Why Do People Get Better With Exposure Therapy?

2019 ◽  
pp. 19-32
Author(s):  
Carolyn Black Becker ◽  
Nicholas R. Farrell ◽  
Glenn Waller
Keyword(s):  
Eating Disorders ◽  
Anxiety Disorders ◽  
Therapeutic Intervention ◽  
Exposure Therapy ◽  
Therapeutic Benefit ◽  
Evidence Based ◽  
Systematic Desensitization ◽  
Evidence Based Treatments ◽  
Inhibitory Learning

This chapter outlines a theoretically based rationale for using exposure consistently in the treatment of individuals with eating disorders. Due to the substantial overlap between eating disorders and anxiety disorders (both in symptom content and in comorbidity between the conditions), exposure therapy is a sound choice for therapeutic intervention. Indeed, the most evidence-based treatments for eating disorders contain a number of exposure-based strategies that drive much of the therapeutic benefit. The chapter discusses habituation, systematic desensitization, and inhibitory learning and differentiates exposure therapy from systematic desensitization. Using a case study to consider how exposure therapists can help patients learn to tolerate their anxiety by leaning into it rather than engaging in safety behaviors, this chapter lays the foundation for the application of exposure therapy to patients with eating disorders.

Exposure Therapy for Eating Disorders

2019 ◽  
Author(s):  
Carolyn Black Becker ◽  
Nicholas R. Farrell ◽  
Glenn Waller
Keyword(s):  
Eating Disorders ◽  
Binge Eating ◽  
Exposure Therapy ◽  
Behavioral Therapy ◽  
Limited Attention ◽  
Evidence Based ◽  
Walk Away ◽  
Wide Range ◽  
Evidence Based Treatments ◽  
Family Based

Exposure therapy is a core component of evidence-based treatments for eating disorders (EDs), including cognitive-behavioral therapy and family-based treatment. Despite this, existing treatment guides give relatively limited attention to the clinical issues associated with good implementation of exposure. This book is designed to augment a wide variety of treatment manuals by providing ED clinicians with practical advice for maximizing the effectiveness of exposure, regardless of which evidence-based treatment they use or the profession to which they belong. Written in an easy-to-understand format, this book not only translates the most up-to-date empirical research on exposure for EDs, it also extrapolates clinical advice from the anxiety disorders literature to help busy clinicians become more effective in treating EDs. Readers will walk away with a solid foundation in the theoretical underpinnings of exposure therapy, as well as an understanding of how to utilize this information to sell the rationale for exposure to their ED patients. Clinically rich chapters, with ample case material, demonstrate how to prepare to embark on exposure therapy with a wide range of ED patients, including those with anorexia nervosa, bulimia nervosa, binge-eating disorder, and avoidant/restrictive food intake disorder. Specific types of ED exposure are covered in detail, including exposure to food and eating, cue exposure for binge eating, weighing and weight exposure, body image exposure, emotion and interpersonally focused exposure, and novel forms of exposure for EDs. Clinicians also will walk away with strategies for overcoming obstacles to implementation of exposure therapy, including institutional resistance.

The Complex Relationship Between Eating Disorders and Substance Use Disorders

2017 ◽  
pp. 60-78
Author(s):  
Amy Baker Dennis ◽  
Tamara Pryor
Keyword(s):  
Eating Disorders ◽  
Substance Use ◽  
Substance Use Disorders ◽  
Treatment Plan ◽  
Integrated Treatment ◽  
Evidence Based ◽  
Complex Relationship ◽  
Adaptive Function ◽  
Case Examples ◽  
Evidence Based Treatments

Eating disorders (ED) and substance use disorders (SUD) frequently co-occur but are rarely treated in a comprehensive integrated manner. This chapter elucidates the complex relationship between ED and SUD to help the treating professional create an integrated treatment plan that addresses both disorders and any other co-occurring conditions. Evidence-based treatments for each disorder are discussed, and recommendations on how to take “best practices” from both fields to formulate a treatment plan that addresses the specific needs of the patient are presented. The chapter includes case examples that demonstrate the importance of understanding the adaptive function of both disorders when developing an effective intervention.

Emotion Regulation and Eating Disorders

2017 ◽  
pp. 196-209
Author(s):  
Julian Baudinet ◽  
Lisa Dawson ◽  
Sloane Madden ◽  
Phillipa Hay
Keyword(s):  
Eating Disorders ◽  
Emotion Regulation ◽  
Anorexia Nervosa ◽  
Evidence Based ◽  
Improve Treatment ◽  
Novel Approach ◽  
Evidence Based Treatments ◽  
Regulation Strategies ◽  
Family Based ◽  
Adolescent Eating Disorders

Chapter 10 discusses the prevalence and manifestation of childhood and adolescent eating disorders focusing on Anorexia Nervosa (AN), due to its prevalence. Implementation of maladaptive emotion regulation strategies, with a reduced ability to label and describe emotions leads to the development and propagation of AN. Family based treatments have been widely recognized, as the leading intervention for adolescents with AN, with efficacy rates from 20% to 60%. However, this chapter focuses on a novel approach to AN treatment, centered on emotion regulation in its management, as this may improve treatment outcomes. Programs include: Maudsley Model of Anorexia Nervosa Treatment for Adults and Emotion Acceptance Behavior Therapy, in addition to the modification or adaption of existing, evidence based treatments, such as Radically-Open DBT, although many programs require empirical validation in adolescent samples.

Evidence-Based Treatments and the Atypical/Complex Conundrum

2017 ◽  
pp. 1-18
Author(s):  
Jenna L. Schleien ◽  
Gina Dimitropoulos ◽  
Katharine L. Loeb ◽  
Daniel Le Grange
Keyword(s):  
Eating Disorders ◽  
Clinical Trials ◽  
Anorexia Nervosa ◽  
Diagnostic Criteria ◽  
Historical Development ◽  
Randomized Clinical Trials ◽  
Evidence Based ◽  
Symptom Presentation ◽  
Evidence Based Treatments ◽  
Conceptual Overview

It is well recognized that diagnostic assessments and evidence-based treatment approaches developed for anorexia nervosa (AN) or bulimia nervosa (BN) do not apply as well to atypical and complex eating disorders. This chapter provides a description of the evolution of diagnostic criteria for eating disorder presentations that do not fall under the categories of AN and BN. The chapter begins with an overview of atypical and complex comorbid eating disorders, including historical development, diagnostic criteria, and symptom presentation. Following this conceptual overview, the chapter discusses the challenges of applying results from randomized clinical trials for AN or BN to individuals affected by atypical eating disorders or comorbid diagnoses such as anxiety and substance abuse. The chapter concludes by outlining some possible solutions to the conundrum of identifying effective solutions for individuals with atypical and complex comorbid eating disorders.

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