A scoping review of psychological interventions and outcomes for avoidant and restrictive food intake disorder (ARFID)

Objective: This scoping review identifies and describes psychological interventions for avoidant restrictive food intake disorder (ARFID) and summarizes how outcomes are measured across such interventions. Method: Five databases (Cochrane, Embase, Medline, PsycInfo, Web of Science) were searched up to December 22, 2022. Studies were included if they reported on psychological interventions for ARFID. Studies were excluded if participants did not have an ARFID diagnosis and if psychological interventions were not delivered or detailed. Results

cognitive-behavioral therapy (10 studies), and family therapy (5 studies), or combinations of these therapeutic approaches (19 studies) were delivered to support patients with ARFID.Many studies lacked validated measures, with outcomes most commonly assessed via physical health metrics such as weight.
Discussion: This review provides a comprehensive summary of psychological interventions for ARFID since its introduction to the DSM-5.Across a range of psychological interventions and modalities for ARFID, there were common treatment components such as food exposure, psychoeducation, anxiety management, and family involvement.Currently, studies reporting on psychological interventions for ARFID are characterized by small samples and high levels of heterogeneity, including in how outcomes are measured.Based on reviewed studies, we outline suggestions for clinical practice and future research.
Public Significance: Avoidant restrictive food intake disorder (ARFID) is an eating disorder characterized by avoidance or restriction of food due to fear, sensory sensitivities, and/or a lack of interest in food.We reviewed the literature on psychological interventions for ARFID and the outcomes used to measure change.Several psychological interventions have been developed and applied to patients with ARFID.Outcome measurement varies widely and requires further development and greater consensus.
Prevalence estimates of ARFID vary widely depending on population and setting examined.In a systematic review of 30 studies, the estimated prevalence of ARFID in non-clinical child and adolescent samples ranged between 0.3% and 15.5% (Sanchez-Cerezo et al., 2023).This is in line with recent prevalence estimates of ARFID among high school students of 1.98%, similar to the community prevalence of anorexia nervosa (van Buuren et al., 2023).Estimated prevalence rates are typically higher in specialized eating disorder services ranging from 5% to 55.5%, with specialized feeding clinics reporting the highest prevalence rates between 32% and 64% (Sanchez-Cerezo et al., 2023).Overall, ARFID is thought to be common in clinical settings and likely common in the general population too (Micali & Cooper-Vince, 2020;Thomas, Lawson, et al., 2017).
Given the prevalence of ARFID, and its associated physical, nutritional, and psychosocial difficulties, clinicians need to understand how to manage the needs of those with ARFID (Norris et al., 2016).
Existing research suggests that behavioral interventions can help to increase dietary volume and variety for young patients with feeding problems (Sharp et al., 2017), typically those under the age of six (Taylor et al., 2019).Cognitive-behavioral therapy (CBT) can also be delivered to support children and young people with ARFID (Howard et al., 2023).Thomas and Eddy (2019) have developed a manualized CBT treatment for ARFID (CBT-AR), applicable to those aged 10 and over, with preliminary evidence for the feasibility and acceptability of CBT-AR across various ARFID presentations (Thomas et al., 2020;Thomas et al., 2021).Similarly, family-based treatment (FBT) has also been adapted for ARFID (FBT-ARFID), using the main principles of the approach (Lock, Robinson, et al., 2019).
Whilst there are some promising developments in psychological interventions for ARFID, at present, there are no evidence-based treatment recommendations to guide care for patients with ARFID (National Institute of Health and Care Excellence, NICE, 2017).The Practice Guideline for the Treatment of Patients with Eating Disorders (APA, 2023) highlighted a lack of clinical trial data due to the relative recency of the ARFID diagnosis and therefore does not make statements relating to the treatment of ARFID.However, the guideline suggests that some principles from the treatment of anorexia nervosa, such as medical stabilization and nutritional rehabilitation, may be required for patients with ARFID (APA, 2023).For all eating disorders, including ARFID, consensus guidelines recommend a form of psychobehavioral therapy in addition to addressing physical, nutritional, and mental health comorbidities (Hay, 2020;Hay et al., 2014).
Currently, it is difficult to understand how outcomes are being measured during psychological interventions for those with ARFID.There has been some slow progress in the development of psychometric measures for ARFID and its symptomatology (Cooke, 2020).Recent developments include the eating disturbances youth-questionnaire (EDY-Q); a 14-item self-report measure with 12 items based on DSM-5 criteria for ARFID designed for 8-13-year-olds to assess eating disturbances (Hilbert & van Dyck, 2016).For adults, the nine-item ARFID screen (NIAS) has been developed (Zickgraf & Ellis, 2018).The International Consortium for Health Outcomes Measurement (ICHOM) recently completed a review of patient-reported outcome measures for eating disorders and selected the EDY-Q and NIAS as recommended measures for ARFID (ICHOM, 2022).
Additionally, the Pica, ARFID, and Rumination Disorder Interview (PARDI) has been developed as a clinical interview tool to assess ARFID (Bryant-Waugh et al., 2019).Given its length, its use in routine clinical settings may not be practical (Bryant-Waugh et al., 2022).Consequently, the Pica, ARFID, and rumination disorder interview ARFID questionnaire (PARDI-AR-Q), focusing on the psychopathology of ARFID, has been developed as a self-and parent-report questionnaire, with preliminary support for its validity and reliability (Bryant-Waugh et al., 2022).
Existing reviews of the ARFID literature have provided a broad overview of the field (e.g., Bourne et al., 2020).This review aims to update previous reviews, with a focus on describing psychological interventions for ARFID across the lifespan and across clinical settings.Additionally, this review also aims to identify how outcomes are measured in psychological interventions for ARFID.It is hoped that in doing so, this review will support understanding of current clinical practice in the absence of evidence-based practice guidelines and will identify considerations for both clinical practice and further research.

