The Monte Nido level system for eating disorder treatment is set up so that clients have maximum structure and protection upon admission and then increasingly gain greater responsibility and freedom. As clients progress through our program they start shopping, planning meals, preparing their own meals, etc. Clients also go on passes with significant others in the beginning and then, if possible, alone to practice skills in the outside world. These passes can be as short as a trip to a restaurant or as long as a weekend back home. For example, a local client might go home overnight to see what it was like having dinner in her home environment and then return to Monte Nido to process the experience.
Our level system allows for increased freedom and responsibility as clients progress in the program. Each client has a written contract, which she helps create. The contract shows the current level the client is on and spells out the goals for that level. Each client's program is individualized even though there are certain activities, reading assignments, and other requirements for every level. A copy of the contract is given to each client, one is kept in the chart and one is posted.
There are 6 basic levels to our system:
- Entry Level - During this time clients are getting acquainted with our program and will be given an Entry Level contract, which lists certain tasks to be accomplished.
- On Level I, clients will be selecting food choices from our preset weekly menu options with help from a dietitian.
- Level II clients will begin contracting to portion their own breakfast and snacks and can request to help the cook during meal preparation
- Clients should request Level III when they have demonstrated competency on Level II including the ability to eat their meals without undue incident and accomplishing weight goals.
- Level IV is a very critical level; our research shows that clients who make it to Level IV have a far better chance of recovery approximately 90% of our clients who are in full or partial recovery made it to Level IV. This level is where our clients can really work at internalizing the skills and abilities they have learned. This step is often omitted from other treatment programs, yet is essential to prepare clients for all they will have to do to maintain recovery post discharge.
- Discharge Level - To be on this level does not mean that the client has advanced to level IV. However, this special discharge level is provided because the client will soon be leaving Monte Nido and must plan well for their upcoming re-entry back to "normal" living with the help of the Monte Nido staff