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Session 4

Parents and Carers – Selective Eating vs ARFID

Session 4

Expectations and Resources

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What to expect

ARFID needs long term treatment as it takes time to develop a new skill, and the young person will need a lot of support from parents/carers/family members during this time.

It is important to manage your expectations, recovery is not always linear and it will take time.

  • There is no right/wrong way as each young person is different.

  • Each step can take days, months, and sometimes years. Young people may change their minds multiple times during the process.

  • Depending on their presentation, they can “jump” stages (i.e. from square bread to bread and cheese) OR they will need more steps – always ask how they feel about it and explain what to expect.

  • The new food should not be expected to be eaten straight away, sometimes it is just about exposure.

  • Remember that there are several steps (i.e. tolerating food in the room, tolerating smell etc.) before actually eating.

Expectations

We all know that as
parents, we would like to
eat a good variety of
foods and eat in
restaurants but the
reality is that
sometimes this will take a
long time to happen

So adjusting our
expectations and
thinking about how
important the “baby
steps” are is
essential

We do have successes but we also have “good enough”

So have a think about what success looks like…

What does success look like

Saying "I am hungry"

Trying something new even if just once

Not having conflict at the dining table

Going to a restaurant

Sitting at the dining table with the family

Not reducing their accepted foods

Weight gain

Height gain

Eating at school/sitting in the dining room with peers

Reduction in hospital admissions

Sitting in the same room as others eating

How to manage others expectations
including extended family

1

We know that the pressures from the
extended family and a close circle
of friends has a huge impact on how
parents feel

2

Involve extended family members as much as you can, giving them a role to play in supporting the child – exposure and removing pressure

3

Acknowledge that they may not be able to understand but accepting that the child needs support is the main thing

Hunger Chart

  • 0
  • 2
  • 4
  • 6
  • 8
  • 9
  • 10
really hungry
really full
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Early Snack
Breakfast
Mid morning
snack
Lunch
Pudding
Afternoon snack
Dinner
Pudding
Evening snack

My Reward Chart

Task

SUN MON TUE WED THUR FRI SAT

WEEKLY GOALS

DONE

Download and print out the reward chart!

Helpful Resources
Take Away Lessons

Step 1 - Explore what type of difficulties are present

Step 2 - Get help if needed

Step 3 - Choose the approach together

Step 4 - Consider a different intervention if the first one doesn´t work

Step 5 - Be consistent and manageable expectations

Everyone is unique

“ Ultimately change will happen
over time, but I know
I have begun my journey “

Acknowledgements: Selective Eating vs ARFID

Created by:

  • (Module Lead): Dr Paola Falcoski, Advanced Specialist Eating Disorder Dietitian
  • With contributions: Dr Erica Cini - Consultant Child and Adolescent Psychiatrist ELFT (London)
  • Bedfordshire and Luton Mental Health and Wellbeing Services

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My Notes

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