About

Edna B. Foa, PhD, is a Professor of Psychiatry in the Department of Psychiatry at the University of Pennsylvania and the Director of the Center for the Treatment and Study of Anxiety. She received her Ph.D. in Clinical Psychology and Personality from the University of Missouri in 1970. Dr. Foa has devoted her academic career to studying the psychopathology and treatment of anxiety disorders, primarily obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and social phobia. She is recognized as one of the world’s leading experts in these areas.

Research topics

• Medicine
• Psychiatry
• Physical therapy
• Clinical psychology
• Internal medicine
• Psychology

Selected publications

• Differential Effects of Hazardous Drinking on Post-Traumatic Stress Disorder Outcomes Across Two Prolonged Exposure Treatment Formats.

  PubMed · 2025-07-15

  articleOpen access

  = 0.025) at the 6-month follow-up. There was no significant difference in treatment engagement based on drinking classification and outcomes did not vary based on PE format. The findings suggest that PE is an appropriate treatment for individuals with PTSD and hazardous drinking. However, group differences in PTSD symptom reductions indicate concurrent hazardous drinking reduces treatment benefits of PE.

  PublisherOA PDFDOI

• Does postworkshop consultation affect which patients receive prolonged exposure and who improves the most?

  Psychological Services · 2025-12-08

  article

  = 103) working at military behavioral health clinics were randomized to receive a 4-day PE workshop with or without weekly postworkshop consultation for their first two patients and then provided the treatment of their choice to 242 patients with PTSD. Poisson regression analyses and multilevel models tested the moderating effect of PTSD severity, comorbid disorders, anger, and suicidality on provider use of PE components and on patient change in PTSD severity. Results showed that both the presence of a comorbid substance use disorder (SUD) and the total number of comorbid anxiety disorders moderated the impact of provider training on the use of PE. Specifically, providers who did not receive PE consultation used few PE components across comorbid conditions, whereas providers who received consultation used more PE components with patients with comorbid SUD and fewer components with patients with comorbid anxiety disorders. In addition, comorbid SUD and suicidality moderated the impact of training on clinical improvement such that patients with comorbid SUD and patients with suicidality experienced greater PTSD improvement when treated by providers who did versus did not receive postworkshop consultation. Findings demonstrate the impact of postworkshop consultation on therapy implementation and clinical outcomes across common clinical presentations in a military treatment setting. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

  PublisherDOI

• An Open-Phase Pilot Trial of an Integration of Prolonged Exposure Therapy and the Coping Long-Term With Active Suicide Program

  Cognitive and Behavioral Practice · 2025-06-11

  articleOpen access

  • Posttraumatic stress disorder increases risk for suicide. • Prolonged exposure therapy was integrated with a suicide prevention program, CLASP. • CLASP-PE reduced suicidal ideation, PTSD, and depression. • Improvements in PTSD and depression predicted improvements in suicidal ideation. Posttraumatic stress disorder (PTSD) is associated with an increased risk for suicidal ideation and behavior, yet clinical practice guidelines for addressing suicide risk in the context of PTSD are not yet available. This open trial evaluated the safety and preliminary efficacy of an integration of a trauma-focused treatment, prolonged exposure therapy (PE), with the coping long-term with an active suicide program (CLASP). CLASP-PE was delivered to patients with PTSD who reported suicidal ideation with intent, a plan, or a past month attempt. Veterans or active-duty military personnel with a confirmed PTSD diagnosis and suicide risk (N = 14; 86% male) began the CLASP-PE protocol, which was delivered via telemedicine in 10–16 sessions, including a session with a support person as feasible. Two participants only provided baseline data; of the remaining 12, 8 participants (n = 66.7%) completed their treatment sessions. Participants reported significant reductions in PTSD symptoms ( p <.05), suicidal ideation ( p <.05), and depression symptoms ( p <.001). The degree of reduction in PTSD symptoms and depression symptoms in treatment predicted the degree of reduction in suicidal ideation in treatment. No suicide attempts or serious adverse events occurred in treatment. A case vignette is shared. CLASP-PE was safe, with preliminary evidence supporting its efficacy. Additional randomized controlled trial research is needed to evaluate its impact compared to a control group. If replicated, the CLASP-PE protocol would be a useful and safe clinical tool for individuals with PTSD who are experiencing significant suicide risk.

