ARFID, Picky Eating, & Feeding Difficulties Therapy for Children, Adolescents, and Young Adults in Portland, OR

What Are Eating Difficulties?

Many children, adolescents, and young adults struggle with eating challenges that go beyond typical picky eating. These difficulties may include a very limited range of accepted foods, strong sensory aversions to certain tastes, textures, smells, or appearances, fear of choking or vomiting, low interest in eating, nutritional concerns, or significant distress around meals.

Some individuals meet criteria for Avoidant/Restrictive Food Intake Disorder (ARFID), an eating disorder characterized by restricted eating that can affect nutrition, growth, physical health, social functioning, and quality of life. Eating difficulties can be especially common among individuals with anxiety, ADHD, autism, sensory sensitivities, gastrointestinal conditions, or a history of difficult feeding experiences.

Evidence-Based Treatment for ARFID and Eating Difficulties

As a child psychologist, teen therapist, and young adult therapist in Portland, Oregon, I provide evidence-based treatment for ARFID, picky eating, sensory food aversions, and other feeding-related challenges.

Treatment begins with understanding the factors contributing to eating difficulties, including sensory preferences, anxiety, past experiences, developmental factors, medical concerns, and family mealtime patterns. Because eating difficulties are complex, treatment is individualized to each person's unique strengths, needs, and goals.

I draw from evidence-based approaches including:

• Cognitive Behavioral Therapy (CBT) for ARFID and anxiety-related eating concerns

• Acceptance and Commitment Therapy (ACT) to increase flexibility and reduce avoidance

• Exposure-based interventions to gradually expand tolerated foods

• Parent coaching and family-based strategies

• Collaboration with medical providers, dietitians, occupational therapists, and other professionals when appropriate

What to Expect During Therapy

Treatment focuses on helping children, adolescents, and young adults develop a healthier and more flexible relationship with eating while reducing distress and avoidance.

Therapy may include:

• Understanding factors that contribute to food avoidance

• Expanding the variety of accepted foods

• Addressing fears related to eating, choking, vomiting, or unfamiliar foods

• Reducing mealtime stress and conflict

• Building tolerance for sensory experiences

• Increasing flexibility around food

• Supporting nutritional goals

• Helping parents and caregivers respond effectively to eating challenges

When appropriate, parents and caregivers play an active role in treatment and learn strategies to support progress at home without increasing pressure, conflict, or anxiety around meals.

A Compassionate, Neurodiversity-Affirming Approach

Many individuals with ARFID or feeding challenges have spent years being told they are "too picky" or "just need to try harder." My approach recognizes that eating difficulties are real and often influenced by sensory, emotional, developmental, and biological factors.

I provide a supportive, nonjudgmental environment where clients can gradually build confidence, reduce anxiety, and work toward their goals at a manageable pace. The goal is not perfection, but helping young people experience greater flexibility, confidence, health, and enjoyment around eating.

Common Eating Concerns Addressed

• Avoidant/Restrictive Food Intake Disorder (ARFID)

• Picky eating

• Sensory food aversions

• Fear of choking

• Fear of vomiting

• Low appetite or low interest in eating

• Anxiety around food

• Limited food variety

• Mealtime stress and conflict

• Feeding difficulties in ADHD and autism

• Nutritional concerns related to restricted eating