F.E.A.S.T's Around The Dinner Table forum

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Sorry new to this but what is EXRP?
Sherry Savage

Exposure Response therapy

Exposure therapy is a technique in behavior therapy intended to treat anxiety disorders and involves the exposure to the feared object or context without any danger in order to overcome their anxiety.[1][2] Procedurally it is similar to the fear extinction paradigm in rodent work.[3][4] Numerous studies have demonstrated its effectiveness in the treatment of anxiety disorders such as PTSD and specific phobias.[5]

Exposure-based therapy may be effective in preventing the progression from acute stress disorder to post-traumatic stress disorder, according to a report in the June 2008 issue of Archives of General Psychiatry.[6]

It is also very closely related to exposure and response prevention, a method widely used for the treatment of obsessive–compulsive disorder.


If you are refeeding a child likely you are doing EXRP every time you come to the table.

especially obsessive–compulsive disorder and phobias. It is an example of an exposure therapy.

The method is predicated on the idea that a therapeutic effect is achieved as subjects confront their fears and discontinue their escape response.[1] The behavioral process is called Pavlovian extinction or respondent extinction.[2] An example of how this process works: Imagine a person who repeatedly checks light switches to ensure they're in the off position, even when entering a clearly unlit room. The person would be exposed to their feared stimulus (leaving lights switched on), and would refuse to respond with any safety behaviors. It differs from exposure therapy for phobia in that the resolution to refrain from the escape response is to be maintained at all times and not just during specific practice sessions. Thus, not only does the subject experience habituation to the feared stimulus, they also practice a fear-incompatible behavioral response to the stimulus. While this type of therapy typically causes some short-term anxiety, this facilitates long-term reduction in obsessive and compulsive symptoms.[3]

Recent results indicate that ERP can be carried out effectively with minimal face-to-face contact between the therapist and the subject.[4]

In the field of eating disorder research & treatment, this is a groundbreaking paper that makes the connection between refeeding and exposure therapy:  http://www.ncbi.nlm.nih.gov/pubmed/21190174

EXRP is the gold standard treatment for phobias, fears, anxieties, OCD, but it has yet to be researched with anorexia -- this will be changing as top researchers are looking for better treatments for AN & BN.  You can read about EXRP all over the web.  EXRP offers a more comprehensive way of treating all the involuntary symptoms of AN, not just treating malnutrition and restoring weight.  And as we all know, restoring weight is just the beginning of all the other super-parenting work needed for full recovery!

EXRP can be done at home with the support of a behavioral therapist.  Typically, a therapist will do some exposure work with family in the office and then assign exposure homework -- repetition, consistency, commitment, a strong strategy, and experienced professional support are the keys to successful EXRP.

And here's a interview with one of the authors of the article, Thomas Hildebrandt, clinical psychologist at Mt. Sinai where he briefly explains the article, exposure, and FBT: 
mom to teen daughter in remission/recovery; treatment included UCSD's multi-family program and FBT with EXRP & ACT