  PublisherDOI

• Examination of the Top Three Traumatic Experiences Among United States Service Members and Veterans with Combat-Related Posttraumatic Stress Disorder

  Behavioral Sciences · 2025-09-05

  articleOpen access

  Many trauma-focused psychotherapies for posttraumatic stress disorder (PTSD) focus on the most distressing trauma. However, military personnel are often exposed to multiple traumatic experiences. This study aimed to evaluate and categorize the top three traumatic experiences identified by United States (U.S.) military service members seeking treatment for PTSD and compare frequency of trauma types by demographic/military characteristics. Active duty service members and veterans (N = 110) with PTSD identified and ranked their top three most distressing experiences. Behavioral health professionals classified experiences according to one categorical and four dichotomous classification schemes. The categorical scheme included life threat to self, life threat to others, aftermath of violence, traumatic loss, moral injury by self, and moral injury by others. The Life Threat to Self classification represented the largest portion of categorical experiences (43%). Most experiences were dichotomously classified as military-related (86%), combat-related (70%), non-sexual (91%), and trainability (versus futility; 71%). Women were more likely to report sexual traumatic experiences and less likely to report military- and combat-related experiences. Military occupational specialty, number of deployments, time in military, active duty status, and marital status were also associated with different classification rates. There was noteworthy variability in types of experience across top three traumas, especially among certain subpopulations.

  PublisherOA PDFDOI

• State of the Science: Prolonged exposure therapy for the treatment of posttraumatic stress disorder

  Journal of Traumatic Stress · 2024-04-23 · 29 citations

  reviewSenior author

  Prolonged exposure therapy (PE) is a well-established first-line treatment for posttraumatic stress disorder (PTSD) that is based on emotional processing theory. PE has been rigorously evaluated and tested in a large number of clinical trials in many countries covering a wide range of trauma populations. In this review, we summarize the evidence base supporting the efficacy of PE across populations, including adults with sexual assault-related PTSD and mixed trauma-related PTSD, military populations, and adolescents. We highlight important strengths and gaps in the research on PE with individuals from marginalized communities. We discuss the efficacy of PE on associated psychopathology and in the presence of the most commonly comorbid conditions, either alone or integrated with other treatments. In addition, we provide an overview of research examining strategies to augment PE. Much of this work remains preliminary, but numerous trials have tested PE in combination with other psychological or pharmacological approaches, interventions to facilitate extinction learning, and behavioral approaches, in the hopes of further increasing the efficiency and efficacy of PE. There are now several trials testing PE in novel formats that may have advantages over standard in-person PE, such as lower dropout and increased scalability. We examine this recent work on new models of delivering PE, including massed treatment, telehealth, and brief adaptations for primary care, all of which have the potential to increase access to PE. Finally, we highlight several promising areas for future research.

  PublisherDOI

• A dynamical systems analysis of change in PTSD symptoms, depression symptoms, and suicidal ideation among military personnel during treatment for PTSD

  Journal of Affective Disorders · 2024-01-16 · 7 citations

  articleOpen access

  OBJECTIVE: The connections among posttraumatic stress disorder (PTSD), depression, and suicidal ideation are elusive because of an overreliance on cross-sectional studies. In this secondary analysis of pooled data from three clinical trials of 742 military personnel, we examined the dynamic relationships among PTSD, depression, and suicidal ideation severity assessed repeatedly during and after outpatient treatment for PTSD. METHODS: We conducted dynamical systems analyses to explore the potential for coordinated change over time in psychotherapy for PTSD. RESULTS: Over the course of psychotherapy, PTSD, depression, and suicidal ideation severity changed in coordinated ways, consistent with an interdependent network. Results of eigenvalue decomposition analysis indicated the dominant change dynamic involved high stability and resistance to change but indicators of cycling were also observed, indicating participants "switched" between states that resisted change and states that promoted change. Depression (B = 0.48, SE = 0.11) and suicidal desire (B = 0.15, SE = 0.01) at a given assessment were associated with greater change in PTSD symptom severity at the next assessment. Suicidal desire (B = 0.001, SE < 0.001) at a given assessment was associated with greater change in depression symptom severity at the next assessment. Neither PTSD (B = -0.004, SE = 0.007) nor depression symptom severity (B = 0.000, SE = 0.001) was associated with subsequent change in suicidal ideation severity. CONCLUSIONS: In a sample of treatment-seeking military personnel with PTSD, change in suicidal ideation and depression may precede change in PTSD symptoms but change in suicidal ideation was not preceded by change in PTSD or depression symptoms.

