Work

CBT-AR Teletherapy for ARFID in a Gastroenterology Clinic Specializing in Celiac Disease: A Proof of Concept and Feasibility Case Series

Year: 2025

Type: article

Abstract: • Four adults with Celiac Disease and ARFID completed 10 sessions of CBT-AR. • Three showed improvements on a measure of ARFID symptoms. • All four met some or all treatment goals and reported high acceptability. • Difficulties with participant recruitment in a tertiary CD clinic are discussed. Patients with gastrointestinal (GI) tract diseases are at high risk for developing avoidant/restrictive food intake disorder (ARFID). Patients with Celiac Disease (CD) may be particularly susceptible given their need to adhere to lifelong dietary restrictions. The current article presents the proof-of-concept stage of a planned clinical research program evaluating cognitive behavioral therapy (CBT) for ARFID (CBT-AR) delivered in a 10-session teletherapy format to adult patients in a CD clinic. We present data on the program feasibility and preliminary evidence for acceptability and proof of concept, i.e., that CBT-AR is associated with improvement in ARFID symptoms and engagement of targeted mechanisms of change. Over a 12-month period, 293 patients were screened for ARFID, and 18% screened as high-risk on a validated screener. Of these, approximately half agreed to be contacted by the study team, 8 completed an assessment, 6 entered, and 4 completed treatments. Three patients showed improvement on validated measures of symptom severity and clinical impairment, and both patients with clinically relevant fear ARFID symptoms showed improvement in cognitive/behavioral mechanisms hypothesized to maintain fear-ARFID symptoms. All 4 reported high acceptability and met some or all treatment goals. Implications of these preliminary findings and lessons learned for the design of the next phase of the research are discussed.

Source: Cognitive and Behavioral Practice

DOI: 10.1016/j.cbpra.2025.08.002

Authors: Madison A. Hooper, Hana F. Zickgraf, Katrina S. Rbeiz, Joanna Perl, Dawn W. Adams

Institutions: Vanderbilt University, Rogers Behavioral Health, Vanderbilt University Medical Center

Language: English

Topic: Eating Disorders and Behaviors

Subfield: Clinical Psychology

Field: Psychology

Domain: Social Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,600