July 2024 - Food For Thought Therapy

Food for Thought Therapy | SPACE Treatment - ARFID Focus

Avoidant/Restrictive Food Intake Disorder (ARFID) is a complex eating disorder characterized by an individual’s persistent failure to meet appropriate nutritional and energy needs. Unlike other eating disorders, ARFID is not driven by body image concerns but can arise from a lack of interest in eating, avoidance due to sensory characteristics of food, or fear of aversive consequences like choking or vomiting. Treating ARFID is challenging, especially in children and adolescents. One promising approach is the Supportive Parenting for Anxious Childhood Emotions (SPACE) program. Developed by Dr. Eli Lebowitz at the Yale Child Study Center, SPACE treatment is designed to help parents manage and reduce their children’s anxiety and related disorders, including ARFID.

Understanding SPACE

SPACE is a parent-based intervention that focuses on changing parental behaviors rather than directly treating the child. Your child DOES NOT need to be motivated to attend therapy or be interested in changing. It is ideal for families that have tried feeding therapy without success. The underlying principle is that by modifying the way parents respond to their child’s anxiety and avoidant behaviors, the child’s symptoms can be significantly reduced. SPACE helps parents learn to support their child’s capacity to handle anxiety independently and reduce accommodating behaviors that reinforce avoidance.

The Core Components of SPACE

Parental Accommodation:
1. Definition: Parental accommodation refers to the adjustments parents make to help their child avoid distress. In the context of ARFID, this could mean preparing special meals, avoiding certain foods, or allowing the child to eat only their preferred foods.
2. Impact: While accommodating behaviors are often well-intentioned, they can perpetuate the child’s avoidance and anxiety around eating. SPACE aims to reduce these accommodations gradually, encouraging children to face their fears and anxieties.
Communication of Support and Confidence:
1. Supportive Statements: Parents are trained to deliver messages of support and confidence, emphasizing their belief in the child’s ability to cope with anxiety and challenges related to eating.
2. Positive Reinforcement: By consistently reinforcing the child’s efforts and small successes, parents help build the child’s self-efficacy and reduce anxiety.
Creating a Plan:
1. Step-by-Step Approach: SPACE involves developing a structured plan for reducing accommodations. This plan is tailored to the individual needs of the family and the specific behaviors that need to be addressed.
2. Incremental Changes: Changes are introduced gradually to ensure that both the child and parents can adjust to the new expectations without becoming overwhelmed.
3. Monitoring Progress: Regular check-ins are scheduled to monitor progress, address challenges, and adjust the plan as needed.

Benefits of SPACE for ARFID

Empowerment of Parents: SPACE empowers parents by providing them with the tools and skills needed to effectively support their child’s progress.
Reduction of Anxiety: By addressing the underlying anxiety and avoidance behaviors, SPACE helps reduce the overall level of distress experienced by the child.
Improved Eating Habits: As accommodations are reduced, children gradually expand their diet and improve their nutritional intake.
Long-Term Outcomes: SPACE fosters long-term resilience in children, equipping them with the ability to cope with anxiety and challenges beyond food-related issues.
Children do not need to be invested in therapy or present at session.

Challenges and Considerations

While SPACE is a promising approach, it requires commitment and consistency from parents. Resistance to change, both from the child and parents, can be a significant barrier. Additionally, each child’s situation is unique, and SPACE may need to be adapted to meet individual needs. Collaboration with a trained therapist is crucial for successful implementation.

Conclusion

SPACE offers a novel, evidence based, and effective approach to treating ARFID by leveraging parental influence to reduce anxiety and avoidance behaviors. Through careful planning, skill development, and consistent support, SPACE helps children overcome their eating challenges and fosters long-term resilience. As awareness and understanding of ARFID continue to grow, interventions like SPACE provide hope and practical solutions for families navigating this complex disorder.

Kelly is a Speech Language Pathologist who specializes in providing therapy and coaching from toddlers to teens and young adults with feeding challenges. She is tried in the SPACE Treatment technique and helps those in the Lake Nona area and beyond. She prides herself on individualizing therapy sessions so that you meet your goals, whether that’s expanding your food repertoire, ordering something off a restaurant’s menu, or just appreciating your food preferences so that you can be present at social events.

Kelly is starting a NEW SPACE treatment hybrid group this September. Click here to find out more information about the upcoming SPACE hybrid group.

Sign up for our first cohort! Groups are limited to 6 families, so space is limited!

Contact Kelly at Food 4 Thought Therapy at kelly@food4thoughttherapy.com or visit https://food4thoughttherapy.com/contact/ to book your free consultation, get your questions answered and to take the first step towards your journey.

Find us on Facebook and Instagram to learn more about Kelly’s services and hypnosis.

6 Fun Food-Related Activities to do at Home this Summer

1. Use Cookie Cutters to Cut Out Fruits and Make Patterns on Skewers

Turn snack time into a creative adventure by using cookie cutters to cut fruits into fun shapes. You can use watermelon, cantaloupe, apples, or any fruit that’s firm enough to hold its shape. Once you have an assortment of shapes, thread them onto skewers to make colorful and appealing fruit kebabs.

2. Add Jello to a Water Table Outside

Bring a new twist to outdoor play by adding Jello to a water table. The wobbly, slippery texture of Jello provides a unique sensory experience and can help children become more comfortable with different textures, which is important for their feeding development. Plus, as the Jello melts, it turns back into liquid, making clean-up a breeze.

3. Use Cut Fruits for Painting

Combine art and food by using cut up fruits for painting. Slice apples, oranges, or other fruits and dip them in edible paint or food coloring mixed with water (or even use the cookie cutters from idea number 1!). Your kids can use these fruit pieces as stamps to create beautiful patterns and pictures. This activity encourages creativity and provides a playful introduction to new foods.

4. Mix Ice Cream Flavors Together

Experimenting with ice cream flavors can be a delightful and tasty activity. Gather a few different ice cream flavors and let your kids mix small scoops together to create new combinations. They can use spoons to stir and taste their creations. This activity promotes sensory exploration and can help children become more open to trying new flavors and textures.

5. Freeze Some Fruits and Check Out What Happens

Who doesn’t love a good science experiment? Try freezing various fruits and observing the changes. Place grapes, berries, or slices of bananas on a baking sheet and freeze them. Once frozen, let your kids touch, taste, and describe how the fruit has changed. You could even fill out a chart together with your predictions, observations, and final conclusions!

6. Create a “Menu” and Choose Items for a Smoothie

Encourage your kids to design a menu for their own smoothie bar. Provide a selection of fruits, vegetables, and other ingredients like yogurt, milk, or juice. Let them choose their favorite combinations and blend them into a delicious smoothie. This activity gives children a sense of control and ownership over their food choices, making them more likely to try and enjoy different ingredients.

These playful food-related experiences can help build a positive relationship with food that will benefit their feeding development. It’s important to provide low-pressure opportunities when engaged with food, which may mean that they don’t taste the foods during these activities right now and that’s ok! Work with your child’s feeding therapist to help determine what cues may be best for your child when it comes to tasting foods.

Kelly is a Speech Language Pathologist who specializes in providing therapy and coaching from children to teens and young adults with feeding challenges. She prides herself on individualizing therapy sessions so that you meet your goals, whether that’s expanding your food repertoire, ordering something off a restaurant’s menu, or just appreciating your food preferences so that you can be present at social events.

Kelly uses a variety of therapy techniques, including sensory and behavioral therapies, as well as alternative therapy techniques, such as hypnosis, to help each of her clients find the success they’re seeking.