Helping Professionals Interview Series: Understanding ARFID with St. Louis Therapist Kierstin Godier-Franklin, LCSW
At Compassionate Counseling St. Louis, we often work with kids, teens and young adults who are struggling with anxiety. And we know that anxiety doesn’t always show up in obvious ways - one surprising area where anxiety can show up is around food.
You may have heard of a child being a picky eater or even eating disorders like anorexia or bulimia, but Avoidant/Restrictive Food Intake Disorder (ARFID) is different, and it's more common than people often realize.
Kierstin Godier-Franklin, LCSW
What is ARFID?
ARFID (Avoidant/Restrictive Food Intake Disorder) is a diagnosis that describes extreme food avoidance or restriction due to sensory sensitivities, fear of aversive consequences (like vomiting or choking), or a general lack of interest in eating. It’s not just a phase, and it’s not something someone can “just get over.”
Previously we connected you with Kierstin Godier-Franklin, LCSW to learn more about her specialization working with kids, teens, and adults treating eating disorders at Partners in Wellness - you can read that blog right here.
Today we are reconnecting with Kierstin to learn more about ARFID and her approach to treating ARFID.
What are common signs that someone may be experiencing ARFID?
While every child is different, there are several common signs that may indicate ARFID. These include:
eating a very limited variety of foods
showing distress or refusal when introduced to new foods
having strong aversions to foods based on their texture, smell, or appearance
Some children may avoid eating altogether due to fear of choking, vomiting, or other negative physical sensations. Others may lack interest in food and seem indifferent toward eating in general.
Over time, ARFID can lead to significant weight loss, poor growth, nutritional deficiencies, or reliance on supplements to meet basic needs. It’s also common for children with ARFID to experience heightened anxiety or meltdowns around mealtimes.
What role does anxiety play in ARFID, and how do you integrate CBT strategies?
Anxiety often plays a central role in ARFID. In my work, I integrate CBT to help children recognize and externalize those anxious thoughts and gradually reduce their avoidance.
CBT offers practical tools for building distress tolerance, challenging unhelpful beliefs, and approaching food exposure in manageable steps. We work together to understand what the anxiety is telling them, why it’s not always accurate, and how to make brave choices anyway.
With younger children or those who are highly avoidant, I often incorporate creative, play-based methods to reduce resistance and increase curiosity around food. Parent involvement is key here—caregivers are coached to respond calmly, confidently, and consistently during exposures. By using a CBT framework, we empower both the child and the parent with tools to make mealtimes less about fear and more about progress.
What does a typical course of treatment look like for ARFID?
Every treatment plan for ARFID is personalized, but there are a few consistent phases that tend to guide the process.
We begin with assessment and relationship-building, taking time to understand the root of the eating difficulties—whether sensory, fear- based, or related to low appetite.
From there, we move into psychoeducation, helping the child and family understand what ARFID is and how the brain and body respond to anxiety and avoidance. This helps reduce shame and opens the door for externalizing the disorder, rather than blaming the child or parents.
Parent coaching is an essential part of treatment. I support caregivers in learning how to structure meals and exposures, reduce conflict, and maintain a calm feeding environment.
As therapy progresses, we use exposure hierarchies and CBT tools to introduce avoided foods gradually. This might mean starting with tolerating a food on the plate, then touching it, smelling it, and eventually tasting and eating it. Over time, the focus expands to generalizing progress to other settings, like school, restaurants, or family gatherings.
The ultimate goal is for the child to experience flexibility and confidence in their eating, while the family regains peace at the table.
What advice would you give to parents or caregivers who are feeling confused, overwhelmed, or worried about how to best support their child with ARFID?
If you’re a parent or caregiver feeling confused, overwhelmed, or worried about your child’s eating, you’re not alone. ARFID can be incredibly distressing to witness—and hard to talk about—especially when people around you don’t understand what’s going on.
One of the most important things to remember is that ARFID is not your fault, and it’s not a behavioral issue your child is choosing. It’s a fear-based disorder that often requires a structured, therapeutic approach to resolve.
My biggest piece of advice? Don’t wait to get support. Early intervention makes a difference. Focus on creating a calm and predictable meal structure at home, avoid pressuring your child to eat, and celebrate even the smallest signs of progress.
Recovery from ARFID is possible with the right support system—and parents are a vital part of that system. With guidance and consistency, your child can build a more flexible, confident, and nourishing relationship with food.
How can you connect with Kierstin?
People are welcome to either call our office at 314-736-5446 or email me at Kierstin@partnersinwellnessstl.com.
You can connect with Partners in Wellness via social media at these links:
https://www.instagram.com/partnersinwellnessstl/#
https://www.facebook.com/PartnersinWellnessSTL
You’re Not Alone - And Support is Available
At Compassionate Counseling St. Louis, we specialize in helping kids, teens and college students navigate anxiety and anxiety-driven anger using evidence-based treatments like Cognitive Behavioral Therapy (CBT).
CBT is a powerful, structured approach that helps kids, teens, and young adults identify the anxious thoughts and avoidant behaviors that keep them stuck, and build new, healthier patterns over time.
If you or your child is struggling with anxiety, know that there is help available.
Reach out today to schedule a free consultation. Let’s talk about what’s been going on and how we can help. Our team of St. Louis therapists is here to provide expert and compassionate care every step of the way.
Curious to learn more about getting treatment for anxiety and anxiety-driven anger or interested in getting individualized parent coaching? Wondering if you need to connect with a therapist in St. Louis? Contact Compassionate Counseling St. Louis to set up a free 15-minute phone consult. We’ll talk about what’s going on and best next steps - and if we’re not the right fit, we’ll connect you with other wonderful St. Louis-based therapists, like Kiersten!
Curious to learn more about anxiety and anxiety-driven anger? Reach out to us at hello@compassionatecounselingstl.com. As child anxiety experts, we love working with kids, teens, college students and parents to help manage their anxiety, stress, and anger. Compassionate Counseling St. Louis is located in Clayton, MO and works with families by offering both in-person counseling and online therapy throughout St. Louis City, St. Louis County, Ladue, University City, Town and Country, Webster Groves, Creve Couer, Kirkwood, Richmond Heights, and Brentwood. We also provide online therapy Missouri -wide to teens and college students. You can set up your first free consult on this website, on our consultation page.