SPACE Treatment – ARFID Focus: A promising new evidence-based treatment for ARFID/Picky Eaters

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

  1. 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.
  2. 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.
  3. 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

  1. Empowerment of Parents: SPACE empowers parents by providing them with the tools and skills needed to effectively support their child’s progress.
  2. Reduction of Anxiety: By addressing the underlying anxiety and avoidance behaviors, SPACE helps reduce the overall level of distress experienced by the child.
  3. Improved Eating Habits: As accommodations are reduced, children gradually expand their diet and improve their nutritional intake.
  4. 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.
  5. 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

Food 4 Thought Therapy | Color picture of parents and son eating ice cream together | Read for fun food-related activities for the summer

Depending on where you live, you’re probably looking for indoor activities to escape the heat just like me. So, let’s talk about some fun food-related activities that you can do at home either indoors or in your backyard. I want to emphasize that simply exposing your child to foods alone is not going to make them a more flexible eater or increase their food repertoire. However, positive and playful experiences with food can enhance a child’s willingness to try new things, help them develop a healthy relationship with eating, and foster their curiosity and comfort around various foods.

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.

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.

A Personal Story: One Individual’s Success with ARFID using Hypnosis with Kelly

Food 4 Thought Therapy | Color picture of boy smiling with arms crossed | Read more about our client success story

About ARFID

Avoidant/Restrictive Food Intake Disorder (ARFID) is a relatively new and often misunderstood eating disorder that goes beyond picky eating. Unlike other eating disorders, ARFID isn’t driven by concerns about body image or weight. Instead, it involves an aversion to certain foods, leading to significant nutritional deficiencies and challenges in daily functioning. While ARFID can sometimes feel like a constant battle, there is hope and success with support from a trained speech language pathologist.

Here is just one of our client success stories using hypnosis as a treatment option.

Meet Our Client: Matthew*

(*This client’s name has been changed for the purpose of this blog post to maintain confidentiality)

Matthew’s mother reached out to Kelly when Matthew was 12. He was a very motivated young man frustrated with his limited diet. According to Matthew, he had been “scared” of eating since he was 4. Prior to that, he ate a variety of foods and enjoyed them. While neither Matthew nor his mother could think of a “triggering” incident that brought on his fear, his food repertoire became more and more limited over the years. By the time they sought out help, Matthew was only eating 7-10 foods consistently. He usually ate cheerios without milk for breakfast, chicken nuggets and fries for lunch or dinner, and snacked on a few fruits throughout the day (limited to bananas, apples, and pears in limited volumes).

Going out to eat was extremely hard, traveling was miserable, and although he wanted to attend summer camp, he was simply unable due to limited food selection. He also was more hesitant to eat in social situations.

Matthew had attended a sensory based feeding program in the past without success. He would participate, but there was limited slow progress. He stated that there was “just something in my head” stopping him from tasting new foods. He had been evaluated by GI and there were no significant concerns.

These were Matthew’s goals that he discussed with Kelly:

  • Taste and try things without extreme hesitation.
  • Learn to enjoy pizza and pasta (even if it had to be modified).
  • Add some type of meat other than chicken nuggets to his diet.
  • Expand the types of fruits that he ate.
  • Add sweet potatoes to his diet (this was “veggie-like” for him, and he was leaning towards trying to work on this. Other veggies were really of no interest).

Kelly and Matthew agreed that his goals were realistic, as well as ambitious. He made all the final decisions about foods that motivated him while Kelly helped guide him to a few more things that would make life easier, such as obtaining the summer camp menu to identify foods he may want to eat and/or try on the schedule. After an initial evaluation, he and Kelly moved on to the first hypnosis session with prepared foods close by that he was interested in trying. After he underwent hypnosis, Matthew felt calm, relaxed, and was excited to try some new foods! Matthew reported that the voices in his head telling him not to eat were much quieter, and he felt more in control.

Here’s what happened: Matthew tasted each of the foods brought to the session. He described how each food item tasted, discussing flavor, texture, etc. He found some new foods that he enjoyed, and now felt comfortable working on progressively. There were still some foods that were difficult for him, but he even said, “I don’t get why I didn’t try this sooner!” about pancakes with and without syrup.

