If you or someone you love has been diagnosed with Avoidant/Restrictive Food Intake Disorder, treatment can help restore good physical and mental health and balanced eating habits.
Since ARFID is a fairly new diagnosis, little is known about its optimal treatment. There is no evidence-based psychological treatment suitable for all forms of ARFID at this time (that is, not enough studies have been conducted nor extensive research been documented on a particular treatment programme to determine a ‘recipe for success’) but that’s not to say that nothing can be done.
Older children and adults with ARFID have experienced huge improvements to their health and quality of life from some of the same cognitive and behavioural interventions used to treat anorexia nervosa that have been adapted to treat ARFID. Most encouraging is a new ARFID-specific form of CBT, CBT-AR, that is newly published for adoption by both medical practitioners and parents.
Any form of ARFID treatment however should take place under the supervision of a specialist team skilled in treating ARFID. Such a team is usually multidisciplinary and can devise a programme designed to meet an individual's multiple, unique issues and needs.
Since ARFID doesn't occur exactly the same way for every individual, ARFID treatment is only successful when it's based on the individual problems and challenges a person is facing. There is no one-size-fits-all ARFID treatment. Depending on the severity of the disorder, the individual's state of health, and their proximity to a treatment team, ARFID treatment is almost always done in an outpatient capacity.
ARFID treatment will always begin with the individual and his or her treatment team setting goals surrounding eating.
Goals may include:
Correcting growth deficiencies and micronutrient status.
Eating a larger range of foods
Becoming comfortable eating in front of others
Becoming less fearful of choking or vomiting
Increasing interest towards food
Reducing anxiety surrounding eating
During ARFID treatment, a variety of therapies, services and interventions will address issues of both body and mind and depending on the clinic, may involve one or more of the following approaches:
FOR YOUNGER CHILDREN AND THOSE ON THE AUTISM SPECTRUM:
Is often used with very young children and those on the autism spectrum. It involves a 'play time' approach which enables a child to feel comfortable with the feel, smell and sight of foods.
Is used to help remove the fear and anxiety attached to certain foods. This therapy involves relaxation techniques, mental visualization; writing and talking about the avoided foods; learning positive coping skills for overcoming the fear and anxiety surrounding food; and ultimately eating the avoided foods in a safe environment. As part of this therapeutic approach, a 'tiny tastes' reward programme might also be used away from mealtimes.
FOR OLDER CHILDREN WITH LANGUAGE, MAY OR MAY NOT BE SUITABLE FOR THOSE ON THE AUTISM SPECTRUM:
For some people, unhealthy thought and behaviour patterns are at the root of their eating disorder. ARFID treatment will likely include cognitive-behavioural therapy, or CBT, a "talk" therapy that helps individuals identify and change self-destructive patterns of thought and behaviour. CBT also treats anxiety, depression and obsessive compulsive disorder, which often co-occur with ARFID.
DIALECTICAL BEHAVIOUR THERAPY
Dialectical behaviour therapy, or DBT, is another talk therapy commonly used in ARFID treatment. DBT helps people learn to live mindfully and within the moment in order to cope effectively with negative sensations and emotions. During DBT, individuals develop skills for distress tolerance that help them manage high-anxiety situations and identify the negative emotions they're feeling. By understanding and mindfully accepting negative feelings and emotions, people with ARFID are able to work through them in healthy ways.
Can be useful if it is carried out by a health professional as part of exposure and desensitisation programmes.
EYE MOVEMENT AND DESENSITISATION AND REPROCESSING THERAPY
(EMDR) therapy is an interactive psychotherapy technique used to relieve psychological stress. It is an effective treatment for trauma and post-traumatic stress disorder (PTSD) and there are indications that when used properly, it can be effective in treating ARFID.
IN ADDITION, USEFUL FOR ALL AGES AND ABILITIES:
During ARFID treatment, nutritional support is an important part of recovery. Nutritional support involves meeting with a registered dietician to identify any nutritional deficiencies and determine whether additional supplements are needed, although there may well be difficulties in getting the child to take them.
PARENT GROUP THERAPY
Group therapy for parents is often offered by Feeding clinics treating ARFID as an important part of AFRID treatment since the effects of ARFID are usually felt by the entire family.
Parent therapy is a great way for parents to learn more about ARFID whilst equipping them with tools to use at home. It also can provide parents with a sense of belonging and the opportunity to hear from other parents who are dealing with similar situations as themselves.