are eating/making weight you can use the phones, have visitors, and use the computer at night.

Does it work on a level system?

What sort of groups do they have?
art therapy, CBT, DBT, IPT, mindfulness, occupational therapy, motivation to change, family dynamics, nutrition education, relapse prevention, mindful movement, stress management, horticulture, snack prep, body image…they also have specialty groups (substance abuse and PTSD)

What level of activity or exercise was allowed?

What did people do on weekends?
you have groups in the morning and then the whole afternoon/evening is visiting hours. so if you don’t/can’t have visitors it gets pretty boring.

Do you get to know your weight?
yes. every morning.

How fast is the weight gain process?
they aim for .2 kilos a day (roughly 1/2 pound) so about 3-4 pounds a week.

What was the average length of stay?
it varies a lot. i definitely stayed a lot longer than most but i think in general it’s about 3 weeks inpatient and 3-4 in partial.

What was the average age range?
that varies a lot too. when i was there the youngest was 13 and the oldest was 57. they do divide up the groups though (18 and under, 18-24, and 24 and older)

What kind of aftercare do they provide?
they have a php program (7am to 7pm) and IOP (3pm-7pm), and they have outpatient providers as well.

Do they help you set up an OP treatment team?

How many IP beds?


Has anyone been to Sheppard Pratt’s free weekly support group? I’m looking into going, but I’m slightly hesitant because I don’t know what to expect or whether it’s worth it. Is it any good? What does the typical meeting look like?
I used to attend the group every week, but haven’t been in a year or so. I think it was worth it. There are “rules” that are explained at the beginning of what you can or can’t say (i.e triggering stuff). The group starts with an ice-breaker question that everyone answers, which is helpful. Some weeks there are about 10 people, and other weeks, there are like 30+. There is a group leader who is on staff at the CED, which is also good because they can add another view to things and they can also redirect inappropriate talk. You don’t have to raise your hand to speak, and after the initial “shyness” of the group, people are pretty comfortable talking. The group leader also prevents one person from taking the floor for too long….gives everyone a chance to speak if they chose to. The group takes place in a big room and you sit in chairs in a HUGE circle, so it’s not like you’re sitting right across from someone



34 replies
« Older Comments
  1. Marissa says:

