Latest trauma research published in the Journal of Eating Disorders

“Eating Disorder Patients With and Without PTSD Treated in Residential Care: Discharge And 6-month Follow-up Results,” was recently published in the Journal of Eating Disorders. This 5-year comprehensive and statistically significant study is peer-reviewed and approved by an Institutional Review Board.

This is the culmination of many years of work and will undoubtedly help further our field’s understanding that trauma can be treated at higher levels of care. This is also another proof point that our small milieu and warm, home-like environment create a safe space for clients as they engage in life-changing treatment.

Our clients get better.

Our research allows us to better understand our clients and meet their needs

We have been evaluating the benefits of our treatment for decades and have previously published the only peer-reviewed decade-long post-graduate outcome study on residential eating disorder clients. Our current research is an extension of our twenty-seven year commitment to providing research-backed care.

Step Down Graph
Clients Currently Enrolled in the Study
With A Image
High Response Rate*
at Admission
at Discharge
Based on consent rates
High response rate indicates data truly reflects our client population
And Image
Weight Restored by Discharge from Residential
of Adolescents
Scale Image Scale Lbs Image
of Adults
Among clients diagnosed with Anorexia Nervosa

Our clients maintain treatment gains 6-months post-discharge

They get well and stay well

We are the first treatment provider to show lasting improvement

significantly improved
Reduced ED Symptoms
significantly improved
Reduced Depression Symptoms
significantly improved
Reduced Anxiety Symptoms

of adults admitted to residential eating disorder treatment meet criteria for posttraumatic stress disorder (PTSD)

In response to high rates of trauma, we developed an integrated trauma treatment program. We are the first to provide evidence-based trauma treatment (CPT) concurrently with eating disorder treatment in higher levels of care

Improvements Graph

Important Takeaways

  • Almost half (45%) of adults admitted to residential eating disorder treatment have posttraumatic stress disorder (PTSD). Clients with significant traumatic histories and/or PTSD have more severe eating disorder symptoms, more suicidality, more anxiety and depressive symptoms.
  • We studied clinical outcomes in clients with and without PTSD. Using an integrated clinical approach including cognitive processing therapy (CPT) and other evidence-based treatments, clients improved significantly and remained improved 6 months following discharge compared to admission.
  • 81% of patients with PTSD at admission had reductions in trauma symptom scores from admission to discharge and 73% from admission to follow-up (6 months later).
  • Symptom improvements made during treatment were maintained 6 months after discharge. Clients treated at Monte Nido & Affiliates get well and stay well long-term.
  • According to the journal, “Posttraumatic stress disorder (PTSD) is common in clients with eating disorders and is associated with higher severity of symptoms and worse outcomes. However, this has not been studied extensively in clients admitted to higher levels of care, such as residential treatment. Using an integrated clinical approach based upon principles of cognitive processing therapy (CPT) and other evidence-based treatments, we studied outcomes at discharge and 6 months following discharge in 609 clients (96% female; mean age (+ SD) = 26.0 + 8.8 years; 25% LGBTQ+) with and without PTSD.”
  • Our post-discharge outcomes data show that we are not only treating clients’ mental health illnesses, but we’re also providing them with the tools and coping skills to self-manage symptoms and maintain recovery.
Trauma Male Therapy

Cognitive Processing Therapy (CPT)

Cognitive Processing Therapy (CPT) is an evidence-based therapeutic approach used to treat trauma by addressing and challenging negative thought patterns and beliefs related to the traumatic event. Through structured sessions, individuals learn to reevaluate and reframe their thoughts, helping to reduce distress and improve their psychological well-being.

Beyond trauma informed care

At Monte Nido & Affiliates, we go beyond trauma-informed care by being the first to provide evidence-based trauma treatments. We integrate cognitive processing therapy (CPT), one of the three gold standard trauma treatments, in parallel with eating disorder treatment that complements cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT).

This is how we continue to be able to provide robust research that informs our programs.

If I never started CPT, I don’t know if I would have gotten to a point in my life where my trauma didn’t consume me. Now I have the skills it takes to sit through it, manage it, and move on from it.

Guy 6
Client Sentiment about CPT

I have never addressed my trauma before. I was either too scared or told it wasn’t the right time, or both. I’ve been in and out of treatment for my eating disorder and kept relapsing. I continued to be told that I was too unstable in my eating disorder to begin the trauma work, but I know my trauma is at the root of all my issues

Gal 2
Client Sentiment about CPT

I 10 out of 10 recommend CPT.

Guy 5
Client Sentiment about CPT

I have been able to witness miraculous shifts in the way that clients navigate their lives because of CPT.