| Objectives
the field took place in April 2020, with the search terms and strategy being developed in consultation with a subject librarian.In March 2022, terms were refined and tailored to each database through a process of piloting.The final search strategy for each database was constructed by Rachel Dickinson and Kevser Sadikovic under supervision from Emma Willmott and Tom Jewell.Given limited extant research into ARFID, search terms were applied in all/any fields, without applying filters, data restrictions, or limits, nor using Boolean operations.The main search was conducted on May 9, 2022 and a further search was conducted on December 22, 2022.The specific search strategy for each database is available in Appendix A.

| Selection process
Data selection was conducted in line with PRISMA guidelines (Page et al., 2021).All database searches were imported into Covidence, which was used for the screening and data extraction phases.After completing searches, duplicates were removed, and remaining titles and abstracts were reviewed.Full texts were then screened for eligibility.Text citations and reference lists were also screened for eligibility.See Figure 1 Gartlehner et al. (2015).

| Data extraction and synthesis
Interventions were organized into four categories: behavioral therapy, cognitive behavior therapy (CBT), family therapy, and mixed interventions.
The decision to categorize interventions in this way was based on several factors, including the different histories of these modalities, the different etiologies in the presentation of ARFID (Mairs & Nicholls, 2016), and the development of ARFID from a feeding to an eating disorder (Sharp & Stubbs, 2019).A risk of bias assessment was not completed, in line with scoping review guidance (Munn et al., 2018;Peters et al., 2020).

| Study selection and characteristics
Overall, the searches identified 7322 studies, of which 6292 were duplicates, leaving 1030 studies to be screened by title and abstract.
Of these, 107 studies were assessed according to the eligibility criteria.Out of these studies, 57 studies were excluded, and 50 studies were deemed eligible for this review.References of excluded studies are presented in Appendix B. Fifty studies were included; see Table 2 for study and sample characteristics.Most studies were based in North America (USA and Canada) (35 studies), followed by Europe (6 studies), Australia and New Zealand (5 studies), with one study each from Japan, India, Brazil, and Turkey.
Studies often had small sample sizes, including 23 single-case reports with one participant.Most studies focused on child and adolescent populations (42 studies), with a small number of studies reporting on adults only (6 studies) and two studies in which participants included children and adults (Brewerton & D'Agostino, 2017;Makhzoumi et al., 2019).The youngest participant was aged 13 months (Sharp et al., 2016) and the oldest participant was 55 years (Thomas et al., 2021).Almost half of the reviewed studies (24 studies) had mixed-sex samples, 15 studies included only female participants, and 10 studies included only male participants.One study did not report sex (Peterson et al., 2021).Race or ethnicity was reported in 28 studies, with most participants being T A B L E 1 Scoping review eligibility criteria.White (23 studies).Socio-economic status (SES) was reported in six studies, with the majority being from high SES backgrounds (5 studies).
Comorbid disorders were reported frequently, including anxiety disorders (19 studies), ASD (16 studies), attention deficit hyperactivity disorder (ADHD) (9 studies), and developmental and/or intellectual disabilities (10 studies).Enteral feeding was reported in 12 studies.3-6 for behavioral, cognitive behavioral therapy, family therapy, and mixed interventions, respectively.training (e.g., behavioral analyst).Indeed, many of the behavioral interventions were highly specialized and intensive feeding programmes,