    CED at Sheppard Pratt has been a lifesaver for me. I can see why some may have posted negative reviews but through my time with this program I have come to believe in what they do. The center for eating disorders is located within the main hospital of Sheppard Pratt. Sheppard Pratt is a psychiatric hospital that has units for other things as well. Sheppard Pratt hospital is always ranked within the top 5 best psych hospitals in the country.
    The daily inpatient schedule from others listed above is pretty accurate, PHP follows a similar schedule but inpatients and PHP don’t have groups together except for community meetings.
    There are lots of benefits of this program. First of all, they don’t turn anyone down just because they don’t have certain criteria of being “sick enough” they are not like that at all. Another great benefit is that in inpatient and php you meet with your psychiatrist everyday, which you don’t in some other programs. Your psychiatrist is your treatment team leader, and you also have a dietician, individual therapy, and family therapist. Individual and family therapy is 2x per week.
    The schedule for inpatients is definitely very structured and they do this to help you block your eating disorder symptoms. Bathrooms are always monitored and staff actually flushes the toilet with a key, so you have no way to hide if you purge.
    You can see your weight everyday if you choose but weights are in kilograms so you don’t have to just see your weight in lbs.
    Since this is a major psychiatric hospital, the staff is great with all the psychiatric disorders that you may have like anxiety, trauma, or mood disorders. If you need your medication adjusted they are good for that.
    I would say one of their main priorities is safety for all patients, so there are searches of bags in inpatient, and each day in PHP you have a search, for safety and to make sure you aren’t bringing any diet pills, laxatives, ect.
    The program is big on CBT and DBT, they also have group like interpersonal therapy, motivation to change, and occupational therapy.
    As others have stated the unit is locked 24/7, even for PHP patients during program hours. PHP has their own day room and dining room though. Another good thing is that if you first do inpatient and transition to PHP you have your same team you have been working with for inpatient.
    Kids 15 and a below are completely separate from adults, they have their own unit upstairs from the adult unit.
    From what I hear the unit has been renovated within the last year, so it has a different look from what I hear, although I have not been there since.
    If you have never been in eating disorder treatment before this program is great and structured although arriving and getting adjusted can be daunting at first. There are just a lot of rules and regulations, and since they are within a psychiatric hospital there is more of this than in the average Ed program.
    The Center for Eating Disorders also has an IOP that is Monday-Thursday 3:30-7:30pm. This program is good because you specifically have to be doing well and you must be motivated otherwise they won’t keep you at this level. So the group is usually a pretty good one. IOP is also much smaller than the inpatient and PHP programs. IOP is completely separate from the inpatient and PHP unit, and of course it is not locked and bathrooms are not monitored, but you are only allowed to use the bathroom once- before dinner, definitely not after for obvious reasons.
    After IOP they also have a regular outpatient program, which is where I have been for the last year and a half. You have a psychiatrist and therapist and you can choose to add appointments for family therapy or with a dietician.
    One thing I will say for sure is that the program throughout all levels of care are very consistent. All rules are expected for all patients, and the staff is very consistent. The only thing I will say is that the meal plans could be a little more individualized but besides that this program is great, especially if you have the chance to do all levels of care. Just doing inpatient can hard when you leave because you are in a very protected environment and then you just go out in the real world- so they like everyone to do their PHP and even IOP if you live in the area.
    The staff is great and the program directors are leaders in the field!!

  2. Kathryn says:

    Part of recovering from an eating disorder requires you to eat all different types of food. She will learn that ALL food is healthy in moderation. No hospital or ED program is going to feed your child unhealthy food. As a parent, it is important for you to encourage her to think this way rather than supporting her in believing some foods are “healthier” than others. When someone with an ED say she will only eat certain “healthy” foods, that is her eating disorders way of helping her restrict – the underlying reason is not so much about the nutritional value of the food but rather about avoiding certain foods.

  3. Anne says:

    My daughter is 15 yrs old and is an avid runner. In late May, she started skipping meals and losing at lot of weight. She said that she was researching the internet and was following different “runner’s diets,” but now it has gotten to the point that if she doesn’t find out the nutritional value of everything she puts in her mouth, she won’t eat it. She is 5’2″ and weighs 88 lbs. I took her to two doctors, a general pediatrician and a sport medicine pediatric doctor, and both said she has an eating disorder. One of the doctors recommended Sheppard Pratt, but I am concerned that my daughter, being an athlete, will not find some of the foods that others have commented on in this forum I.e. Desserts, healthy enough to eat. Can anyone comment on whether SP has an adequately healthy meal plan for people like my daughter? Do you think SP would be effective for her? I would appreciate anyone who can reply. Thank you.

    • AJ says:

      [Note: I truly hope that this response is admitted to this thread, in spite of it being somewhat controversial in taking a hard line against certain treatment centers and methodologies, and of it discussing not only SP, but other facilities as well. I do feel that all of this was very important to write.]

      Hi Anne,

      In many respects, I agree with the above statement about your daughter needing to learn that it is okay to eat all kinds of food, and that moreover, with a new eating disorder diagnosis, you and the rest of your family will likely need to re-learn entirely what ‘healthy eating’ is. But this is anything but a lecture, and I want to offer a few caveats that I would personally add to the above, as someone who has anorexia and has been in and out of several different treatment centers for the majority of my life.

