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

It 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-min 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.