| Behavioral interventions
utilizing applied behavioral analysis (ABA).Few adjunctive treatments were delivered; one study described the use of adjunctive psychiatric medication (Lesser et al., 2022), several studies reported on additional dietetic intervention (e.g., Volkert et al., 2021) and one study reported adjunctive speech therapy (Tomioka et al., 2022).Interventions were led by therapists, some with specific CBT training or under the supervision of CBT-accredited therapists, and some with wider MDT support.Several studies (Thomas et al., 2020;Thomas et al., 2021;Thomas, Brigham, et al., 2017) described the use of a CBT protocol developed specifically for ARFID, CBT-AR (see Thomas & Eddy, 2019), applied to those with ARFID across the lifespan (aged 11-55).CBT interventions ranged in length from 7 weeks (Dolman et al., 2021) to 2 years (Soffritti et al., 2019).For seven studies, psychiatric medication was also administered.
CBT interventions commonly included goal setting, psychoeducation (e.g., nutrition, anxiety, physical sensations), graded exposure to avoided or unfamiliar foods, behavioral experiments, cognitive restructuring, anxiety management (e.g., relaxation and breathing techniques), homework and self-led exposure, and generalization to broader food-related contexts.Parent and family involvement was also common, including specific child-parent sessions (e.g., Dumont et al., 2019) and parents being involved in co-developing plans (e.g., Dolman et al., 2021).

| Family therapy interventions
In total, five studies reported family interventions for ARFID (two case series, one case study, one single-case experimental design, and one RCT).All studies focused on those aged 21 and under.
As with other intervention modalities, outcomes were measured in various ways for mixed modality approaches.Many studies measured physical outcomes, including blood results, BMI, weight, and height.
Several studies used validated measures regarding changes in attitudes or behaviors regarding food, such as the children's eating attitude test (ChEAT) and some used validated psychological measures, such as the revised children's manifest anxiety scale (RCAMS) (e.g., Lane-Loney et al., 2022;Ornstein et al., 2017).Two studies used measures of family accommodation (Shimshoni et al., 2020;Wagner et al., 2020).

| DISCUSSION
Our review provides a comprehensive overview of psychological  (Frankel et al., 2012).
For example, FBT-ARFID typically followed principles and phases of FBT established for other eating disorders, such as anorexia nervosa, adapted to patients' presentations and drivers of ARFID (e.g., Lock, Robinson, et al., 2019).Similarly, CBT interventions for ARFID used common cognitive and behavioral strategies, such as psychoeducation, self-monitoring using diaries, graded exposure, and behavioral experiments.More specifically, CBT strategies focused on reducing maintaining cognitions and behaviors pertinent to ARFID, such as reducing avoidance around foods, increasing exposure to foods, and targeting cognitions underlying the limited diet, such as fear of vomiting or fear of interoceptive sensations (e.g., Dumont et al., 2019;King et al., 2015).CBT was adapted to specific patient-related comorbidities, such as a learning disability (e.g., King et al., 2022).
Of note, the majority of studies used combinations of therapeutic approaches, perhaps reflecting the multidimensional nature of ARFID in which numerous factors typically contribute to its etiology and presentation (Mairs & Nicholls, 2016;Thomas, Lawson, et al., 2017) et al., 2021).
A variety of means to determine nutritional and dietetic change were also used across many studies including the number of foods accepted overall, measuring caloric intake, measuring the percentage of a meal consumed in grams, and evaluating whether patients were reliant on supplements or enteral feeding at the end of the intervention.
Direct food-related changes were measured in some studies, for example, foods accepted or the number of new foods added into a diet.Some studies measured nutritional change in terms of no longer requiring an oral nutritional supplement (e.g., Dumont et al., 2019), whereas other studies measured nutritional change in terms of being able to successfully introduce an oral nutritional supplement (e.g., Dolman et al., 2021).This emphasizes the importance of outcome measurement being specific to the patient presentation and patient-specific goals, in the context of a highly heterogeneous condition.
Given that this review focused on studies reporting psychological interventions for ARFID, it is perhaps surprising that only eight studies used validated psychometric measures to determine psychological change, such as changes in mood or anxiety.Some studies used visual-analogue scales or the patients' subjective ratings to measure aspects of anxiety relating to food, such as pre-and post-meal anxiety, though many studies did not measure any psychological change.
Behavioral change was often measured using questionnaires and scales, including the behavioral pediatric feeding assessment scale (BPFAS) (Crist & Napier-Phillips, 2001), the children's eating behavior questionnaire (CEBQ) (Wardle et al., 2001), and the mealtime behavior questionnaire (MBQ) (Berlin et al., 2010).Unsurprisingly, such measures were used in behavioral interventions or across mixedmodality interventions which included behavioral components.Thirteen studies determined change in ARFID diagnostic status or symptomatology, with some using measures including the NIAS or PARDI, in line with recommendations (ICHOM, 2022).Whilst promising, the fact that most studies did not directly measure changes in ARFID or its symptomatology may reflect slow progress in the development of specific measures for ARFID (Cooke, 2020) and a lack of agreement upon what outcomes should be measured and how recovery for ARFID is operationalized (Thomas, Lawson, et al., 2017).

