On September 27^th, 2024, Monte Nido partnered with MEDA to host a successful Continuing Education (CE) event, featuring Amanda Smith, LICSW, LCSW, LCSW-C, CEDS, Regional Director of Virtual Programming at Monte Nido Walden. The event, titled "ARFID: Lessons Learned from Virtual Treatment," provided valuable insights into the challenges, solutions, benefits, and interventions associated with virtual treatment for individuals with Avoidant/Restrictive Food Intake Disorder (ARFID).‍

Challenges and Solutions of ARFID Virtual Treatment 

Challenge: Difficulty Observing

• Solution 1: Ensure the device is positioned far enough to observe as much as possible.
• Solution 2: Enlist the support of caregivers to identify early signs of distress or safety behaviors.

Challenge: Engagement Obstacles

• Solution 1: Verify that individuals only have the device to log in and are away from video game systems, phones, etc.
• Solution 2: Utilize short activities to quickly build rapport.

Benefits of Virtual Treatment for ARFID

• Comfortable and Familiar Environment: Reducing stress and anxiety related to new places allows individuals to be more flexible with eating and advancing exposures throughout treatment.
• Connections: Individuals and caregivers have the opportunity to meet others who struggle with ARFID through larger group sizes, thanks to the ability to expand the geographical net.
• Exposures: The ability to see individuals in vivo and address safety behaviors within their homes.
  

ARFID Interventions

Sensory Sensitivities

• 5 Steps to Eating: Choosing 5 foods to try in their weekly session, with the goal to interact with them all. Incorporate 1-2 foods throughout the week.
• Fade-in: Start with larger portions of preferred food and mix in a small amount of the new food, gradually increasing the new food and decreasing the preferred food with each interaction.
• Chaining: Use preferred foods to link to new foods (e.g., apple Nutri-grain bars to applesauce to warm apple slices to cold apple slices).

Fear of Aversive Consequences

• Education: Providing information on avoidances and the process of exposure helps reduce anxiety and build confidence in the process.
• SUDs Scale: Individuals and families create a hierarchy using SUDs that will guide the introduction of exposures throughout treatment.

Lack of Interest

• Eating by the Clock: Developing a routine around eating helps ensure individuals can meet nutritional needs throughout the day (e.g., alarms, visual cues).
• Interoceptive Exposures: Induce feelings of fullness, nausea, etc., then complete highly preferred foods. This serves to reset internal scales of hunger and fullness.

Learn more about Monte Nido’s continuing education events

Monte Nido and MEDA were delighted with the engagement at this event, and we are committed to providing ongoing support and resources for individuals, families, and professionals in the eating disorder community.

Visit our Monte Nido Continuing Education website to review and register for our future CE offerings. In addition, visit MEDA Inc for more ED resources and professional training opportunities. We look forward to seeing you there!