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Therapists' Attitudes and Exclusion Criteria for Prolonged Exposure and EMDR in Patients With Eating Disorders and
J van der Starre1,2, M de Jong1, R A de Kleine2,3
1Parnassia Psychiatric Institute, PsyQ Eating Disorders Center, The Hague, the Netherlands.
Objective:
A significant proportion of patients with eating disorders (EDs) also meet criteria for posttraumatic stress disorder (PTSD). Guidelines recommend exposure-based treatments for PTSD, including prolonged exposure (PE) and eye movement desensitisation and reprocessing (EMDR). Investigating therapist-related factors could lead to improve their use when ED and PTSD co-occur.
Method:
A cross-sectional survey was conducted among 81 EDs therapists (88% female; M age = 40.4, SD = 10.4) in 2023 in the Netherlands. Hierarchical multiple regression analyses assessed predictors of excluding patients with EDs and comorbid PTSD from exposure-based treatments for PTSD.
Results:
Therapists held more favourable beliefs about EMDR (M = 10.5, SD = 7.5) than PE (M = 13.9, SD = 6.9), and were less likely to exclude patients with EDs and comorbid PTSD from EMDR (M = 15.5, SD = 9.3) than PE (M = 17.7, SD = 9.3) (t(80) = 3.47, p < 0.002). Beliefs about exposure-based interventions predicted the likelihood of exclusion from both PE (β = 0.56, p < 0.002) and EMDR (β = 0.69, p < 0.002).
Conclusions:
Therapists' beliefs influence the use of exposure-based treatments for PTSD in patients with EDs and comorbid PTSD. Addressing these beliefs in training, may support broader implementation.
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