| Implications for practice
This review suggests that a range of psychological interventions can be implemented to support patients with ARFID, across its heterogeneity in presentation and population, and that such interventions can be applied across a range of settings.At present, due to the nature of the evidence-base for ARFID, the absence of practice guidelines, and the scope of this review, we cannot be certain of the relative efficacy of different interventions for those with ARFID.Therefore, at present, we agree with prior suggestions that clinicians will need to be guided by psychological formulation (e.g., Bryant-Waugh et al., 2021) to determine the most suitable intervention approaches and concur that multidisciplinary care is often indicated (e.g., Hay, 2020).From the reviewed studies, considerations when applying psychological interventions for patients with ARFID include the patient's demographics, the presence of any physical or nutritional risks and any psychosocial impact or impairments, patient comorbidities including psychiatric and/or neurodevelopmental conditions, the driving and maintaining factors of ARFID, and the patient and family's priorities and goals.
Clinicians should also measure outcomes during psychological interventions for ARFID and will need to consider how to appropriately measure outcomes to assess meaningful change for patients with ARFID.This review highlights a broad array of approaches to outcome measurement that clinicians can further consider.Clinicians may wish to incorporate the use of validated measures of ARFID and/or broader psychological comorbidities, and to consider whether physical and nutritional changes are useful to measure.Studies included in this review highlight that certain measures are likely more appropriate depending on the intervention modality and patient demographic.For example, the behavioral pediatric feeding assessment scale (BPFAS) (Crist & Napier-Phillips, 2001) would be an appropriate measure of behavioral change during behavioral interventions for pediatric populations.Studies from this review also suggest that patients' goals or outcomes will likely be personalized to the individual with ARFID.For example, the goal or outcome for one patient with ARFID may be to introduce an oral nutritional supplement, whereas for another the goal and desired outcome may be to no longer require an oral nutritional supplement.Clinicians can also measure other outcomes, such as patient/family satisfaction and intervention acceptability.

| Recommendations for research
Our review highlights several important areas for future research.
Firstly, given that ARFID can affect people across the lifespan, adults are currently underrepresented in research.Further studies are required to better understand the application of psychological interventions for adults with ARFID.This is especially important given that ARFID was introduced to the diagnostic nomenclature to better reflect a life course approach to eating pathologies (Sharp & Stubbs, 2019).Furthermore, research with adults is especially important given that recent data suggests that ARFID presentations in adulthood may differ from those in childhood in terms of both medical and psychiatric profile, with a greater prevalence of female patients and rates of 68% for comorbid anxiety (Nitsch et al., 2023).
Most studies were from Western countries with predominantly White samples.Further studies exploring ARFID in non-Western countries and with patients from a diverse range of cultural and ethnic backgrounds are needed, especially given that ARFID presents across a range of ages, ethnicities, countries, and socio-economic backgrounds (Bourne et al., 2020;Micali & Cooper-Vince, 2020).To build understanding of cultural competencies when delivering psychological interventions for ARFID, studies should include detailed demographic information including race, ethnicity, and socio-economic status.
The ARFID literature at present consists mostly of single-case reports, case series, and retrospective chart reviews.The current evidence-base limits the conclusions that can be drawn regarding the Our review highlights important gaps in outcome measurement.
There is a need for research to investigate the psychometric properties of measures, including sensitivity to change, with greater research into selfreport measures for ARFID (Kambanis & Thomas, 2023).Researchers