At the end of the session, Matthew was extremely proud of himself for tasting so many things calmly! His mom was in tears. Matthew and Kelly discussed a personalized and logical follow up to the session, including eliminating foods, adding foods to his meal rotations, and practicing with more foods based on how he was feeling.

After Matthew’s fifth and final session hypnosis session, he felt confident he could try a variety of foods fairly easily. He loved how he could taste and try for himself to determine if he liked something or not, and there was not an irrational fear in his way. He still had likes and dislikes, but he was in control now of his experiences.

Here were a few important factors in Matthew’s success when it comes to hypnosis:

  • HE was highly motivated to change.
  • His mother fully supported him, but it was HIS choice to seek help and “get better” (Matthew’s words).

Six months later, Matthew was able to attend a summer camp and loved it! He had added 10-15 new foods to his consistent food rotations and was still working on increasing this.

Many of our clients have expressed that it’s helpful to hear about and learn from other’s experiences, and it reminds them they are not alone in this journey. Read more about some of our client’s journey’s in Kelly’s book, ARFID Lived Experiences.

ARFID and Hypnosis

Every individual’s experience related to ARFID is different. Therefore, it’s important to find a speech language pathologist who specializes in treating ARFID and who can develop an effective treatment plan to help meet your needs.

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.

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.

8 Things You Didn’t Know About Picky Eating

Food 4 Thought Therapy | Color picture of child and mother baking together | Read for more information on 8 Things About Picky Eating

Picky eating, a common concern among parents, caregivers, and even adults themselves, is truly a complex concern. It isn’t a “phase” or a “preference”. While we just recently talked more specifically about Avoidant Restrictive Food Intake Disorder (ARFID), I wanted to delve into picky eating overall just a little more. Continue reading for 8 things about picky eating that you may not have known.

Just in case you missed it, you can find our blog on 8 Things You Didn’t Know About ARFID here!

8 Things You Didn’t Know About Picky Eating

1. Speech Language Pathologists are Feeding Specialists Too

Speech Language Pathologists (SLPs) can address a variety of concerns. While “speech” and “language” needs may seem obvious, SLPs are also trained to address disorders of feeding and swallowing, voice, cognition, fluency, and more. SLPs understand the intricate connection between oral motor skills, sensory sensitivities, and mealtime behaviors, making us feeding experts.
Read more about the SLPs’ Scope of Practice and Service Delivery Areas on the American Speech-Language and Hearing Association website.

2. Sensory Sensitivities Play a Key Role

Picky eating often stems from sensory sensitivities, where the individual may have heightened responses to certain textures, tastes, smells, or even visual aspects of food. These sensitivities can significantly impact their willingness to try new foods.

3. It’s Not Just a “Phase”

Contrary to popular belief, picky eating is not always a passing phase. If you ask any parent, they will likely tell you they’ve gone through the “picky eating” stage with their child (it’s a part of typical development!). But for some children, picky eating persists as they get older and requires targeted and specialized intervention and support.

4. There Are Many Different Therapy Techniques to Address Feeding Concerns

Feeding therapy is NOT one size fits all! SLPs will use a variety of therapy techniques to address feeding concerns. Some of these include:

  • exposure therapy
  • food chaining
  • hypnosis
  • behavioral strategies
  • oral motor support
  • calming strategies, and
  • family-based treatment

There are even more strategies than those listed above, but it’s important to find an SLP who is willing to see what works best for your child, which may include a mixture of the techniques above. And sometimes, they may pivot to a new strategy based on what you or your child is working on and therapy progression.

5. Your Mealtime Environment Can Affect Eating Habits

Creating a positive mealtime environment is crucial for promoting healthy eating habits. Fostering a relaxed atmosphere and offering foods in a low-pressure manner can help the individual develop a positive association with food.

6. Early Intervention Is So Important!

Addressing feeding difficulties early on is crucial. Since feeding difficulties can impact growth and development, as well as overall quality of life, early intervention can help minimize the impact of the feeding disorder. Early intervention can also help ensure the feeding difficulty doesn’t become more complex as the individual grows older.

7. It Can Be Something More Than Picky Eating

While picky eating is common, it’s essential to identify if there is a medical or underlying factor causing the individual to demonstrate picky eating characteristics, such as reflux, chronic health programs, or Eosinophilic esophagitis (EoE). Addressing these medical and underlying factors is critical for effective intervention.

