Clinical Round Table 22 - Translating Inhibitory Learning Principles into Clinical Practice: Optimizing Exposure Therapy for Eating Disorders

The contemporary “inhibitory learning” approach to exposure therapy may optimize treatment outcomes for anxiety disorders relative to traditional habituation-based approaches (Abramowitz, 2019; Craske et al., 2008; Deacon et al., 2013; Kennedy & Hawks, 2021), and has the potential to enhance the effectiveness of exposure therapy for eating disorders (Schaumberg et al., 2021). However, limited practical guidance exists on distinguishing this approach from habituation-based methods, and implementing this shift toward inhibitory learning in real-world clinical settings. This clinical round table brings together experts who research, teach, supervise, and deliver exposure therapy for eating disorders, anxiety disorders, and obsessive-compulsive disorder (OCD) across diverse treatment settings, including large private health systems, academic medical centers, university-based clinics, and clinical trials. The discussion will focus on the practical shift from habituation-based to inhibitory learning approaches in eating disorder treatment across these settings and multiple levels of care (e.g., outpatient, partial hospitalization, residential treatment). Panelists will address how this theoretical shift transforms several aspects of clinical practice, including: psychoeducation and treatment rationale, development of exposure lists or “menus,” selection criteria for feared stimuli and situations, decision-making around exposure progression, designing and structuring exposures, implementation of exposure exercises, and post-exposure processing. Eating disorder specialists will share implementation experiences, highlighting benefits, barriers, and comparative advantages over traditional approaches, while OCD and anxiety disorder experts will provide cross-diagnostic perspectives, comparing applications across disorders and identifying transferable techniques. Together, this round table of experts will explore similarities and differences between anxiety and eating disorder exposure applications and identify novel strategies to optimize exposure therapy for eating disorders.