Table 1.
Session # | Workbook | Body Investigation | Lesson | Worksheets/Practice | Decision Point |
---|---|---|---|---|---|
Session 1: Introduction to Feeling and Body Investigators (FBI) – ARFID Division | Henry Heartbeat Gassy Gus Samantha Sweat Betty Butterfly | Which of two activities makes our heart beat faster or slower? | My heart changes to meet my needs. | Body Brainstorms (e.g., activities outside that make your heart beat faster or slower, things that make you sweat); Pick 2 sensations and draw what you were doing in your FBI journal. |
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Session 2: The Eats a | Harold the Hunger Pain, Georgia the Gut Growler, Solomon Satisfied, Sabrina Stuffed | How many crackers are needed to move from Georgia to Solomon? (Compare parent’s guess with child’s guess.) | My body tells me if I’m hungry when I learn to listen. | Body Brainstorms (e.g., think of last meal you felt satisfied, last time you felt Harold); Learn Step 1 and 2 of Decision-Tree Worksheet (label and contextualize sensations). |
Does child need additional practice with hunger and fullness detection? a If yes, assess energy and refuel after body investigations every session. Energy monitoring added to FBI-ARFID worksheet |
Session 3: The Noisies a | Gassy Gus, Victor Vomit, Gaggy Greg, Gordon Gotta Go | Can we guess the location of our gag reflex? | My body has a lot of safety strategies to help me. | ||
Session 4: The Feels a | Betty Butterfly, Nauseous Ned, Julie Jitters, Ricky the Rock, Tommy Thunderbolt | How can we can get the most butterflies (e.g., sitting in the dark and telling scary stories, doing timed math problems)? | Butterflies help you get ready to face challenges. | Body Brainstorms (e.g., what gives you the butterflies? positive jitters?); Body Decision Tree Worksheet (all 5 steps from now on, with Hunger exercises if needed.) Body missions tailored to child’s needs, for example, increasing energy intake. | Does child need additional practice with sensory aversions to food? b If yes, exteroceptive sessions (Sessions 5a – 5d) focusing on Appearance (e.g., Lumpy Lucy); Smell (e.g., Floral Fanny); Taste (e.g., Spicy Sahib); Texture (e.g., Clingy Clara) –, following the same format (education, exposure, lesson summary, generalization, practice) |
Sample Exteroceptive Session 5a: The Looks ab | Smooth Stephanie, Bright Bea, Flawed Frankie | Sample Food Investigation: Examine effects of changes in appearance on taste. | Flaws can be friendly and fascinating. | Food Brainstorms (e.g., find 10 foods that are bright red); Food Investigations Worksheet | |
Session 6: The Ouches, Part 1 ab | Polly Pain, Patricia the Poop Pain, Brenda the Brain, Ella the Emotional Pain | How fast can we run with a belt tight around the tummy? (Food exposure as needed.) | Pain is a messenger to help you take care of yourself. | Body Brainstorms (e.g., last time you had poop pain, fun things to do on the toilet); Decision Tree Worksheet (and/or Combined FBI-ARFID Worksheet with Sensory Challenges.) |
Notes. For each session, we provide some examples of the characters that form the psychoeducation for each session. We also provide a sample interoceptive exercise and the new experience/lesson that may correspond with this exercise. For the various motivations for food avoidance in ARFID (e.g., indifference, sensory aversions), there are decision points in which different skills may need to be emphasized (e.g., more training in hunger awareness or repeated sessions with food exposures to address sensory aversions). Each session has interoceptive exposures to at least 2 body sensations.
If monitoring energy/hungry is problematic, checking in on energy and refueling becomes part of subsequent sessions. Monitoring hunger is also added to Decision-Tree worksheets.
If sensory aversions to food is problematic, food exposures are added as one of the exposures in subsequent sessions. However, each food exposure session also includes an interoceptive exposure exercise so the focus is not solely on food.