8. It Can Cause Not Only Nutritional Deficits, But Social and Family Distress as Well

Picky eating can have far-reaching effects beyond nutritional deficits. It can strain family relationships, lead to social isolation, and impact overall quality of life.

Picky eating is a complex issue that requires an individualized approach. SLPs play a vital role in supporting individuals and families on their journey towards healthier eating habits. If you or someone you know is struggling with picky eating, don’t hesitate to seek help from a qualified professional.

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. Contact Kelly at Food 4 Thought Therapy to get your questions answered and to take the first step towards your journey, You can contact Kelly and Food 4 Thought Therapy at kelly@food4thoughttherapy.com or visit https://food4thoughttherapy.com/contact/ to book your free consultation. Together, we can work towards fostering positive mealtime experiences and promoting overall well-being.

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

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Maintaining Progress After Feeding Therapy

Food 4 Thought Therapy | Maintaining Progress After Feeding Therapy | Color image of family of four eating together

Imagine this: You (or your child) are making strides during feeding therapy sessions and everyone is celebrating all of your successes (no matter what those are!). But then you get home and you’re back to eating the same 5-10 preferred foods and mealtime is still a struggle. You’re not alone!

Maintaining and continuing progress after feeding therapy is a challenge for many individuals and families. Here are some tips to help sustain and continue progress after feeding therapy, whether it’s for you or for your teen/child.

Read more about Pediatric Feeding Disorders and Avoidant/Restrictive Food Intake Disorder (ARFID) on the American Speech-Language Hearing Association website.

Tips for Maintaining Progress After Feeding Therapy

Using a Schedule to Incorporate Newly Tried Foods:

Even if you’ve successfully tried a new food during therapy, many individuals find it challenging to incorporate this new food into their regular diet. Just thinking, “I’ll eat that new food now,” typically doesn’t work. One way to overcome this is to try maintaining a journal or record of the foods tasted and creating a schedule to include this food in your diet on a weekly basis. You’re more likely to see success when there’s a written plan to follow; it helps keep you accountable!

Prioritize Based on Preferences:

When faced with a variety of foods you’re attempting to add into your rotation, it’s helpful to write down and rank these foods based on personal preferences. Think about ranking them by taste and texture. Foods with a rating of “5” or higher should be prioritized on your schedule to taste and try again weekly, while those with a lower rating can be set aside. Even if it had a ranking of “4”, you can let it go and don’t stress about it! This approach prevents unnecessary stress and focuses on building a diet that aligns with individual preferences and comfort levels.

Incorporate Calming Techniques and Positive Reinforcement:

Eating habits are deeply intertwined with emotions and anxiety levels. Your therapist should be working with you on calming techniques and positive thinking or words of affirmation that you can integrate into your daily routines. To make the process more enjoyable and eating more fun, pair exposure to or eating some newer or challenging foods with activities that bring joy. For instance, watch the next episode of your favorite TV show after exposing yourself to a newer food. By associating positive experiences with food, the journey becomes not only beneficial but also enjoyable.

Transitioning from Therapy to Home Environment (For Children/Teens):

A common challenge arises when progress made in therapy doesn’t extend to home environments, especially for children. To address this, ensure that the last sessions of therapy involve the parent and child alone, with the therapist observing and intervening as needed. This step is critical for transitioning the learned skills from therapy to everyday life. Parents should actively participate in feeding, gradually taking over the responsibility and placing demands for eating with your child, or if needed, feeding your child. If your child never performed well for you at the feeding clinic, it will be almost impossible for it to generalize to home. As an example, in my last 2-3 sessions with a client, I have the parent and child engage in the session alone, with me watching and stepping in when needed. This is a crucial step practiced in therapy to ensure a smooth transition and generalization of skills.

Feeding journeys don’t conclude with the end of therapy; it’s the beginning of your independent journey to positive changes. Adopting structured plans, prioritizing preferences, incorporating positive reinforcement, and ensuring a smooth transition from therapy to home can help you or your child/teen maintain the progress and success achieved in sessions. The key truly lies in consistency and a positive approach! Not sure where to start? Kelly can help no matter what stage of the process you’re in.

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

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

How Can I Better Understand Selective Eating and What It Stems From?

