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South Africa’s premier extended care retreat specialising in the treatment of eating disorders.

Montrose Manor, the latest addition to the Montrose family, furthers the Montrose vision to become a world-leader in the treatment of addictions, eating disorders and compulsive behaviours, governed by the highest standards of evidence-based practice. Montrose Manor is a specialised retreat, with a unique programme designed to provide exceptional treatment and clinical care for clients suffering from anorexia, bulimia, compulsive over-eating and other forms of disordered eating.

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WE BELIEVE We believe that every individual has the capacity to live a fully empowered life, making effective choices for optimal physical, emotional, cognitive and spiritual health. With this belief we aim to help our clients to attain freedom from the painful, self-destructive behaviours associated with eating disorders.

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Surrounded by acres of garden and located in the exclusive suburb of Bishopscourt, Cape Town, Montrose Manor boasts the unrivalled combination of a luxurious environment, world-class facilities and an exceptional ‘step-forward’ clinical programme.

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an introduction to the montrose manor programme With a homely atmosphere and gentle clinical ethos, treatment at Montrose Manor is less institutional than the standard primary in-patient eating disorder facility and it is, therefore, the ideal setting for extended care. Our experienced staff encourages healing through awareness; helping clients to focus on their relationship with themselves, with others, and with their environment. A holistic, mindfulness-based programme such as this encourages reconnection with the core self, immeasurably increasing the client’s quality of life, and chance of a full and lasting recovery.

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ABOUT eating disorders

PROGRAMME OBJECTIVES

Eating disorders are thought to be caused, and perpetuated, by a complex constellation of issues including genetics, environmental factors, traumatic events and concurrent psychological problems; depression, anxiety, obsessivecompulsive disorder or addiction. The acts of food restriction, binge eating, purging and excessive exercise can be viewed as an attempt to control and cope with internal sources of conflict and stress.

- To offer treatment at a critical phase of the client’s recovery – providing a crucial bridge between primary in patient care and a return to their homes and lives. As such our principal objective is to introduce clients to a path of self-sustainable recovery. Eating disorders are chronic, relapsing problems and treatment requires addressing long-standing maladaptive patterns of behaviour. Having established a regular eating schedule and dealt with any critical associated medical concerns in primary care we assist our clients in utilizing the plethora of treatment modalities available at Montrose Manor to explore key personal issues relating to their illness. 10 /

- To promote re-integration into healthy community living by encouraging clients to take increasing responsibility for their own recovery within a safe and nurturing home-like space that is conducive to personal growth. - To utilise a variety of group and individual therapies that attend to the complicated issues underlying eating disorders; with a strong focus on exposure therapy, re-entry issues and relapse prevention. / 11


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THE TREATMENT

PROGRAMME Our highly skilled team of mental health and nursing professionals are experienced in the presentation of eating disorders as primary or secondary processes, and are trained to manage dual diagnoses or concurrent/ co-morbid disorders. On admission a psychiatrist will evaluate all clients; thereafter a comprehensive treatment protocol is established. Each client is then assigned a counsellor who will manage their programme, seeing the client a minimum of twice weekly for individual counselling. 14 /

PHASE ONE -

Individual therapy Group therapy Self-awareness groups

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Body image groups

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Special focus groups exploring a variety of topics including gender, bereavement, trauma, sexuality and spirituality Life skills groups focusing on a variety of topics including relationships, communication skills, assertiveness, conflict and anger management, co-dependency, understanding and coping with criticism, handling stress and anxiety and self-esteem and self-concept enhancement Workshops exploring emotions and boundary setting

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Expression workshops using clay, collage, music and art

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Experiential therapy; psychodrama, role play, outdoor activities Equine Assisted Psychotherapy An exploration of the 12-Step principles in relation to eating disorders, including workshops on coping with fear, guilt and shame

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“Food and Me� nutritional groups

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Individual weekly sessions with the dietician

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Meal planning groups

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Psycho-educational lectures

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Attendance of fellowship meetings/external support groups / 15


PHASE TWO

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Weekly restaurant outings

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Groups exploring trauma and family of origin issues Self-directed reading and reflection to encourage personal growth Relaxation and recreation The Wellness Programme Planning and preparation of house meals

PHASE THREE

- Continue to attend weekly fellowship meetings / support groups, have a sponsor and meet with him / her at least once a week - Continue to attend a certain number of therapeutic / programme groups - Take increasing responsibility for the planning and preparation of house meals

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The focus at this stage of treatment is on re-entry and relapse prevention. All clients in Phase Three will also have access to assessments for career guidance and an “Imago� image consultant who will offer guidance on clothing and personal presentation. / 17


THE NUTRITIONAL PROGRAMME The nutritional programme at Montrose Manor strives to incorporate the latest medical and nutritional findings and recommendations. Depending on the phase of treatment, and under the guidance of our dietician, clients will be encouraged to take responsibility for the planning and preparation of daily meals. They will eventually be taken on regular restaurant outings and food shopping trips.

