Na het behandelen van haar eerste eetstoornispatiënt in 1979, herkende Carolyn Costin, zelf ook ervaringsdeskundige, dat het haar roeping was. Haar succesvolle behandeling van mensen met eetstoornissen bracht haar om haar filosofie naar het publiek brengen door middel van presentaties, haar boeken en de oprichting van haar unieke residentiële behandelingscentrum, Monte Nido in de Verenigde Staten.
Carolyn bezocht in oktober 2017 Be-LeeF! in Portugal en deelt hier haar ervaringen.
“I recently visited Be-LeeF!, a residential program in Portugal that is connected to a program in Holland called Human Concern. The program is founded and run by Carmen Netten, recovered herself from Bulimia. Carmen only hires recovered staff and offers them an intensive training program to ensure they know how to use their personal experience when working with clients. Here are my observations abut my brief experience at Be-LeeF!.
You can at once feel an atmosphere of love and acceptance and nurturing as you walk on to the property. The staff all smile and greet one another and guests offering huge smiles and sometimes hugs. The pace looks like a large family home with various structures on site and beautiful gardens. There are many places for quiet contemplation and privacy.
The chef was bustling in the kitchen, happily making a beautiful, healthy meal witch is always a surprise to the clients. As the meal is served the chef with his wonderful English accent and love of food actually comes out and explains to the clients what they are about to eat. The philosophy of serving a meal unbeknownst to the clients is new to me. In my 20 or so years running Monte Nido I always prepared the clients ahead of time for what was being served and the clients were able to also make choices off our menu. I am intrigued by Carmen’s idea of just serving food like you would if guests were coming to dinner. Carmen idea is getting back to what norma eating is…you don’t portion food or count calories or require people to gain a certain amount of weight every week. You get them to do what we all did as kids, and what the ultimate goal is… to sit down and eat a meal without fear and without counting calories or engaging in other eating disorder behaviors.
There are many unique features of Be-LeeF! but the one that stands out the most is that all therapists who work at Be-LeeF! are recovered and they live there interacting with the clients at all times. Every staff member seemed to love his or her job and they all talked and acted like very dedicated human beings who take the job of helping others recover very seriously. To me the entire place from the chef to the therapists, the nurse, and even the gardener were all like one big committed and dedicated family. The clients also described their time at the program as inspiring and loving and hopeful.
The program takes 8 to 12 clients at a time and is unique in that they all come together to Be-LeeF! in a group and stay for one month. Some therapists seem to be permanently at the facility while others will come with the group and then leave back to Holland and continue to work with the group. Upon return to Holland the group stays together for a period of time, continuing to come to the outpatient program at Human concern so continuing to work with each other as they continue in recovery.
I was struck by how most of the clients seemed happy and hopeful. It certainly seemed like they felt cared about. I came in their 4th week so it was the week they were preparing to go home so the group I did with them and my friend and colleague Jo Cook from Tasmania who is also recovered, focused on how one continues recovery upon discharge. Jo and I let them ask us questions abut our own recovery and our current work.
I found it intriguing that the program runs by taking a group for one month only in a sort of “immersion” program. All the clients start and end together so there is no criteria for discharge. This was a bit hard for me to grapple with as my experience at Monte Nido was that some would do well after a month but most needed more than that. At Monte Nido I used a level system and based discharge ( or what we called “Graduation” on criteria that depended on the clients progress; their accumulation of skills and behavior change that would enable them to be successful outside of 24 hour care. Though Be-LeeF! clients leave residential after one month Human Concern has very favorable outcome data. Carmen’s idea is as I see it is to turn clients around during that month so that they want to get better, so that they are motivated to keep working for their recovery and then they will do it. This is an interesting concept of how to do residential treatment and though I cant cite the data I do believe that truly convincing a client, not just cognitively, but emotionally and spiritually, that he or she wants to get better is key. I would say that is getting the heathy self to come forward and get back in the drivers seat, no longer getting the eating disorder self to take control.
The one month model may very well be something for others to explore but it cant just be the 30 days that makes the program work. Remember these clients are exposed 24/7 to recovered staff who have fought and won their own battle and who can say to all clients “Been there , done that.” There is a different kind of empathy and understanding that can be delivered by those recovered themselves. As anyone who knows me knows, I believe it is imperative for clients to be exposed to recovered staff, and not just a mentor here and there I mean therapists, dietitians, doctors. But Carmen went a big step further hiring almost ONLY staff who are recovered. This may explain some of the magic of the place. As Carmen says, people are often very curious as to why their loved one starts eating when they come to Be-LeeF! and its something hard to describe, something that is unexplainable, something that ha to do with the “L” word. I would venture to say the staff actually love the clients there as if they were family. That is a very familiar feeling and one that happened at Monte Nido. I did not require it or write about it. It is not something you find in a staff manual or anything, but it is a feeling that trickles down from the founder of a place and it is something that can be pulled off when staff members are carefully selected for Who they are, and HOW they are rather than just their degree or education. Both Monte Nido and Be-LeeF! are places that one can easily see value person first, patient second.
All in all my visit was powerful and I was left with the impression of a place I could recommend when and if Carmen and her staff decide to take clients outside of Holland and expand their program so that clients can stay longer if they need to. This will require many changes and is not an easy undertaking so I do not know if or when this will happen, but I will stay in touch so that if it does happen I can let people know.”