Therapists’ attitudes and exclusion criteria for prolonged exposure and EMDR in patients with eating disorders and PTSD
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.
Abstract
“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.
Highlights
- Therapists hold more favourable views towards EMDR compared to prolonged exposure when treating PTSD in patients with eating disorders.
- Attitudes towards exposure based treatment predict the likelihood that clinicians exclude patients with eating disorders and PTSD from exposure-based treatment for PTSD.
- Addressing these attitudes towards exposure-based treatment in clinical training and supervision may increase uptake and treatment outcomes for patients with PTSD and eating disorders.”
—Description from publisher
Resource Access
Open Access
van der Starre, J., de Jong, M., De Kleine, R. A., Voogt, C. V., Schoorl, M., & Hoek, H. W. (2025). Therapists’ attitudes and exclusion criteria for prolonged exposure and EMDR in patients with eating disorders and PTSD. European Eating Disorders Review, Early View. https://doi.org/10.1002/erv.70073
Date
December 25, 2025
Creator(s)
J. van der Starre, M. de Jong, R. A. de Kleine
Contributor(s)
C. V. Voogt, M. Schoorl, H. W. Hoek
Topics
Eating Disorders/Body Image, PTSD
Extent
12 pages
Publisher
Eating Disorders Association and John Wiley & Sons Ltd.
Rights
© 2025 The Author(s).
APA Citation
van der Starre, J., de Jong, M., De Kleine, R. A., Voogt, C. V., Schoorl, M., & Hoek, H. W. (2025). Therapists' attitudes and exclusion criteria for prolonged exposure and EMDR in patients with eating disorders and PTSD. European Eating Disorders Review, Early View. https://doi.org/10.1002/erv.70073
Audience
EMDR Therapists, Other Mental Health Professionals
Language
English
Content Type
Article, Peer-Reviewed
Access Type
Open Access