      I think your comment resonated with me in particular for two reasons: first, I was at Sheppard Pratt when I was first diagnosed—having just turned thirteen, so barely younger than your daughter. From what I hear, not much has changed regarding that facility; to that end, I want to IMPLORE YOU NOT TO ADMIT YOUR DAUGHTER TO SHEPPARD PRATT. Please do NOT settle for a treatment center just because it is close to you—not all facilities are created equally. This brings me to my second point: I was diagnosed with anorexia when I was thirteen. I am now twenty-seven. It is no one’s fault that I have an eating disorder, but part of the reason that I now refuse to seek further treatment and continue down this path, knowing where it will end if not exactly when, is because of traumatic treatment experiences like those that I endured at Sheppard Pratt and other facilities. In addition to anorexia nervosa, I also have a diagnosis of PTSD from my subsequent hospitalizations.

      Full recovery is, and always will be, possible for your daughter… and she has the best shot at recovery if you treat this with the individualization, compassion, and tenacity that someone as exceptional as your daughter deserves. To that end, it is likely that you will—if you haven’t already—be told about a certain treatment method known as Maudsley or FBT (Family-Based Treatment). I do NOT recommend you attempting this method with your daughter, and I say this emphatically and explicitly because Maudsley/FBT—with its emphasis on rapid weight gain often above and beyond a child’s set point, on parental deception, and on resenting, rather than having compassion, for the eating disorder—is being touted as the ‘best treatment method,’ particularly in the Sheppard Pratt area. The data that support Maudsley/FBT are based on scientific studies, yes, but the error analyses for these studies are about a mile long. This is the method, and these are the principles, that have made me so fearful of treatment now, as several treatment facilities have adopted certain tenets of the Maudsley methodology categorically.

      Some things the philosophy gets right, however, are that, first, this is neither your daughter’s fault nor your own: parents do not cause eating disorders. Ever. Ever. Ever. They also cannot cure eating disorders (although as written previously, one can recover fully), and yet, whenever possible, families help to play a central role in an individual’s recovery… but this involves, like I said, re-writing your own beliefs about food, weight, and health. It means learning a new ‘language’ where foods are neither ‘good’ nor ‘bad’ and that very often, at least in the early stages of healing (and sometimes long after), the word ‘healthy’ means ‘fat’ to your daughter.

      One of very few facilities I would recommend is called Center for Change in Orem, UT. In fact I did not have a particularly glowing experience there, but this is because of a number of factors that just had to do with me possibly not being a very good ‘fit’ with the facility. I have been there twice. The vast majority of the women I was with both times have gone on to recover fully… and these women were severely ill, in the grips of their eating disorders. CFC may have changed substantially from the time that I was there, but again, from what I hear it is still quite similar.

      Another excellent center is Monte Nido in southern California; I have heard several individuals speak highly of its remote affiliates as well. Monte Nido and CFC would be my two primary recommendations.

      Although several of my friends speak very highly of the Eating Recovery Center of Denver, where I have also spent time—and these friends are also very strong in recovery or recovered—I cannot in good conscience recommend ERC without noting that I disagree with certain aspects of their treatment philosophy. Similarly, however, I cannot in good conscience neglect to mention it, since they have done very good work across a full continuum of care for several of my friends.

      Finally, I would recommend avoiding at all costs not only Sheppard Pratt but Castlewood and its affiliates (Monarch Cove and The Highlands). Castlewood used to be a remarkable facility—perhaps the best in the country—and the new management that has long since overtaken these centers have continued to ride on the coattails of the model that they no longer abide by, and of phenomenal staff who are no longer in any way a part of their centers.

      All my best to you and your daughter… and please do remember… all foods are healthy for your family.

