People / Cognitive, behavioural and contextual
Edna B. Foa
Founded the Center for the Treatment and Study of Anxiety and, with Michael Kozak, proposed emotional processing theory as an account of exposure therapy.
At a glance
Lived 1937 to 2026. Israeli-American. Clinical Psychologist & Anxiety/Trauma Researcher.
Active 1974 to 2026. Landmark year 1986. Clinical era: 1970 to 1989, cognitive, systemic and alliance.
Lineage: Cognitive, behavioural and contextual. Roles: Modality founder or co-founder; Process and outcome researcher; Clinical theorist.
Associated modalities: Prolonged Exposure Therapy (PE) for PTSD; Exposure and Response Prevention (ERP / EX/RP) for OCD.
Clinical psychologist who developed prolonged exposure for PTSD and contributed to research on exposure and response prevention for OCD.
Review status: Educational draft, subject review pending. Source status: source checks not documented for this draft. Dates, sources and clinical statements require independent verification and specialist review.
Clinical overview
Edna B. Foa (1937–2026) was an Israeli-born American clinical psychologist and professor of clinical psychology in psychiatry at the University of Pennsylvania. She founded and directed its Center for the Treatment and Study of Anxiety. She earned a BA in psychology and literature at Bar-Ilan University in 1962, an MA in clinical psychology at the University of Illinois in 1970, and a PhD in clinical psychology and personality at the University of Missouri in 1970. Penn reports that she retired in 2021 and died on 24 March 2026.
Foa studied behavioural treatments for obsessive-compulsive disorder and post-traumatic stress disorder. Exposure and response prevention had earlier roots in Victor Meyer’s work in the 1960s and was developed further by Foa and others. With Michael J. Kozak, she published an influential theoretical account of exposure in 1986.
Historical and clinical context
Early behaviour therapy relied on conditioning accounts of habituation, yet struggled to explain why some patients who confronted feared stimuli failed to improve and why cognitive meaning shifts accompanied successful exposure. Building on Peter Lang's bio-informational theory of emotion, Foa and Kozak (1986) proposed that fear is represented in memory as a 'cognitive structure' (a network linking stimulus elements, physiological/behavioural responses, and meaning evaluations of danger and incompetence) that becomes pathological when its associations do not match reality.
Beginning in the 1980s, Foa and colleagues developed prolonged exposure for PTSD. Their account proposed that avoidance and negative beliefs about threat and coping can contribute to persistent distress; this is a model, not an established explanation for every person’s experience.
Core therapeutic contributions
Emotional Processing Theory (with Michael J. Kozak, 1986). Foa and Kozak proposed that exposure can modify fear structures when the relevant fear is activated and new information is available. This theoretical account remains one way to explain treatment processes, rather than proof that a particular mechanism is necessary for every person.
Prolonged Exposure (PE) Therapy for PTSD. Developed a manualised 8-to-15-session individual treatment combining four core components: psychoeducation about common reactions to trauma, breathing retraining, graded in-vivo exposure to objectively safe situations avoided since the trauma, and repeated, present-tense imaginal exposure (revisiting and recounting the trauma memory aloud, followed by 15–20 minutes of collaborative emotional processing).
Exposure and Ritual/Response Prevention (EX/RP) for OCD. Foa and colleagues researched and refined exposure and response prevention for OCD. The approach developed from earlier work, including Victor Meyer’s treatment reports in 1966.
Posttraumatic Cognitions Inventory (PTCI) and Diagnostic Scales. Foa and colleagues developed measures including the Posttraumatic Diagnostic Scale, Posttraumatic Cognitions Inventory and Obsessive-Compulsive Inventory. Research uses such measures to study symptoms and their relationship to outcomes.
In the consulting room
Therapeutic stance. Prolonged exposure is a structured approach that is typically planned collaboratively with the client. The pace and content depend on the person and the treatment setting.