Selective Eating means limited or restricted food selections (usually less than 20) that have the potential to impact nutrition, development, and growth. The individual with selective eating typically shows interest in the foods they enjoy eating, but may refuse all other foods or even to eat meals with the family.

When treating selective eating, it is extremely important to find the root cause of the problem. Otherwise, we will never truly see results! There are four main causes of selective eating:

1. Sensory Concerns

An individual with sensory needs may show hypersensitivity to specific textures, tastes, sight, or smells. They may say things like:

  • “I don’t like it”
  • “I need a lot of spice”
  • “I only like cold foods”
  • “I don’t like how this [texture] feels in my mouth”

2. Medical Concerns

Some feeding concerns are related to certain medical conditions. Examples include chronic health problems such as ear infections, frequent respiratory infections, dental problems, or seizures. Other examples include gastroparesis (slow emptying of the stomach), chronic or intermittent constipation, and pain or discomfort with feeding from things such as reflux or allergies. Some allergies are very difficult to diagnose, such as EoE (Eosinophilic Esophagitis), which takes special testing to examine and diagnose. You may hear an individual with underlying medical concerns say things like:

  • “It hurts”
  • “I have/had allergies”
  • “My tummy hurts” or “I have constipation”

3. Oral Motor Concerns

Another possible cause of selective feeding is oral motor concerns. Oropharyngeal and laryngeal anomalies can impact overall mechanics needed for feeding. The individual may have poor oral motor control or low/high muscle tone that can impact chewing and swallowing. They may say things like:

  • “I can’t”
  • “My mouth gets exhausted from all of the chewing”
  • “I can’t chew food well enough to swallow it”

4. Past Challenges

Finally, past and current challenges can cause selective feeding needs. Examples include parent-child conflict (especially surrounding food), parental anxiety, general anxiety, negative experiences related to the mouth (history of NG tubes, oral procedures, being on a ventilator, or surgeries), and time spent in the hospital as a baby (e.g., the NICU). This can also include negative past experiences with feeding, such as pain, coughing, vomiting, or gagging during feeding. Specific fear or anxiety around food is commonly referred to as ARFID, or avoidant/restrictive food intake disorder and can commonly be caused by negative past experience with feeding. You may hear them say:

  • “I was force fed when I was smaller and now I’m nervous about it”
  • “I have had negative experiences such as gagging or choking when I was eating and it’s hard for me to not feel like that now“
  • “I like things to always be the same”

A Speech-Language Pathologist can evaluate your child’s needs through a comprehensive feeding evaluation, which includes an extensive health history. They can help determine the cause of your child’s feeding needs and work with you to develop a treatment plan.

Kelly is an SLP and a feeding specialist who also specializes in using hypnosis to support feeding difficulties, weight management, and anxiety. If you have questions, please reach out to Kelly. Kelly can answer your questions over a free phone consultation where she can further discuss feeding therapy and/or how hypnosis works and how hypnosis could help you or your loved one’s specific needs. Contact Kelly and Food 4 Thought Therapy at kelly@food4thoughttherapy.com or check out her website at https://food4thoughttherapy.com/ to book a free consultation.

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

Success in Feeding Therapy Beyond Food Expansion – A Journey with Me, Kelly

For individuals struggling with feeding challenges, such as Avoidant/Restrictive Food Intake Disorder (ARFID), the idea of seeking help to overcome their challenges with food can be both daunting and hopeful. That’s exactly why I started Food 4 Thought Therapy. I know that food success is about more than just expanding your food repertoire and my goal is to empower you and help you make the changes you’re seeking. I also believe that therapy looks different for everyone; I don’t use the same approach for every client because there is no one approach that works for every person.

One challenge to getting started with therapy is the number of unknowns. We all like to know what to expect, so I’ve decided to outline just that – here is how your journey can start out with me:

The First Session

Our first session together is all about you (get ready to talk openly and honestly with your therapist!). This first session, whether it’s with me or someone else, is about building trust and our therapeutic relationship. It’s important to trust your therapist while they take you through the next steps of your journey. We will discuss your medical health history, food dairy intake, whether or not you’re ready for change, what that change may look like for you, and how to tell if you’re really “ready” for therapy (sometimes we’re not quite ready for change yet! We can work together to help you become more “ready”). I will also just want to generally get to know you! This helps me understand you and your personality, so I can adjust our sessions to best suit your needs.

