| 1 (90 min) |
Psychoeducation Acceptance-based interoceptive exposure |
Review of differences between fear, worry, and disgust (Hildebrandt, Bacow, Markella, & Loeb, 2012), emphasize failure of disgust to habituate or extinguish. Create hierarchy of somatic situations inducing disgust while eating. Generate coping strategies for tolerating disgust. Exposure with shake of unknown content and caloric density (~30 min). Parental review of refeeding strategies and homework planning.
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| 2 (90 min) |
Mindfulness: Observing and describing Acceptance-based interoceptive exposure |
Review of experience with ABIE homework. Teaching mindfulness skill: Observing and describing versus judging. Utilize an exercise of eating a raisin and practicing a non-evaluative description of the experience. Exposure with shake of unknown content and caloric density practicing mindfulness skill (~30 min). Homework planning.
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| 3 (60 min) |
Mindfulness: Present moment Acceptance-based interoceptive exposure |
Review of experience with ABIE homework. Discuss mindfulness skill of staying in the present moment. Exercise to practice focusing on breathing without exerting control. Use a finger trap to elicit the experience of greater control inducing more discomfort. Exposure with shake of unknown content and caloric density practicing mindfulness skill (~30 min). Homework planning.
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| 4 (60 min) |
Willingness to experience discomfort Acceptance-based interoceptive exposure |
Review of experience with ABIE homework. Introduce willingness to experience discomfort to manage negative experiences and interoceptive disgust. Examples of life events where pain must be endured to arrive at a positive and/or valued outcome. Consider benefits of willingness to experience discomfort. Exposure with shake of unknown content and caloric density (~30 min). Homework planning.
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| 5 (60 min) |
Positive coping Acceptance-based interoceptive exposure |
Review of experience with ABIE homework. Expand use of value-based activities as active coping tools. Elicit and list positive activities that correspond to values. Translate abstract values into a concrete coping strategy. Use positive coping strategies for the in-session ABIE and with any distressing events outside session. Exposure with shake of unknown content and caloric density (~30 min). Homework planning.
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| 6 (60 min) |
Active acceptance Acceptance-based interoceptive exposure |
Review of experience with ABIE homework. Reviewed of progress with tolerating aversive somatic symptoms and attempts at counter-conditioning. Active acceptance introduced to acknowledge current difficulties followed by an active intention to continue living life in a valued-based way. Consider values in the context of difficulties incorporate the skill of acceptance into ABIE. Exposure with shake of unknown content and caloric density (~30 min).
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