| Limitations
This review has several limitations.Firstly, the quality of studies included, and their risk of bias, have not been assessed in line with scoping review guidance (Briggs, 2015).By conducting a scoping review, we aimed to provide a broader overview of the literature than would be possible in a meta-analysis due to the considerable variation in design and measures of studies in this field.As the evidence base increases, focused systematic reviews and meta-analyses can be conducted which can include quality assessment.
Second, readers should consider that whilst we organized are not yet possible.
Thirdly, by including studies describing ARFID, we recognize that a vast and well-established body of literature regarding interventions for pediatric feeding disorders have not been included, despite their potential utility for this patient group (Sharp & Stubbs, 2019).

| CONCLUSION
This review highlights the growing literature and details a range of psychological interventions for ARFID, since ARFID was added to the diagnostic nomenclature 10 years ago.Behavioral approaches, CBT, family therapy, and combinations of these modalities, are being delivered to support patients with ARFID across the lifespan and different clinical settings.
Given that a range of psychological approaches can be applied for patients with ARFID, our key message for clinicians is that the choice of psychological intervention should be guided by psychological formulation, taking into consideration patients' demographics, physical and/or nutritional risks, the impact on psychosocial functioning, psychiatric and/or neurodevelopmental comorbidities, the driving and maintaining factors of ARFID, and the patient and family's priorities and goals.Similarly, clinicians need to carefully for PRISMA flowchart.Searches, title, and abstract screening were conducted by Rachel Dickinson, Kevser Sadikovic, and Celine Hall.Disagreements were resolved by Emma Willmott and Tom Jewell.Full text screening was conducted in pairs by Rachel Dickinson/Emma Willmott and Rachel Dickinson/Tom Jewell, with disagreements resolved by a third member of the research team (Emma Willmott or Tom Jewell).
Data were extracted by Rachel Dickinson and Celine Hall using data extraction templates developed by Emma Willmott and Tom Jewell for the study preregistration, with discrepancies resolved by Emma Willmott and Tom Jewell.Data were synthesized by Nora Trompeter, Emma Willmott, and Tom Jewell based on the main treatment modality, informed by prior work to categorize psychological interventions by
. Intervention components across family interventions for ARFID often included parental empowerment, parent skills training, psychoeducation, externalization, and the family meal.Physical outcomes, including weight, height, and BMI were measured across all family-based interventions for ARFID and all studies effectiveness of psychological interventions for ARFID.Larger scale studies and randomized controlled trials with adequate statistical power are necessary to establish the efficacy of interventions.The use of validated outcome measures would also support more sound conclusions to be drawn about the effectiveness of interventions for ARFID.None of the reviewed studies investigated potential treatment mechanisms (mediators).Future research should examine such proposed mechanisms, such as decreased fear of food, to further understand and improve the efficacy of current ARFID treatments.Relatedly, more research is needed to identify cognitive drivers of ARFID which could guide treatment selection and enhance treatment efficacy by targeting distinct cognitions.Additionally, future research should investigate factors associated with treatment success (moderators) to further understand which treatment modality might be most effective for individuals.Studies would also benefit from measuring treatment targets (e.g., anxiety) with repeated measures throughout treatment.Whilst larger scale studies are required, any future case studies could use single-case experimental designs to better evidence the relationship between the intervention and behavior change and outcomes.Process evaluation studies could be added to trials to understand the process of change from the perspective of patients and carers.Such studies would also illuminate potential common elements across treatment modalities.
conducting treatment studies need to employ validated measures where possible and agreed definitions of recovery.Whilst there is a substantial literature on eating disorder recovery from the perspective of individuals with lived experience (de Vos et al., 2017; Wetzler et al., 2020), studies of recovery meanings in ARFID are absent and needed.Additionally, Delphi studies to develop consensus on the best choice of measures for ARFID and support definitions of recovery criteria, building on the work conducted previously by ICHOM (2022) and Eddy et al. (2019), would help to lead to improvements in outcome measurement.Finally, future studies and reviews of interventions may need to become narrower in their focus to disentangle what types of psychological interventions are best suited for specific ARFID populations and presentations.
