others having similar experiences , may have considerable therapeutic impact on participant wellbeing and eating behaviours .
Occupational therapists are used to working as part of a multidisciplinary team and working alongside other healthcare professionals to deliver interventions . We felt this particular partnership of occupational therapy , psychotherapy and informal group learning provided participants with space to hear and explore how participants experienced ARFID eating , including :
• Considering how they experienced changes in their bodies .
• Exploring sensory difficulties and needs – this was pertinent for the people on the group to understand what food difficulties were due to sensory difficulties and how the wider sensory landscape affected eating .
• A focus on goals and ensuring that any changes were meaningful for individuals and would lead to participants being able to achieve personal aims such as eating out with family and friends .
• Focusing on the environmental conditions that best facilitated change .
• Considering what motivated and demotivated different participants , including exploring their relationships and how those enabled or disabled them .
Expertise in training , including effective use of online learning platforms ( such as Zoom ), and knowledge of learning styles ensured that format and materials were accessible , informative and engaging .
The use of breakout rooms enabled sharing between participants , which built trust between them , creating a safe space for exploration and sharing .
Feedback and evaluation
The SYEDA ARFID pilot group was evaluated using quantitative surveys and qualitative discussions , in groups and individually .
In feedback , participants reflected that they were not aware that other adults had similar difficulties and that sharing experiences and knowing they weren ’ t alone was an exceptionally valuable aspect of the programme .
Listening to and validating each person ’ s unique experience helped participants to better understand themselves , as well as enabling facilitators to better understand the experiences and challenges of ARFID .
It is worth noting that one of the facilitators , being autistic and ADHD , has lived experience of sensory and executive function challenges with food and eating . This may have enabled trustbuilding in the group , but is an element not fully explored in evaluation .
Analysis and learning about what is needed continues as SYEDA considers what will be the next stage on the journey to support people living with with ARFID .
Following the success of this multidisciplinary partnership approach , and having recognised the value of building a community of commonality , we want to explore how connections and sharing can be developed further across the SYEDA service as a whole , via co-facilitated activities such as a creative writing group and a choir .
Final thoughts to consider
The authors would like to encourage other occupational therapists to explore working more closely with non-traditional health roles , such as counsellors and psychotherapists .
We also emphasise the importance of facilitating safe group spaces for people with ARFID , where they can connect with others and explore the nature and causes of their eating behaviours . In doing so , we believe people with ARFID presentations may feel less isolated and more supported , so they can start to explore and better understand their own experiences .
Facilitated groups , such as this , can help identify and support them through any changes they want to and are able to make . We believe a more holistic , person-focused approach , using multidisciplinary teams – such as this combination of occupational therapy , psychotherapy and informal learning – may be well placed to enable those experiencing ARFID to identify , implement and sustain change more readily than approaches that consider only the behavioural and nutritional aspects of eating .
American Psychiatric Association ( 2013 ) Diagnostic and Statistical Manual Of Mental Disorders , ( Fifth Edition ). DOI : https :// bit . ly / 48Wreie
Words AITCH NICOL , Training Worker , and HAZEL BRYCE , Occupational Therapist , South Yorkshire Eating Disorder Association ( SYEDA ). For more information visit www . syeda . org . uk or hazel @ syeda . org . uk . To find out more about Eating Disorders Awareness Week 2024 visit https :// edaw . beateatingdisorders . org . uk
20 OTnews February 2024