CBT-AR

What is CBT-AR?

CBT-AR is a form of CBT designed specifically for people with Avoidant Restrictive Feeding Intake Disorder (ARFID). The focus of CBT-AR is to reduce nutritional compromise (low weight or significant nutritional deficiencies) and to reduce negative thoughts or feelings about eating. It is appropriate for both children over 10, adolescents and adults, as long as they are medically stable and eating food by mouth.

How does CBT-E work?

CBT-AR aims to improve nutritional intake/deficiencies by increasing overall food intake and improving variety of food eaten. It also aims to address the factors maintaining the difficulties eating, by challenging specific fears around food and eating or helping people get used to different sensory experiences through graudal exposure to new foods.

CBT-AR has four stages:

  1. Creating an individual “formulation” or shared understanding of what is causing/maintaining the eating disorder and making intial changes to stabilise eating patterns and/or increase weight if required. This usually primarily involves eating preferred foods, but does encourage some gradual reintroduction of slight variations.

  2. Providing information about nutritional deficiencies and identifying new foods which will help address these deficiencies or encourage more weight gain

  3. Address the most relevant mechanisms maintaining the eating disorder, either sensory sensitivity, fear of what will happen if certain foods are eaten, or a lack of interest in food/eating. There are different techniques depending on the cause of the ARFID, but a primary technique is gradual exposure to different experiences around food.

  4. Preparing for ending by thinking about any further goals for ongoing change and how to prevent future relapses.

How long does CBT-AR take?

CBT-AR typically lasts 20 sessions (for those who are not underweight) to 30 sessions (for those who need to gain weight). These typically occur over 6-12 months.