this review according to four broad categories of psychological interventions, our review highlights that there are often common components across psychological interventions for ARFID.As the evidence base matures, more sophisticated analyses will be possible, such as component meta-analyses to identify core "ingredients" of successful treatments.However, based on this scoping review, conclusions about the most effective interventions for ARFID, or indeed the effective components of such interventions, McMahon et al., 2022;Phipps et al., 2022;Sharp et al., 2016)/doi/10.1002/eat.24073byUniversityCollege London UCL Library Services, Wiley Online Library on [25/10/2023].See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions)onWileyOnline Library for rules of use; OA articles are governed by the applicable Creative Commons License as providing attention for a desired behavior and not giving attention for undesirable eating and mealtime behaviors.Several studies involved escape extinction, in which the patient is not allowed to "escape" the feeding demand through re-presenting the food or not removing a spoonful of food (e.g.,McMahon et al., 2022;Phipps et al., 2022;Sharp et al., 2016).Working closely with parents was central to behavioral inter- Lesser et al., 2022;TaylSharp et al., 2016;Tomioka et al., 2022)ons (https://onlinelibrary.wiley.com/terms-and-conditions)onWileyOnlineLibraryforrules of use; OA articles are governed by the applicable Creative Commons License T A B L E 2 (Continued) Abbreviations: ADHD, attention deficit hyperactivity disorder; ARFID, avoidant restrictive food intake disorder; ASD autism spectrum disorder; ED, eating disorder; F, female; FBT, family based therapy; GAD, generalized anxiety disorder; GERD, gastroesophageal reflux disease; iEAT; integrated eating aversion treatment manual-parent version; M, male; NGT, nasogastric tube; OCD, obsessive compulsive disorder; ODD, oppositional defiant disorder; PTSD, posttraumatic stress disorder; R, range; RCR, retrospective chart review; SCED, single case experimental design; SCID-IV-5, structured clinical interview for DSM-IV, DSM-5; SD, standard deviation; USA, United States of America.T A B L E 3 Behavioral interventions.1098108x,0,Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/eat.24073byUniversityCollegeLondonUCLLibrary Services, Wiley Online Library on [25/10/2023].See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions)onWileyOnlineLibraryforrules of use; OA articles are governed by the applicable Creative Commons License T A B L E 3 (Continued) 1098108x, 0, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/eat.24073byUniversityCollegeLondonUCLLibrary Services, Wiley Online Library on [25/10/2023].See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions)onWileyOnlineLibraryforrules of use; OA articles are governed by the applicable Creative Commons License T A B L E 3 (Continued) or shorter mealtime durations.Several studies used measures of behavioral and/or feeding changes to determine outcomes (e.g., Bloomfield et al., 2019; Dahlsgaard & Bodie, 2019; Murphy & Zlomke, 2016), including the BAMBIC, BPFAS, CEBQ, MCH feeding scale and MBQ.Caregiver treatment satisfaction and meeting of treatment goals were also commonly measured outcomes (e.g.,Lesser et al., 2022;Taylor, 2021;Volkert et al., 2021).Several studies reported increasedBMI (Bąbik et al., 2021;Sharp et al., 2016;Tomioka et al., 2022), although no difference in BMI was found in Volkert et al. (2021).4.1.2| Cognitive behavioral therapy (CBT) interventions In total, 10 studies reported CBT interventions for ARFID (eight case studies, two case series).CBT interventions were reported for patients with ARFID aged 10-55 years.Interventions were delivered across settings, including inpatient, day treatment, outpatient, and virtual settings.
those aged 21 and under, and CBT interventions were implemented across the broadest age range for those aged between 10 and 55.The variation in intervention modality across age groups perhaps stems from the history of ARFID and its positioning in the intersection between feeding and eating disorders(Sharp & Stubbs, 2019), necessitating differentiation in its treatment approach across the lifespan.
range of settings, including outpatient clinics, home settings, virtual appointments, and partial hospitalization and inpatient treatment programmes.Certain psychological interventions were more likely to be employed depending on the age and developmental stage of patients with ARFID.For example, behavioral interventions were typically delivered to those aged 15 and under, family therapy interventions were applied to