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THE WELLNESS PROGRAMME

Towards the end of Phase One each client’s current relationship with exercise is explored, and a goal is defined as to how s/he would like that relationship to develop. Montrose Manor’s wellness facilities include a swimming pool, walking trails, yoga and Pilates classes.

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THE FAMILY PROGRAMME

Our family programme consists of individual counselling with a specialist family counsellor, family sessions with an eating disorders expert and family counsellor, group counselling and interactive psycho-educational lectures. The family will have the opportunity to explore new ways of communicating feelings and needs, understanding and setting healthy boundaries, developing and renewing intimacy and overcoming problems that have arisen from broken lines of communication. Relapse is common (although not inevitable) so clients and family can discuss vulnerabilities together and develop a relapse prevention plan to refer to when the client is discharged. 16 /

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montrose stables The Equine Assisted Psychotherapy Programme

At Montrose Stables, a short drive from Montrose Manor, clients have the opportunity to participate in Equine Assisted Psychotherapy sessions.

EAP is an experiential treatment process, which consists of clear and concrete tasks that motivate the client and address a variety of human development issues. 24 /

the clinical team The multi-disciplinary team consists of the following in-house and /or consulting professionals: -

Psychiatrist Clinical Psychologist Dietician Occupational Therapist Drama Therapist Art Therapist Psychotherapist Counsellor 24hr Nursing Personnel Wellness Programme Coordinator Yoga/ Pilates Instructor Equine Assisted Psychotherapist

Please read more about our staff on the loose inserts at the back of the brochure. / 25


admission criteria - Clients must be 18 years or older, and may be of either gender. - We expect clients to have a Body Mass Index (BMI) of 16.5 or higher. In the case of a BMI lower than 16.5 (an extraordinary case may be made) a physician’s assessment and evidence of a stabilized eating routine is required before admission will be considered. - Clients must have done a form of primary treatment/intervention, and be referred by their counsellor, psychotherapist, psychiatrist or primary care treatment center; with a formal letter of referral. The client must, additionally, be deemed medically fit by a medical doctor. - Blood tests, including Full Blood Count; Electrolytes, Urea and Creatinine; Liver Function Test and TSH must be sent to Montrose Manor PRIOR TO ADMISSION. - The client must agree to being transferred to a local primary care facility should s/he begin to purge or restrict, such that weight loss, or an inability to engage in the programme, occurs. - A minimum of two months treatment, preferably three, must be agreed to prior to admission. - For clients in recovery from a concurrent chemical dependence; in the event of a relapse prior to or during admission, s/he will be referred to a medical facility to detoxify for a minimum of 48hrs. - All clients will be expected to complete an assessment questionnaire. 16 /

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As a therapist or professional it is critical to understand both the Montrose Manor admissions process, and the foundation of our treatment programme.

WE ARE COMMITTED to Professional Partnerships We believe that your involvement is essential to the ongoing recovery of your client and we are committed to regular communication with you throughout the treatment process, thereby providing a smooth transition for your client back to their primary therapist at the end of their stay at Montrose Manor.

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The Residence Montrose Manor is a turn-of-the-century manor house, lying adjacent to the Kirstenbosch Botanical Gardens, with clear views of Table Mountain. A combination of elegant, designer-styled interiors and antique furnishings befit both the location and the house’s history.

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Advice regarding admission Assistance in organising assessments, clinical evaluation and referral prior to admission to Montrose Manor Accompanying clients to Montrose Manor Aftercare for clients returning to the UK after treatment at Montrose Manor Support for relatives, friends and associates of our clients prior to, for the duration of, and after treatment Seminars and events for Montrose Manor alumni, new clients and the professional community

Please telephone or email Jo Griffin for further information and a prompt and confidential response to your enquiry at: M. +44 (0) 782 574 4182 F. +44 (0) 207 323 3136 E. jgriffin@montroseplace.co.za Montrose. 47 Devonshire Street. London, W1G 7AW. United Kingdom

Montrose is a member of Leading Health Care International (LHCI) and European Association for the Treatment of Addiction (EATA) 32 /

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Montrose Manor Brochure