Written Exposure Therapy and Dialectical Behavior Therapy Skills Training as a Novel Integrated Intervention for Women With Co-Occurring PTSD and Eating Disorders: Two Case Studies

• Published in: Cognitive and behavioral practice 2024-05
• Main Authors: Tilstra-Ferrell, Emily L, Salim, Selime R., López, Cristina, Foster, Anna, Hahn, Christine K.
• Format: Article
• Language: English
• Subjects: eating disorder; PTSD; trauma; treatment
• ISSN: 1077-7229; 1878-187X
• DOI: 10.1016/j.cbpra.2024.02.004

•An integrated intervention for Eating Disorders and Posttraumatic Stress Disorder (ED-PTSD) was applied in an outpatient clinic.•The present case series demonstrates the application of combined Written Exposure Therapy (WET) and Dialectical Behavior Therapy (DBT) skills for ED-PTSD.•Two women who received integrated WET and DBT skills reported reduced PTSD and ED symptoms at follow up.•Research should refine and evaluate combined WET and DBT skills for treating co-occurring ED-PTSD in an outpatient setting. Approximately one quarter of people with posttraumatic stress disorder (PTSD) also have an eating disorder (ED). Yet, there is very limited research on interventions addressing PTSD and EDs (PTSD-ED) simultaneously. Two case studies illustrate the treatment of two women with PTSD-ED using Written Exposure Therapy (WET) for PTSD combined with targeted skills from Dialectical Behavior Therapy (DBT) for Eating Disorders (i.e., dialectical abstinence, self-soothing, pro/cons, mindful urge-surfing, coping ahead). Data include pre-, posttreatment, and 6- to 8-week follow-up scores of PTSD and ED symptoms. Client One completed five sessions. At intake, she met criteria for PTSD and Other Specified Feeding and Eating Disorder based on information gathered in a clinical interview and self-report measures. She reported reductions in both PTSD and ED symptoms at posttreatment and at a 6- to 8-week follow-up. Client Two completed seven sessions. At intake, she met criteria for PTSD and Binge Eating Disorder (BED) based on information gathered in a clinical interview and self-report measures. She reported reductions in symptoms of PTSD and BED at her final session and at a 6- to 8-week follow-up. Results from the presented case studies suggest WET for PTSD combined with DBT skills for EDs holds strong promise for reducing co-occurring PTSD and ED symptoms. Future studies should formally assess the feasibility, acceptability, and effectiveness of integrated WET and DBT skills for the treatment of PTSD-ED.