Signature practices. Guiding Imaginal Exposure by asking the client to close their eyes and recount the trauma narrative in the first-person present tense ('I am seeing...', 'I am feeling...'), tracking Subjective Units of Distress (SUDS) every 5 minutes; Zooming in on 'hot spots' (the most terrifying or shameful moments of the trauma memory) once the general narrative has been processed; Conducting post-imaginal 'Processing' immediately after recounting the memory to explore emerging shifts in meaning, self-blame, and competence, and assigning daily audio-recording listening at home
Common misreadings. Assuming dropout rates are the same across all PTSD treatments and settings. Studies differ in how they define dropout and which treatments they compare; some comparisons have found higher dropout from trauma-focused treatment.; Treating exposure as a purely mechanical endurance test of habituation while neglecting the vital post-imaginal emotional processing conversation where meaning and self-blame shift
Landmark clinical works
1986, Emotional Processing of Fear: Exposure to Corrective Information (paper). Co-authored with Michael J. Kozak in Psychological Bulletin; one of the most cited theoretical papers in clinical psychology, establishing Emotional Processing Theory.
1998, Treating the Trauma of Rape: Cognitive-Behavioral Therapy for PTSD (book). Co-authored with Barbara Olasov Rothbaum; foundational clinical text presenting the development and empirical trials of Prolonged Exposure for sexual assault survivors.
2007, Prolonged Exposure Therapy for PTSD: Emotional Processing of Traumatic Experiences - Therapist Guide (manual). Co-authored with Elizabeth A. Hembree and Barbara Olasov Rothbaum; the standard international clinical manual for Prolonged Exposure.
2012, Exposure and Response (Ritual) Prevention for Obsessive-Compulsive Disorder: Therapist Guide (manual). Co-authored with Elna Yadin and Tracey K. Lichner; definitive clinical protocol for EX/RP in OCD.
Clinical critiques and limitations
The mechanisms by which exposure therapies help remain under study. Later research has explored inhibitory learning and the limits of relying on within-session fear reduction as a marker of long-term outcome.
Phase-based complex-trauma clinicians (such as Judith Herman and Marylene Cloitre) debated whether patients with severe childhood-onset developmental trauma and dissociation benefit from a preparatory phase of emotion-regulation skills (such as STAIR) prior to direct imaginal exposure.
Clinical genealogy
Influences and mentors: Joseph Wolpe; Isaac Marks; Stanley Rachman; Peter Lang; Aaron Temkin Beck.
Collaborators: Michael J. Kozak; Barbara Olasov Rothbaum; Elizabeth A. Hembree; Constance V. Dancu; David F. Tolin; H. Blair Simpson; Martin E. Franklin.
Students and successors: Barbara Olasov Rothbaum; Elizabeth A. Hembree; Lori A. Zoellner; Norah C. Feeny; Jonathan S. Abramowitz; Carmen P. McLean.
Sources and inspection notes
Supports: A dated check of its relevance to this profile is not recorded for this draft
Foa, E. B., & Rothbaum, B. O. (1998). Treating the Trauma of Rape: Cognitive-Behavioral Therapy for PTSD. Guilford Press.
Supports: A dated check of its relevance to this profile is not recorded for this draft
Foa, E. B., Hembree, E. A., & Rothbaum, B. O. (2007). Prolonged Exposure Therapy for PTSD: Emotional Processing of Traumatic Experiences - Therapist Guide. Oxford University Press.
Supports: A dated check of its relevance to this profile is not recorded for this draft
Supports: A dated check of its relevance to this profile is not recorded for this draft
Supports: A dated check of its relevance to this profile is not recorded for this draft
University of Pennsylvania Almanac. (2026, September 22). Edna Foa, clinical psychiatry.
Supports: A dated check of its relevance to this profile is not recorded for this draft
University of Pennsylvania Biomedical Graduate Studies. Edna B. Foa, PhD.
Supports: A dated check of its relevance to this profile is not recorded for this draft