      Take care of yourself as well,

  4. Katie says:

    this was my first inpatient treatment experience, which took place in september 2016. it was absolutely atrocious. there is no way i would advise that someone seek treatment here unless they were going to die waiting for a better treatment center. i threw out the paperwork i had received at my time there, but i will try to summarize everything the best i can.

    i felt deceived pretty much the moment i entered the unit. the photos they show online are of their admissions office in an unrelated building, the PHP milieu which inpatients are not allwed to use, and of the children’s/adolescent’s unit, upstairs. both look modern and bright. the actual unit i arrived on, however, was old, filthy, painted in yellows and brows, and carpeted (carpets… throughout the entire eating disorders unit… yeah). it might sound silly but i feel like i had had my trust betrayed then and there. not only that, but they also started doing major renovations on the unit while we were all in there. twice the paint fumes were so bad that all the inpatients had to be relocated for an hour or so.

    next there’s the shower situation. there are 4 showers between the 27 available beds. if you’re not woken up super early, you have to wait for an open shower in the paper gown you’re weighed in. once one person leaves the shower, it’s “cleaned” by a staff member lazily spraying shower cleaner on the walls a couple of times. you have 8 minutes to shower. my first morning, a staff member accused me of not showering and instead exercising because he apparently didn’t hear the shower running. i did indeed shower, my hair was even wet and i left in the towel, but he kept accusing me and i was very scared given that it was my first morning. after your shower you have to walk down the hallway to your room past the other patients on the carpeted floors in only your towel. in order to do things like put on makeup, dry your hair, or even brush your teeth, you have to wait in line for “vanity” – it’s a tiny room with 2 sinks and basically the only mirror you’re allowed to look at on the unit. this, again, has to be used by all 27 inpatients.

    you spend your entire day in the “milieu” and you are not allowed to be in your room except to sleep. there’s never enough chairs for everyone. there’s a long bit of time after everyone has to go to the milieu before breakfast starts where there is literally nothing to do. you’re forced to sit in the milieu and watch tv before going to breakfast for no real reason. you aren’t allowed to sleep during this time.

    the meal plans make no sense whatsoever. the portions are ridiculous even if you don’t need to gain weight, as there are very few meal plans offered. i only knew of 2 – “basic” and “standard,” basic being the initial meal plan everyone begins on. others have went into more detail about this, but i’m still shocked about it to be honest! treating a donut as equivalent to a cup of juice or a huge slice of chocolate cake as equivalent to an apple doesn’t help anybody learn normal eating habits. it’s also absurdly difficult to get enough water here. you’re only allowed one non-caloric beverage per meal; even utilizing all the water breaks, if you want coffee in the morning, you’re down to 5 cups of water per day. if you have to gain weight, like i did, and you get increased to “standard,” you have to have two desserts (meaning things like cookies and ice cream) per day. the only way to get a smaller meal plan is to have symptoms of refeeding in your blood work. then you get reduced portions until your blood work normalizes. even more out of touch with reality, you only get one pass to practice what you’ve learned, and it’s only one meal planned to happen right before you discharge.

    staff was outright rude at times. one nurse actually neglected to give out morning medications entirely one day. very irresponsible. staff can be very inconsiderate and insensitive at times. it really felt like no one cared about your well being. at one point they admitted so many people on the unit that 2 patients had to sleep on cots. combined with the construction, and the milieu that didn’t have enough chairs to begin with, it’s hard to feel like they’re treating you with any motivation but the money.

    the way that “bathroom breaks” are run feels inhumane. the bathrooms all have multiple stalls and are key-flush. multiple women will use the bathroom at the same time. you have to wait in a long line because there are 4 stalls for all the inpatients. if you’re a guy you get to wait until literally everyone else has already gone before you’re allowed in. staff does a terrible job at letting patients use the bathroom for an emergency even if the patient has a medical reason to do so. if a patient needs to use a hat to measure urine output (for kidney function) the hat is left on the window sill with their name on it for anyone and everyone to see. no privacy.

    there are other things that made this program terrible but these are the main ones that made it a useless and upsetting experience for me. i wish it was more widely known just how mistreated patients sent here are. please avoid this if you have any other options!

« Older Comments

Leave a Reply

Want to join the discussion?
Feel free to contribute!

Leave a Reply

Your email address will not be published. Required fields are marked *