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When is a Higher Level of Care Needed?

Individuals, as well as their loved ones, often have a difficult time navigating the treatment services available for those with eating disorders. The clinical field continues to advance in terms of more variety of options — various levels of care, from traditional outpatient care to residential care to medical hospitalization and everything in between, as well as many of these levels of care being offered in a virtual format. What is the best choice? What will be most effective? While the most important step is to get into some type of treatment, it is difficult to determine what the best option is for that entrance into treatment. It is sometimes even more difficult to decide if something different is needed if the first step is not providing optimal improvement. Our discussion will include medical, psychiatric, and behavioral aspects that are important to consider when making these decisions. We will review the most common signs of when a higher level of care is needed. We will discuss how the severity of the illness can warrant additional or different types of support, even when tremendous care is being provided. We will want to leave the discussion with participants having a good grasp of the treatment options available, and the most important signs that indicate a higher level of care is needed.

Dr. Brad Smith, MD, DFAPA (he/him) is the Chief Medical Officer for Accanto Health, overseeing the clinical direction of The Emily Program and Gather Behavioral Health. With 25 years of experience in psychiatry and medical leadership, he is dedicated to advancing high-quality, patient-centered care for individuals with eating disorders.

Board-certified in adult and forensic psychiatry, Dr. Smith has spent his career developing innovative, evidence-based treatment programs. Before joining Accanto Health, he directed clinical services at all levels of care within Eating Disorder Recovery Services at Rogers Behavioral Health. He is recognized for his leadership in improving clinical outcomes and expanding access to care for those in need.

Dr. Smith earned his medical degree from the University of Wisconsin, where he also completed his psychiatry residency, serving as chief resident in his final year. He completed a fellowship in forensic psychiatry at the Medical College of Wisconsin and is a Distinguished Fellow of the American Psychiatric Association, an honor that highlights his substantial contributions to the field.

In addition to his clinical leadership, Dr. Smith is passionate about education and has served as a voluntary assistant clinical professor in the Department of Psychiatry and Behavioral Medicine at the Medical College of Wisconsin. He has lectured nationally on a wide range of topics related to eating disorders and mental health, including peer-selected presentations for the National Eating Disorders Association and the Multi-Service Eating Disorders Association annual meetings.

When is a Higher Level of Care Needed?

Mealtimes have been described as emotionally intense and anxiety provoking when an eating disorder is at the table. Parents have often described their ill child as a different person. In this setting, a normally compliant, reasonable, and controlled person can become angry, distressed, and non-compliant. Oftentimes, the family needs comprehensive meal coaching in order to continue to feed their child successfully as they navigate new barriers and behaviors.
In this presentation, we will focus on how differing parental styles can influence techniques used by parents in the re-feeding of their child. We will also highlight ways to increase parental efficacy in re-feeding by mobilizing individual and combined parental strengths, identifying emotional vulnerabilities and expression, reinforcing healthy eating behaviors, and providing guidance and support during a meal. Examples of strategic meal coaching will be demonstrated with special attention given to the relationship between co-parents, single-parents, and the malnourished child.

With over 18 years of experience working with children, teens, and families, Christin is a dedicated mental health professional who specializes in evidence-based therapies, including Family-Based Treatment (FBT) and Dialectical Behavior Therapy (DBT). As the co-manager of the Adolescent Program at UCSD-EDD, she has spent the past 12 years supporting families through the complexities of mental health challenges, eating disorders, and emotional regulation issues.
Christin is deeply involved in the Saturday Program at UCSD-EDC, where she facilitates family-focused activities, meal coaching, and helps guide participants through process work. She holds a B.S. in Family and Child Development with a Minor in Psychology from San Diego State University, and an M.A. in Marital and Family Therapy from Alliant International University.
In addition to her academic credentials, Christin is certified as a Domestic Violence/Sexual Assault Advocate and has received specialized training in Motivational Interviewing, FBT, DBT, and Crisis Intervention. Her career began working with at-risk adolescents and families, focusing on substance abuse, neglect, eating disorders, and juvenile justice system involvement. This experience spans a variety of settings, including residential treatment centers, inpatient and outpatient care, juvenile hall, and psychiatric hospitals.
Christin’s commitment to supporting families in crisis and her broad skill set have made her a vital member of the UCSD-EDC team, helping to improve the lives of young individuals and their families through compassionate care and evidence-based practices.

