Impact of education on clinicians' attitudes to exposure therapy for eating disorders

Abstract

Article available under the terms of the CC-BY-NC-ND licence (https://creativecommons.org/licenses/by-nc-nd/4.0/) eprints@whiterose.ac.uk https://eprints.whiterose.ac.uk/ Reuse Unless indicated otherwise, fulltext items are protected by copyright with all rights reserved. The copyright exception in section 29 of the Copyright, Designs and Patents Act 1988 allows the making of a single copy solely for the purpose of non-commercial research or private study within the limits of fair dealing. The publisher or other rights-holder may allow further reproduction and re-use of this version -refer to the White Rose Research Online record for this item. Where records identify the publisher as the copyright holder, users can verify any specific terms of use on the publisher's website. TakedownIf you consider content in White Rose Research Online to be in breach of UK law, please notify us by emailing eprints@whiterose.ac.uk including the URL of the record and the reason for the withdrawal request. Addressing clinicians' attitudes to exposure therapy AbstractIt is well established that clinicians use exposure therapy far less often than the evidence would suggest is justified. This shortfall has been explained as being at least partly a result of clinicians' beliefs and attitudes about exposure and their trait anxiety. Recent studies have shown that attitudes to exposure therapy for anxiety disorders can be improved through a simple educational approach. This study aimed to determine whether a similar educational approach can improve therapists' attitudes to exposure therapy for the eating disorders, and whether clinician's pre-intervention characteristics influenced the impact of the training. Thirty-four eating disorder clinicians (30 female, four male; mean age = 39.0 years; 85.3% Caucasian) attended a 90-minute didactic teaching session on the subject of the use of exposure in treatment of eating disorders. Their attitudes to exposure therapy were measured before and after the workshop, in a within-subject design. The outcome was a substantial improvement in attitudes, with a strong effect size (Cohen's d = 1.68) that was comparable to the outcome of a similar intervention among clinicians working with anxiety disorders. The improvement was not related to clinicians' anxiety levels, but was greater among those whose attitudes were more negative at the outset of the teaching. While this finding needs to be tested for long-term maintenance and its relationship to change in clinical practice, it adds to the evidence that a simple educational intervention is sufficient to result in substantial improvement in clinicians' attitudes to exposure therapy.

Exploring the preliminary effectiveness and acceptability of food-based exposure therapy for eating disorders: A case series of adult inpatients

“…Clinicians who are fearful of utilizing food-related exposure therapy will hopefully take confidence from our findings that the treatment was apparently well-accepted and tolerated among an inpatient sample, which is often a treatment setting characterized by a high degree of ED symptom severity, as well as medical comorbidities. Relatedly, our findings may make an important contribution to ongoing efforts to develop educational interventions aimed at decreasing clinician concerns about utilizing exposure-based therapy for EDs (Waller, D’Souza Walsh, & Wright, 2016).…”

Treatment Protocols for Eating Disorders: Clinicians’ Attitudes, Concerns, Adherence and Difficulties Delivering Evidence-Based Psychological Interventions

“…Commonly, a single teaching session of a few hours to two days is treated as ‘training’, even though there is little evidence that this works. For example, whilst it is known that such sessions can influence knowledge of and attitudes to exposure therapy, both for eating disorders and anxiety disorders ( 72 , 73 ), it is not yet known whether such changes translate into better use of the necessary skills in everyday practice. In short, does education translate into competence, and does competence translate into adherence to protocols and hence to more effective treatment?…”

Clinician and patient characteristics and cognitions that influence weighing practice in cognitive‐behavioral therapy for eating disorders

“…Farrell, Deacon, Dixon, and Lickel () have suggested a number of ways in which these changes could be achieved. Even straightforward training sessions on the subject of exposure therapy are relatively effective in changing such attitudes (Deacon et al, ; Waller, D'Souza Walsh, & Wright, ) and should be considered in changing clinician weighing practice. However, creating behavioral change is a complex issue, requiring more than changing beliefs, skills, and attitudes.…”

“…Farrell, Deacon, Dixon, and Lickel (2013) have suggested a number of ways in which these changes could be achieved. Even straightforward training sessions on the subject of exposure therapy are relatively effective in changing such attitudes Waller, D'Souza Walsh, & Wright, 2016) and…”