Navigating “Whack-a-Mole”: Clinical Considerations in Targeting Co-Occurring PTSD and Substance Use

Psychiatric co-occurrence is common in the treatment of eating disorders, with PTSD and substance use co-occurring at particularly high rates. The presence of co-occurring substance use disorders, eating disorders, and PTSD is likely to negatively impact treatment outcomes. Although there has been progress and attention focused on integrated care for eating disorders and PTSD, recommendations and guidelines do not typically consider other co-occurring psychiatric conditions or substance use. This tends to lead to fragmented, siloed care, and vacillation of symptomatology over time. This phenomenon is often described by clinicians as the “Whack-a-mole” effect. Whereas, addressing one set of symptoms only results in an increase in the other addictive or problematic behaviors. Overall, this contributes to higher rates of relapse in this population and poorer treatment outcomes. As such, this population is especially suited for an integrated treatment approach, which can holistically address their complexities and improve treatment outcomes. However, clinicians need further resources, training and education in this area. Thus, the purpose of this webinar is to discuss clinical considerations and treatment recommendations, using evidence-based principles from existing eating disorders, addictions, and trauma treatments, for addressing co-occurring PTSD and substance use in eating disorder treatment.