COGNITIVE-BEHAVIORAL THERAPY FOR AVOIDANT/RESTRICTIVE FOOD INTAKE DISORDER (CBT-AR)
OVERVIEW OF THE WORKSHOP
Avoidant/Restrictive Food Intake Disorder (ARFID) was recently added to the Feeding and Eating Disorders section of DSM-5 to describe children, adolescents, and adults who cannot meet their nutritional needs, typically because of sensory sensitivity, fear of aversive consequences, and/or apparent lack of interest in eating or food. ARFID is so new that there is currently no evidence-based treatment for the disorder.
Jenny and Kendra, in collaboration with their colleague Kamryn Eddy, have recently developed and manualized a novel treatment—Cognitive Behavioral Therapy for ARFID (CBT-AR)—that has been studied at the Massachusetts General Hospital in the United States (funded by the American Psychological Foundation and the Hilda and Preston Davis Foundation). CBT-AR can be offered in an individual or family-supported format and comprises four stages: (1) psychoeducation and early change; (2) treatment planning; (3) addressing maintaining mechanisms (including sensory sensitivity, fear of aversive consequences, and/or apparent lack of interest in eating or food); and (4) relapse prevention over 20-30 sessions. The work has been published in the New England Journal of Medicine, reporting a case study demonstrating the successful treatment of an 11- year-old girl with CBT-AR.
The team are actively recruiting CBT-AR trial participants from their ongoing National Institute of Mental Health- funded grant on children and young adults with ARFID entitled “Neurobiological and Behavioral Risk Mechanisms of Youth Avoidant/Restrictive Eating Trajectories” (R01MH108595). Early data from the efficacy study indicates that, on average, patients who receive CBT-AR add 17 novel foods, gain 12 lbs (if underweight), and significantly reduce food neophobia and food fussiness after treatment completion.
ABOUT THE PRESENTERs
Dr Jennifer Thomas is a clinical psychologist, specializing in the treatment of eating disorders. She is co-director of the Eating Disorders Clinical and Research Program at the Massachusetts General Hospital, where she evaluates and treats individuals of all ages with avoidant/restrictive food intake disorder, anorexia nervosa, bulimia nervosa, binge eating disorder, rumination disorder, and other feeding and eating disorders. In her academic role as Associate Professor of Psychology in the Department of Psychiatry at Harvard Medical School, her scientific research focuses on enhancing eating disorder diagnostic criteria to better reflect clinical reality. Jenny’s books Almost Anorexic: Is My or My Loved One's Relationship with Food a Problem? and Cognitive-Behavioral Therapy for Avoidant/Restrictive Food Intake Disorder: Children, Adolescents, and Adults, as well as her >100 peer-reviewed articles and book chapters, describe the many forms of disordered eating that are not fully captured by current psychiatric definitions. Jenny is also Director of Annual Meetings for the Academy for Eating Disorders and an Associate Editor of the International Journal of Eating Disorders
Kendra Becker is completing her postdoctoral fellowship in clinical psychology as a Clinical and Research Fellow at the Massachusetts General Hospital. She received a B.A. in behavioural neuroscience from Purdue University and an M.S. in clinical psychology from the University of Georgia. Her Ph.D. dissertation focused on applying a dimensional model of emotional experience to understanding negative and positive reinforcement schedules of disordered eating behaviours. She works on studies within the Eating Disorders Clinical and Research Program, and her primary research interests include investigating biological, hormonal and behavioral differences among individuals with low weight eating disorders. Kendra has clinical expertise in dialectical behavioural therapy and cognitive behavioural therapy.Kendra Becker is completing her postdoctoral fellowship in clinical psychology as a Clinical and Research Fellow at the Massachusetts General Hospital.