What Is Exposure-Based Treatment?
Exposure-based treatment is a cognitive behavioral approach that helps people face and reduce fears, worries, and avoidance related to food, eating, body image, and weight. Through planned, gradual practice, the situations that have been avoided become more manageable.
Exposure-based treatment is part of the Eating Disorders Program at PPG, directed by Dr. Heather Rosen. Sessions are available in person at our Chappaqua and Hartsdale offices and online.
Who Exposure-Based Treatment Is For
Exposure is used with children, teens, and adults whose eating disorder involves avoidance of certain foods, eating situations, or body-related experiences. It is used for anorexia, bulimia, binge eating disorder, OSFED, ARFID, and body image concerns, depending on the person.
Exposure is a set of techniques, not a separate full treatment. It can be part of Family-Based Treatment, Enhanced CBT (CBT-E), or other eating disorder care. A clinical assessment helps decide how it fits.
What Exposure Helps With
Foods That Feel Off Limits
Gradual practice with foods that have been avoided, so that a wider range of foods becomes part of everyday eating.
Eating With Others
Practice eating in different settings, such as at home, at school, in restaurants, and with friends or family.
Body Image Distress
Structured practice with looking at the body, and reducing checking, comparing, and avoiding.
Weight and Weighing
Planned practice with weight-related situations, so that weight becomes less of a source of dread.
Rituals and Safety Behaviors
Therapy works on letting go of habits that offer short-term relief but keep the fear going.
Fear of Choking or Vomiting
For ARFID and related concerns, gradual practice with the feared experience and with new foods.
Four parts of exposure-based treatment
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1
Understanding Fear and Avoidance
You and your therapist map the foods, situations, and body-related experiences that have been avoided, and how avoiding them keeps the fear going.
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2
Building a Plan
Together you create a gradual list of steps, from ones that feel more manageable to ones that feel harder, and choose where to begin.
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3
Practicing
You practice the steps in session and between sessions, without relying on rituals or avoidance, and repeat them until they become easier.
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4
Building on Progress
You and your therapist review what you learned, move on to harder steps, and plan for keeping up the gains after treatment.
The Exposure-Based Approach to Care
Exposure is collaborative and paced. You and your therapist build the plan together, practice in session, and plan practice between sessions. Each step is chosen ahead of time, and the pace is reviewed as treatment goes on.
Eating disorders can affect physical health, so ongoing medical monitoring by a physician is part of care. With your consent, your therapist coordinates with your doctor, a dietitian, and any other providers involved.
What to Expect
A Free Consultation
We talk briefly about what you are looking for and match you with a clinician whose training and style fit your needs.
An Assessment
Your clinician gathers history about eating, health, and daily functioning, and discusses whether exposure is a good fit and whether medical monitoring or a higher level of care is needed.
A Treatment Plan
Exposure is tailored to the person and fits within the rest of the treatment plan. We coordinate with your existing providers and help you add others, such as a dietitian or physician, if needed.
Care That Connects Across Specialties
Exposure is often one part of a broader plan. Our clinicians work across specialties, and with your consent your therapist can coordinate with colleagues across the practice.
- Eating Disorders Program: Evaluation, care coordination, and step-down support.
- Enhanced CBT (CBT-E): Individual therapy for adults with eating disorders.
- Family-Based Treatment: A treatment in which parents take an active role in restoring eating and health at home.
- ARFID: Therapy for avoidant/restrictive food intake disorder.
- Body Image Concerns: Therapy for self-criticism and distress about the body.
- OCD, Phobias & Specialized CBT: Cognitive behavioral therapy for OCD and related concerns.