  PublisherDOI

• Examining emotional processing theory and predictors of outcome in prolonged exposure for PTSD

  Behaviour Research and Therapy · 2023-06-07 · 17 citations

  articleSenior author
  PublisherDOI

• Efficacy and moderators of efficacy of cognitive behavioural therapies with a trauma focus in children and adolescents: an individual participant data meta-analysis of randomised trials

  The Lancet Child & Adolescent Health · 2023-11-17 · 33 citations

  reviewOpen access

  Background: Existing clinical trials of cognitive behavioural therapies with a trauma focus (CBTs-TF) are underpowered to examine key variables that might moderate treatment effects. We aimed to determine the efficacy of CBTs-TF for young people, relative to passive and active control conditions, and elucidate putative individual-level and treatment-level moderators. Methods: This was an individual participant data meta-analysis of published and unpublished randomised studies in young people aged 6-18 years exposed to trauma. We included studies identified by the latest UK National Institute of Health and Care Excellence guidelines (completed on Jan 29, 2018) and updated their search. The search strategy included database searches restricted to publications between Jan 1, 2018, and Nov 12, 2019; grey literature search of trial registries ClinicalTrials.gov and ISRCTN; preprint archives PsyArXiv and bioRxiv; and use of social media and emails to key authors to identify any unpublished datasets. The primary outcome was post-traumatic stress symptoms after treatment (<1 month after the final session). Predominantly, one-stage random-effects models were fitted. This study is registered with PROSPERO, CRD42019151954. Findings: We identified 38 studies; 25 studies provided individual participant data, comprising 1686 young people (mean age 1365 years [SD 301]), with 802 receiving CBTs-TF and 884 a control condition. The risk-of-bias assessment indicated five studies as low risk and 20 studies with some concerns. Participants who received CBTs-TF had lower mean post-traumatic stress symptoms after treatment than those who received the control conditions, after adjusting for post-traumatic stress symptoms before treatment (b=-1317, 95% CI -1784 to -850, p<0001, 2=10372). Moderation analysis indicated that this effect of CBTs-TF on post-traumatic stress symptoms post-treatment increased by 015 units (b=-015, 95% CI -029 to -001, p=0041, 2=003) for each unit increase in pre-treatment post-traumatic stress symptoms. Interpretation: This is the first individual participant data meta-analysis of young people exposed to trauma. Our findings support CBTs-TF as the first-line treatment, irrespective of age, gender, trauma characteristics, or carer involvement in treatment, with particular benefits for those with higher initial distress.

  PublisherOA PDFDOI

• Predictors of clinical worsening during a discontinuation trial of serotonin reuptake inhibitors for obsessive compulsive disorder

  Journal of Anxiety Disorders · 2023-12-04 · 1 citations

  articleOpen accessSenior author
  PublisherOA PDFDOI

• A multistep mediation model examining how consultation in prolonged exposure therapy affects PTSD treatment outcomes.

  Psychological Services · 2023-05-08 · 3 citations

  articleOpen access

  = 103). Providers who received extended training reported greater PE self-efficacy compared to standard training providers, but self-efficacy was unrelated to their use of PE components or to patient outcomes. Extended training providers used more PE components and had superior patient outcomes than standard training providers, and patient outcomes were mediated by the use of PE components. To our knowledge, this is the first study to demonstrate that EBP consultation leads to improved clinical outcomes for patients through increased use of the EBP. PE adoption (i.e., use of PE components in therapy) was not explained by increases in self-efficacy among providers who received extended training. Therefore, future research should assess how other factors may influence provider behavior in implementing EBPs. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

  PublisherDOI

Recent grants

• NIH Grant R01MH049340

  NIH · $1.1M · 2002

• 2/2-- Attaining and Maintaining Wellness in OCD

  NIH · $6.4M · 1990–2017

• NIH Grant R01AA012428

  NIH · $5.5M · 2010

• NIH Grant R10MH045404

  NIH · $978k · 2000

• NIH Grant R01MH07450504

  NIH · $429k · 2011

Frequent coauthors

• Elizabeth A. Hembree

  University of Pennsylvania

  117 shared

• H. Blair Simpson

  New York Psychoanalytic Society and Institute

  111 shared

• Martin E. Franklin

  97 shared

• Jonathan Davidson

  Royal Holloway University of London

  96 shared

• Jonathan D. Huppert

  Hebrew University of Jerusalem

  86 shared

• Shawn P. Cahill

  University of Wisconsin–Milwaukee

  71 shared

• Michael R. Liebowitz

  69 shared

• Barbara O. Rothbaum

  Emory University

  65 shared

Education

• B.A., Psychology, Literature

  Bar Ilan University

  1962

• M.A., Clinical Psychology

  University of Illinois

  1970

• Ph.D., Clinical Psychology and Personality

  University of Missouri

  1970

Awards & honors

• Time 100 most influential people for 2010