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Int J Eat Disord. 2019 Apr;52(4):439-446. doi: 10.1002/eat.22994. Epub 2018 Dec 22.

Applying family-based treatment (FBT) to three clinical presentations of avoidant/restrictive food intake disorder: Similarities and differences from FBT for anorexia nervosa.

Author information

1
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California.

Abstract

OBJECTIVE:

This article uses three brief case reports to illustrate how family-based treatment (FBT) can be used to treat pre-adolescents with avoidant/restrictive food intake disorder (ARFID).

METHOD:

We present case material illustrating how FBT can be used in three different clinical presentations of ARFID: (1) low appetite and lack of interest; (2) sensory sensitive eaters; and (3) fear of aversive consequences eaters-all without shape or weight concerns.

RESULTS:

This case material illustrates that the main principles of FBT-agnosticism as to the cause of the illness, externalization, emphasizing the seriousness of ARFID, parental empowerment, behavioral consultation, and practical behavioral focus-are applicable for a range of ARFID clinical presentations. Common challenges in this patient group include (1) promoting urgency; (2) challenging long term behavioral accommodation; (3) lack of parental alignment, parental fatigue, (4) and co-morbid psychiatric problems in the patients. Strategies to address these problems are described.

CONCLUSION:

FBT can be adapted for children with ARFID using the main principles of the approach.

KEYWORDS:

avoidant/restrictive food intake disorder; case studies; family-based treatment

PMID:
30578635
DOI:
10.1002/eat.22994
[Indexed for MEDLINE]

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