FREQUENTLY ASKED QUESTIONS
Got a question about who I am, my appointments or who I can work with? Below I try to answer some of the most common questions people have. If you can't find the answer to your question here, please get in touch.
I am based in Nottingham, UK and work with people across the life span affected by eating challenges. I have extensive training and experience working with ARFID and people who are neurodivergent, such as autistic people and those with ADHD.
I work with people experiencing a range of difficulties with selective eating, from very young children who are struggling to move on from the natural ‘picky eating’ stage, to those experiencing longer term difficulties such as Avoidant Restrictive Food Intake Disorder (ARFID) and everything in between.
Many of the people I’ve worked with have had medical conditions that affect their eating, such as IBS and gastrointestinal disorders, or food allergies and intolerances that have led to a fear of eating. Others may have been fed by tube (such as a PEG or NG tube) and this affected their relationship with food or their ability to feel hunger.
A large number of people experiencing challenges with food are autistic, ADHD or identify as neurodivergent. When I work with people towards their eating goals, we consider all the factors that may be affecting eating and appetite, including neurodiversity. I don’t offer autism or ADHD diagnostic assessments, but I can recommend trusted professionals who do if we agree that this would be helpful.
I aim to offer a neuro-affirming practice that respects autonomy, choice and consent, and works with people's strengths.
Some people find diagnosis helpful in understanding their difficulties or communicating with others about them. However not everyone wants to put a label on their experiences and this is OK. Similarly, not everybody who finds eating difficult will meet all the criteria for a diagnosis. Whichever approach feels right for you, we can collaborate to find a way forward with your eating challenges.
The people I work with usually struggle to eat because they have sensory difficulties with food, they are afraid of unfamiliar food or they find that they just don’t feel hunger and fullness in the same way as other people. If you are looking for help with eating because you don’t want to gain weight, or because you feel bad about the way your body looks, then the first thing you should do to get support is contact your GP. The charity Beat also has excellent advice and information (https://www.beateatingdisorders.org.uk/).
Different approaches are suitable for different circumstances, and we can discuss which may be right for you during your in-depth assessment. I am trained and experienced in a number of therapeutic approaches which current evidence says can be helpful for selective eating and ARFID. These include Cognitive Behavioural Therapy (CBT-AR) and systemic/family therapy approaches. Where appropriate I also use graded de-sensitisation (gradually exploring and experiencing disliked foods or situations). This is always done with full involvement and consent and I will never put you (or your child) in situations you don't choose in advance and feel ready to face.
Follow-up support is offered in a 50 minute session weekly or two-weekly, though we can arrange a schedule and number of sessions that works for you.
For some people, we may agree that the most helpful changes can happen in their wider support network rather than in a therapy session, for example making recommendations for support or adaptations in school. You will receive a thorough report after your assessment which can state your needs clearly.
Yes! Not everyone who has ARFID or selective eating difficulties is a child, in fact recent research suggests a number of people still experience difficulties in to adulthood and many more live with eating challenges without any kind of diagnosis. I have additional training on working with ARFID across the lifespan, and would be happy to support you.
Not everyone with selective eating or ARFID is underweight. People can struggle with sensory processing of food, fear of new food or difficulties with appetite at any size. It may be that the types of foods you’re comfortable eating provide enough, or even more than enough calories for your individual needs. The impact of a restricted diet may be felt in other ways – perhaps it is difficult to get enough healthy nutrients in your diet, or eating out is such a challenge for you that you’re not able to socialise as much as you’d like. We can talk through the ways that difficulties with food affect you, and focus on goals that are meaningful for you, which may not necessarily include a change in weight.