Exposure for eating disorders: supervising a nervous trainee

Exposure therapy is a key component of evidence‐based cognitive‐behavioural therapy for eating disorders and comorbid anxiety‐based disorders. It can be used to address food avoidance, bingeing, restriction, purging, emotional issues, and body image. However, although exposure is widely recognised to be highly effective, remarkably few clinicians use this approach in working with eating disorders. Where exposure is used, clinicians often omit key elements, which reduces effectiveness. We also tend to base our exposure work on an outdated theory and model of practice. One reason that is commonly given for these clinical practices is that clinicians fear distressing their patients. This workshop will detail the rationale for exposure in working with eating disorders, how it works, recent developments in exposure, and why both patients and therapists need to learn to tolerate their own anxiety, overcoming safety, and avoidance behaviours. Case examples will be used throughout the workshop, to illustrate the use of exposure therapy for a range of eating disorder symptoms.

Learning Objectives

Following this session, the attendee will be able to

describe key steps in implementing exposure; identify patients' safety and avoidance behaviours; and identify clinicians' safety and avoidance behaviours, and how they interact with those of patients.