Overcoming Challenges

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ID: 337674
2026
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Abstract
Abstract This chapter examines common challenges that arise during exposure therapy for eating disorders and outlines practical strategies to address them across treatment. It explains how therapists strengthen motivation by revisiting psychoeducation, aligning exposures with client values, calibrating the Fear and Avoidance Hierarchy, and reinforcing progress to counter avoidance and ambivalence. The chapter discusses how to use distress ratings during exposures, exploring how both heightened anxiety and the absence of anxiety provide clinically meaningful information. Eliminating safety behaviors and using an inhibitory learning framework are also discussed. It addresses mental rituals, weight changes, and concerns about treatment progress, underscoring systematic monitoring, and adherence to guidelines for determining medical stability. Finally, the chapter delineates strategies for managing treatment-interfering behaviors, structuring sessions to protect exposure time, promoting homework adherence, and assigning Worksheet 9.1 to consolidate therapeutic gains.
Reference Key
openalex_W7224190483 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Cheri A. Levinson, Rachel M. Butler
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Journal Oxford University Press eBooks
Year 2026
DOI
10.1093/med-psych/9780197816875.003.0010
URL
https://doi.org/10.1093/med-psych/9780197816875.003.0010
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