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Friday 16 August 2013

Sheppard Pratt 3

So imagine you are a 12 year old little girl, desperately ill with the most lethal psychiatric disorder.  Imagine you are anosognostic to a degree and undoubtedly alexithymic.  You are in a hospital, which proudly announces that it caters specifically for children.

One of the rules that most upset me was this:

They are not allowed to touch other patients or staff, no hugs, no comfort, not even if they ask for a hug. It is forbidden. They may however, touch their visitors.

Imagine you are 12 years old and you are only allowed to go to the loo at certain pre-designated times.

Imagine your parents are only allowed to come for an hour in the evening and that gets taken away from you because you have not eaten your supper fast enough.

Imagine you are frightened and confused and just 12 years old and you don't get your nightly hug from your mother.

Imagine then, at the age of 12, unaware of how ill you are or what is wrong with you, that you get faced with this.

The Center’s inpatient program provides a strong foundation for recovery

The treatment experience at each level of care, and ongoing success with recovery, is greatly influenced by one’s willingness to be open and honest with the treatment team and be fully engaged in the therapies provided. We recognize that recovery is hard work and our staff is committed to helping patients get the most out of their time in treatment so that personal growth and healing can occur in meaningful ways.  Completion of the inpatient program not only lays the groundwork for successful transition into the Partial Hospital Program (PHP) but it provides the foundation for long-term positive outcomes.

Imagine how confused and frightened you would be.  How can a 12 year old be "open and honest" and "fully engaged in the therapies provided", when the most basic of human comforts are denied to her and she is being treated as if she is choosing to not eat enough, as if this is something she is deliberately doing wrong, some wilful act?  Imagine how traumatised you would feel.

Should SP be treating children?

I don't believe so, no.  I think this smacks of cruelty and shame and blame, reeking of outdated psychobabble from the 1970's.  

If SP would like some advice on how to update their programme, raise their levels of care, especially of young and vulnerable children and what eating disorders are actually all about, then they could always read the F.E.A.S.T. website, send some of their staff on the Trained2Treat4ed programme, listen to their one member of staff who has been trained on it and start including parents, not as a vehicle for punishment, but as active and useful members of the Team.  

In the meantime, I would suggest parents of children with eating disorders head for CHOP and the compassionate, committed team of Dr Peebles.


  1. This first hand account of the parent of this 12 year old girl, of treatment at Shepard Pratt, sounds utterly draconian! I am astonished to hear this, however, based on other first hand accounts from parents and patients, I am not at all surprised. NO, SP should not be treating children!

    May I also recommend Kartini Clinic in the Seattle area who treat only children and young adults to the age of 22.

    Here is a synopsis from Kartini, founded by Dr. Julie O'Toole!
    "At Kartini Clinic we don't utilize surgical interventions or psychiatric wards. Prompt, adequate weight restoration is the essential first step in our treatment program. This is followed by individualized psychotherapy to treat the whole child, not simply one or more of their eating disorder symptoms. Our overriding treatment goal is to secure lasting remission of eating disorder symptoms, allowing patients and their families to return to their own communities. We practice in the knowledge that families don't cause eating disorders and children don't choose to have them.
    Clinical evidence suggests that family-centered treatment is the best approach for securing lasting remission in children with eating disorders. At Kartini Clinic the active participation of family members in treatment is mandatory. Unlike the Maudsley Method, however, families are not asked to go it alone. Our expertly trained, multi-disciplinary staff will be there to help you ever step of the way."

  2. I still shudder remembering the time when my 15 year old D was at SP - it was 12 years ago and it sounds like they haven't changed their approach of excluding parents/blaming parents/blaming the child for an illness that is biologically based and causes their symptoms. I would find my D there in tears each night so frightened by the way she was treated.

    We all left feeling like we were terrible failures with no solid plan for transition. Their only recommendation was to send her to a place far away that didn't even treat eating disorders.

    I still have nightmares about our trips to SP

  3. This sounds nighthmarish and contrary to evidence-based treatment protocols in the extreme. Kudos to you for spreading the word.

  4. I'm amazed at what I'm reading about Shepard Pratt. It's praying on the despair of parents who have just found out that their child has an ED and knows no better. This place needs to be stopped from practicing until their training has been drastically updated. This practice sounds like something out of a Dickens novel. I'm shocked and dismayed that such an establishment is allowed to practice.

  5. I read around some of these linked posts, here and on Laura's blog, about SP earlier today. In the meantime, my thoughts have been processing ... because I read something that kind of opened up an understanding of a memory. I've always considered myself to be at fault for crying on the first night my mum left me when I was in hospital the first time. I was in a general ward for 6 months, admitted a week after my 11th birthday. They let my mum stay overnight for a week or two then said she had to go. I was devastated and sobbed as she left the building. The nursing sister told me off for being selfish because my mum needed to go back to her own life.

    But seeing the word "parentectomy" and feeling sorry for other children who had similar experiences is making me realise that I can feel sorry for my own 11-year old self too. Because it was devastating. And I guess that the way it made me turn all my emotions inwards, hating myself for being selfish and determined to be self-reliant, has been counterproductive.

    Other aspects of the stories resonate too (bed rest regimes where going to the bathroom rather than using a commode is earned by weight gain, for example, or visiting time cut short because of not finishing a meal in time) but it's the "parentectomy" that's left my emotions reeling.

    I'm hoping that by writing this comment, I'll manage to process some of it and therefore be able to get some sleep.