Cognitive Behavioral Therapy for ARFID (CBT-AR)

Avoidant/Restrictive Food Intake Disorder (ARFID) is a specific type of eating disorder characterized by limited food intake due to sensory sensitivities, fear of adverse consequences, or other reasons unrelated to body image concerns.  Since ARFID is a relatively new diagnosis in the DSM, there have been limited randomized controlled treatment trials which means there is no formal evidence-based treatment for ARFID at this time.  That said, there are several well-designed, structured therapies garnering attention in the field and Cognitive Behavioral Therapy for ARFID (CBT-AR) is among the most promising.  

CBT-AR is an appropriate intervention for children (age 10 and up), adolescents and adults with ARFID.  The goal of the treatment is to guide patients in correcting nutritional inadequacies, achieving a stable, healthy weight, and increasing the range of foods consumed across all food groups.  Within the CBT-AR framework, people with ARFID are understood to be biologically more vulnerable to sensory sensitivity, low appetite or low interest in food and/or anxiety associated with food and eating.  

Here are some key components and strategies commonly used in CBT for ARFID:

  1. Psychoeducation: CBT-AR therapists provide education about ARFID, its causes, and the impact it has on physical and psychological well-being.  The therapist helps the client understand where their struggle is coming from and what needs to happen to improve their relationship with food.
  2. Regular Eating: Therapists assist clients in creating regular and balanced meal plans that incorporate a wider variety of foods. They may use behavioral techniques, such as food chaining (introducing similar foods gradually) or shaping (incremental steps towards a desired eating goal), to help clients expand their food repertory.
  3. Exposure and Response Prevention (ERP): Exposure therapy involves gradually exposing individuals to feared or avoided foods, textures, smells, or situations related to eating. The exposure is conducted in a controlled and supportive environment, allowing clients to confront their fears and gradually reduce avoidance behaviors.
  4. Coping Skills Training: Clients learn adaptive coping strategies to manage anxiety, stress, and other emotions related to food and eating. These skills may include relaxation techniques, mindfulness exercises, and problem-solving strategies.
  5. Family Involvement: In cases where the client is a child or adolescent, family involvement is often essential. Family-based interventions help parents understand ARFID, learn effective feeding strategies, and support their child’s progress in treatment.

It is important to note that CBT for ARFID should be conducted by qualified professionals who specialize in eating disorders or have specific training in ARFID treatment. Every individual’s treatment plan may vary based on their specific needs and goals.

At Columbus Park, we do not treat ARFID in the same way as other forms of disordered eating.  We recognize the condition as notably different and necessitating a highly specialized approach to care.  If you or someone you care about is struggling with highly selective or restrictive eating patterns, Columbus Park is here to help.

Free Guide To Understanding ARFID