Identifying Hurdles and Setting Goals

Aside from this background information, we’ll also discuss foods that interest you, or maybe more likely, if NO foods interest you (and how we can generate some of that interest!). We will discuss some of your biggest hurdles – whether it’s fear of going out to eat, going off to college, holidays, handling pressures from family members, or navigating health concerns – and what you would like to tackle most in therapy. These discussions allow me to help tailor your personalized treatment plan to align with your goals.

As I mentioned, I truly believe that therapy is not a “one size fits all”. We’ll discuss options for therapy, such as food chaining, exposure therapy, diving right in, journaling, medical routes (e.g., testing or medications, such as appetite stimulants), and any other options that may be helpful for you!

Food Success Beyond Expansion

I firmly believe that food success goes beyond eating more food or expanding your food repertoire. It’s also about embracing “small” wins that ultimately lead to transformative changes in your relationship with food. Here are some examples of what these “small” wins might look like:

  • Seeking Help and Support: Acknowledging the need for change and reaching out to family members or professionals for support is a significant step towards progress.
  • Ordering Off the Menu: Trying out new restaurants and ordering off the menu, even with modifications, is an accomplishment worth celebrating.
  • Eating at School: For children struggling with ARFID, the simple act of eating lunch at school, even if packed from home, can mark a major milestone.
  • Finding Fulfillment in Snacks: Understanding that three small snacks can be as satisfying as a traditional meal fosters a healthier relationship with food.
  • Appreciating Your Preferences: Recognizing that having a preference for certain foods does not diminish one’s worth or normalcy.
  • Tasting New Foods without Anxiety: Gaining the confidence to taste new foods without stress or anxiety is a testament to personal growth.
  • Embracing Individual Tastes: Enjoying food in a way that suits individual preferences, even if it defies conventional norms, is a celebration of self-expression.
  • Valuing Nutritious Choices: Appreciating the value of foods that promote health and strength, regardless of their variety, is a crucial aspect of the journey.
  • Willingness to Explore: Embracing the mindset of exploring different ways to prepare foods rather than outright rejection opens up new culinary experiences.

I’m here to celebrate these wins with you, and ultimately help you meet your feeding goals, whatever those may be. If you’re ready for change, reach out to us at Food4Thought Therapy. Contact Kelly at kelly@food4thoughttherapy.com or visit our website at Food4Thought Therapy to book a free consultation.

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

Food Chaining

Mealtimes with selective eaters can be a daily ordeal. Frustration, anxiety, and concerns about proper nutrition can make dining a challenging experience for both parents and children. However, food chaining is one structured, gradual approach that can be used to expand a child’s food preferences.

Food chaining was created by speech therapists Cheri Fraker, CCC-SLP and Laura Walbert, CCC-SLP and was developed to help children with feeding difficulties and selective eating. It’s rooted in the belief that selective eaters have distinct sensory and motor challenges related to food, and therefore it’s important to introduce new foods while respecting the child’s preferences and sensitivities. The method gently guides children to explore new tastes and textures; it is NOT about forcing children to eat new foods!

When food chaining with clients, it’s often easier to work with clients who are looking to change. This technique works best with children who are older and who are looking for ways to transition to new foods. Food chaining with younger children, or with children who aren’t yet ready, can sometimes have an adverse effect. You run the risk of altering or “losing” a food they love. I HIGHLY suggest food chaining with kids or young adults who are actively involved in the process.

Here are just a few ideas of fall foods I have started and ended within a food chain with clients:

  1. Regular fries to sweet potato fries
  2. Apple juice to apple cider
  3. Smoothie to pumpkin pie
  4. Apple to apple pie
  5. Chicken nugget to sliced turkey

P.S. One tip I have throughout this process is to make the food fun! Try using different tools, like toothpicks and cookie cutters to change how they can “touch” the food or what the food looks like! Check out these Fall Cookie Cutters that I love to use with my kids.

Interested in learning more about food chaining? Send us an email at kelly@food4thoughttherapy.com or send us a message on our Instagram (@food4thoughtslp)!

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. Contact Kelly at Picky Eaters Online to get your questions answered and to take the first step towards your journey, You can contact Kelly and Picky Eaters Online at kelly@food4thoughttherapy.com or check out her website at https://food4thoughttherapy.com/ to book a free consultation.

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