{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T05:57:26Z","timestamp":1772344646395,"version":"3.50.1"},"reference-count":21,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"NIH","award":["NCT04450771"],"award-info":[{"award-number":["NCT04450771"]}]},{"name":"NIH","award":["RO1 MH121292"],"award-info":[{"award-number":["RO1 MH121292"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Behavioral Sciences"],"abstract":"<jats:p>Objective: Family-Based Treatment (FBT) is an emerging intervention for youth with low-weight Avoidant\/Restrictive Food Intake Disorder (ARFID), yet little is known about how parents conceptualize progress, learning, and maintenance of behavioral changes after treatment completion. Clarifying parent perspectives may inform future treatment modifications and shed light on potential mechanisms of change in FBT. Methods: This qualitative study explored parent experiences (n = 19 families) during the final session of FBT-ARFID who were treated in the context of a randomized clinical trial. Qualitative data from final-session transcripts were analyzed using reflexive thematic analysis. Results: Qualitative analyses identified four themes capturing parental reflections on learning during FBT: Progress Review, Parent Learning, Maintenance Planning, and Gratitude. Parents emphasized improvements beyond weight restoration, including increased dietary variety, reduced fear around eating, and greater flexibility at meals. Parents universally reported learning core FBT principles and increased confidence about their ability to manage ARFID in their child after treatment was completed. Conclusions: According to systematic qualitative analysis of parent reflections at the end of treatment, FBT for ARFID promotes parental self-efficacy, multidimensional progress, and meaningful parental learning related to managing ARFID symptoms in their children.<\/jats:p>","DOI":"10.3390\/bs16030325","type":"journal-article","created":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T08:31:19Z","timestamp":1772181079000},"page":"325","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Family-Based Treatment for Avoidant\/Restrictive Food Intake Disorder: Last-Session Reflections"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6109-7385","authenticated-orcid":false,"given":"Nandini","family":"Datta","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hali","family":"Boyce","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6555-5283","authenticated-orcid":false,"given":"Caroline","family":"West","sequence":"additional","affiliation":[{"name":"Department of Behavioral Medicine and Clinical Psychology, Cincinnati Children\u2019s Hospital, Cincinnati, OH 45229, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anni","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5169-1484","authenticated-orcid":false,"given":"James D.","family":"Lock","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/s40337-024-00971-8","article-title":"How young people perceive change to occur in family therapy for anorexia nervosa: A qualitative study","volume":"12","author":"Baudinet","year":"2024","journal-title":"Journal of Eating Disorders"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1080\/14780887.2020.1769238","article-title":"One size fits all? What counts as quality practice in (reflexive) thematic analysis?","volume":"18","author":"Braun","year":"2021","journal-title":"Qualitative Research in Psychology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2306","DOI":"10.1002\/eat.24269","article-title":"ARFID parent training protocol (\u201cARFID-PTP\u201d): Results of a randomized pilot trial evaluating a brief, parent-training program for avoidant\/restrictive food intake disorder","volume":"57","author":"Breiner","year":"2024","journal-title":"International Journal of Eating Disorders"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"402","DOI":"10.3928\/00485713-20121105-04","article-title":"Avoidant\/restrictive food intake disorder in DSM-5","volume":"42","author":"Kreipe","year":"2012","journal-title":"Psychiatric Annals"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1002\/eat.22376","article-title":"An exploratory examination of patient and parental self-efficacy in predicting weight gain in adolescents with anorexia nervosa","volume":"48","author":"Byrne","year":"2015","journal-title":"International Journal of Eating Disorders"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1177\/001316446002000104","article-title":"A coefficient of agreement for nominal scales","volume":"20","author":"Cohen","year":"1960","journal-title":"Educational and Psychological Measurement"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1080\/15374416.2022.2109650","article-title":"Evidence