Guy 6
Therapists’ Feedback on CPT

Clients don’t always want to get better from their eating disorder, but they usually want to feel relief in regards to their PTSD symptoms. CPT motivates them to work harder in therapy.

Gal 1
Therapists’ Feedback on CPT

One client realized it was not about feeling skinny, it was about feeling empty.

Guy 1
Therapists’ Feedback on CPT

Informing changes to treatment best practices.

The conventional thinking in the eating disorder field is that it’s best to refrain from trauma work while in intensive treatment settings and defer this to later outpatient treatment. This is often driven by a lack of expertise in trauma assessment and treatment and by fears of making the eating disorder worse.

However, this research tells us that “concurrent, parallel, but interwoven, approaches to treatment, one for the eating disorder and one for PTSD, can be delivered during the same treatment course by the same providers/therapists.”

Integrated treatment approaches that address PTSD and related problems can be successfully delivered in residential treatment and are associated with sustained improvements at 6 months following discharge.

We are hopeful that these findings may help others in the eating disorder field to tailor more effective and integrated treatment approaches for individuals with PTSD who are admitted to higher levels of care for eating disorder treatment.

Staff Co-Authors

The following people co-authored the latest research as well as much of our past research, and we’re honored that they are part of our Monte Nido & Affiliates family.

Molly Perlman
Molly Perlman, MD, MPH, CEDS

Molly M. Perlman, MD, MPH, CEDS, FAPA is Chief Medical Officer of Monte Nido & Affiliates, overseeing psychiatric and medical care at over 50 facilities across the nation. She is double board certified in psychiatry and addiction medicine, graduated from Duke University and the University of Miami, and has trained in psychoanalytic psychotherapy. During residency in psychiatry, Dr. Perlman served as Chief Resident and was awarded the Laughlin Fellowship, which is bestowed annually on 12 elite residents for outstanding leadership and significant achievements in psychiatry. Dr. Perlman is on the Board of Directors of the Eating Disorders Coalition, served as Vice President of the Board from 2018 through 2022, and advocates on Capitol Hill regularly for increasing eating disorder education and access to treatment. Additionally, she oversees Monte Nido & Affiliates IRB-approved research study on clinical outcomes as Co-Principal Investigator and has co-authored several papers in peer-reviewed research journals on PTSD and eating disorders.

Giulia Suro
Giulia Suro, Ph.D., CEDS

Giulia Suro, Ph.D., CEDS is the Director of Research and Clinical Outcomes for Monte Nido & Affiliates directing the day-to-day operations of a nationwide, IRB-approved research program in capturing the treatment outcomes of individuals diagnosed with a range of eating disorder diagnoses across all levels of care. As a member of the broader research program, she helps translate this data to meaningful findings that may inform treatment and improve the field of eating disorders. Prior to this position, she served as a Postdoctoral Resident, Primary Therapist and Clinical Director at the Oliver-Pyatt Centers. She is also a passionate student and practitioner of Acceptance and Commitment Therapy (ACT). In 2019, she published an ACT workbook titled “Learning to Thrive,” which was the first ACT text of its kind written for a general audience.

Ismael Gavidia
Ismael Gavidia, MSc

Ismael Gavidia, MSc is the Clinical Outcomes & Research Manager for Monte Nido & Affiliates responsible for the data collection of the IRB-approved research program for the treatment outcomes of individuals across all levels of care and eating disorders diagnoses nationwide. Ismael conducts statistical analysis to interpret the data into findings that provide feedback to clinical treatment, which are contributing to the advancement of the eating disorders field. He has worked as a biostatistician for more than 20 years in the psychological, medical, and social work fields, and holds degrees from Universidad Simon Bolivar in Venezuela.

Tim Brewerton
Timothy D. Brewerton, MD, DLFAPA, FAED, DFAACAP, CEDS-S

Timothy D. Brewerton, MD, DLFAPA, FAED, DFAACAP, CEDS-S is Affiliate Professor of Psychiatry & Behavioral Sciences at the Medical University of South Carolina in Charleston, SC, and Senior Research Advisor for Monte Nido & Affiliates. He is Distinguished Life Fellow of the American Psychiatric Association; Distinguished Fellow of the American Academy of Child and Adolescent Psychiatry; Founding Fellow of the Academy of Eating Disorders and former president of the Eating Disorders Research Society. He has authored over 180 articles and book chapters, has edited two books, and has presented over 250 scientific presentations at national and international conferences. Dr. Brewerton is also Executive Producer of a documentary about child maltreatment, eating disorders, and dissociative identity disorders. Dr. Brewerton has been instrumental in exploring the overlaps between trauma, PTSD and eating disorders, and promoting integrated treatment approaches for eating and related comorbid disorders. His research profile can be viewed here, where any of his publications can be downloaded or requested.

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