Past Webinars

Date

Title

Watch

Sep. 17th, 2025

Addressing Medications Like Ozempic in the Context of Eating Disorders

Jan. 15th, 2025

Dec. 4th, 2024

Let's Talk About Family Support for Autism and Eating Disorders

Nov. 13th, 2024

Challenging Parent Perceptions on Weight, Fat, and Food

Oct. 31st, 2024

(In Spanish) Reconstruyendo la Confianza en la Mesa: Cómo el FBT Puede Cambiar la Vida de tu Familia

Aug. 14th, 2024

July 11th, 2024

How We Developed FBT and Why it Works

May 8th, 2024

Treating Eating Disorders with Psychedelics: A Guide for Parents

April 10th, 2024

Eating Disorders Affect Us All

March 27th, 2024

Does Medication Work in the Treatment of Eating Disorders?

Feb. 28th, 2024

Promoting Life in the Treatment of Severe and Enduring Eating Disorders

Jan. 17th, 2024

Dec. 6th, 2023

Suicidiality & Self Harm in Eating Disorders

Nov. 9th, 2023

Oct. 11th, 2023

Refeeding Your Loved One

Aug. 14th, 2023

Eating Disorder in Males

July 12th, 2023

The Effect of Eating Disorders on Siblings: An Authentic Conversation

May 3rd, 2023

Understanding ARFID & its Genetic & Environmental Causes

March 22nd, 2023

What is "Fat Phobia" and How can it Affect Your Loved One's Recovery

March 2nd, 2023

Navigating Ramadan with an Eating Disorder

Jan. 31st, 2023

2023 AAP Guidelines with Dr. Anna Tanner

Jan. 18th, 2023

Eating Disorders, Biology, & Body Image

Dec. 15th, 2022

Nurturing Your Loved One with an Eating Disorder through the Holiday Season

Nov. 9th, 2022

Guided Self-Help Family Based Therapy for Adolescents with Anorexia Nervosa: What is it and Who is it for?

Oct. 18th, 2022

This is Hard and Skills Can Help: DBT Skills to Enhance Family Communication

Aug. 11th, 2022

How to Talk to Your Child When ED Has You Walking on Eggshells

July 14th, 2022

Skills Sharing for Supporters of People with Eating Disorders

June 3rd, 2022

What Parents and Patients Have Taught Me

May 18th, 2022

Partnering with Primary Care: Building a Team to Beat Your Child's Eating Disorder

May 1st, 2022

De-Escalating Violence and Aggression

Feb. 25th, 2022

Cognitive-Behavioral Therapy for Eating Disorders: A Guide for Beginners

Jan. 20th, 2022

Permission to Parent

Dec. 16th, 2021

Having a Sibling with an Eating Disorder

Nov. 10th, 2021

What Caregivers Should Know About CBT and DBT

Oct. 13th, 2021

Medical Complications in Children and Adolescents with Feeding and Eating Disorder

Sept. 14th, 2021

Supporting Your Loved One Struggling with Bulimia Nervosa

Aug. 4th, 2021

ARFID 101: Subtypes, Symptoms, and Effective Treatments

July 21st, 2021

Is Anorexia Nervosa an Eating Disorder? How Anxiety Inhibits Eating

June 16th, 2021

Webinar with Daniel El Grange, PHD: What's New with FBT?

May 20th, 2021

What Parents Should Know About Higher Weight Eating Disorders

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