based update on psychosocial treatments for eating disorders in children and adolescents","volume":"52","author":"Datta","year":"2023","journal-title":"Journal of Clinical Child and Adolescent Psychology"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1002\/eat.22350","article-title":"Prevalence of DSM-5 avoidant\/restrictive food intake disorder in a pediatric gastroenterology clinic","volume":"48","author":"Eddy","year":"2015","journal-title":"International Journal of Eating Disorders"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Loeb, K. L., Le Grange, D., and Lock, J. (2015). Family-based therapy for avoidant\/restrictive food intake disorder (ARFID): Families facing food neophobias. Family therapy for adolescent eating and weight disorders: New applications, Routledge.","DOI":"10.4324\/9781315882444"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Guest, G., MacQueen, K. M., and Namey, E. E. (2012). Applied thematic analysis, SAGE Publications.","DOI":"10.4135\/9781483384436"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1016\/j.pedhc.2013.07.012","article-title":"Implementation of family-based treatment for adolescents with anorexia nervosa","volume":"28","author":"Hughes","year":"2013","journal-title":"Journal of Pediatric Health Care"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"159","DOI":"10.2307\/2529310","article-title":"The measurement of observer agreement for categorical data","volume":"33","author":"Landis","year":"1977","journal-title":"Biometrics"},{"key":"ref_13","unstructured":"Lock, J., and Le Grange, D. (2015). Treatment manual for anorexia nervosa: A family-based approach, Guilford Publications."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1002\/eat.22994","article-title":"Applying family-based treatment (FBT) to three clinical presentations of avoidant\/restrictive food intake disorder: Similarities and differences from FBT for anorexia nervosa","volume":"52","author":"Lock","year":"2019a","journal-title":"International Journal of Eating Disorders"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"746","DOI":"10.1002\/eat.23077","article-title":"Feasibility of conducting a randomized clinical trial using family-based treatment for avoidant\/restrictive food intake disorder","volume":"52","author":"Lock","year":"2019b","journal-title":"International Journal of Eating Disorders"},{"key":"ref_16","first-page":"123","article-title":"Termination of psychotherapy: A systematic review","volume":"35","author":"Rabinowitz","year":"2025","journal-title":"Psychotherapy Research"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1002\/eat.22826","article-title":"Are parental self-efficacy and family flexibility mediators of treatment of anorexia nervosa","volume":"51","author":"Arnow","year":"2018","journal-title":"International Journal of Eating Disorders"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1623","DOI":"10.1002\/eat.23341","article-title":"SPACE-ARFID: A pilot trial of a novel parent-based treatment for avoidant\/restrictive food intake disorder","volume":"53","author":"Shimshoni","year":"2020","journal-title":"International Journal of Eating Disorders"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1636","DOI":"10.1002\/eat.23355","article-title":"Cognitive-behavioral therapy for avoidant\/restrictive food intake disorder: Feasibility, acceptability, and proof-of-concept for children and adolescents","volume":"53","author":"Thomas","year":"2020","journal-title":"International Journal of Eating Disorders"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1007\/s11920-017-0795-5","article-title":"Avoidant\/restrictive food intake disorder: A three-dimensional model of neurobiology with implications for etiology and treatment","volume":"19","author":"Thomas","year":"2017","journal-title":"Current Psychiatry Reports"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"107036","DOI":"10.1016\/j.cct.2022.107036","article-title":"Protocol for a randomized clinical trial for Avoidant Restrictive Food Intake Disorder (ARFID) in low-weight youth","volume":"124","author":"Matheson","year":"2023","journal-title":"Contemporary Clinical Trials"}],"container-title":["Behavioral Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-328X\/16\/3\/325\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T05:13:39Z","timestamp":1772342019000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-328X\/16\/3\/325"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,27]]},"references-count":21,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["bs16030325"],"URL":"https:\/\/doi.org\/10.3390\/bs16030325","relation":{},"ISSN":["2076-328X"],"issn-type":[{"value":"2076-328X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,27]]}}}