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I’m a feeding therapist, not a counselor!

I’m a feeding therapist, not a counselor!

by Jo Cormack PhD MBACP | Working with pressure

In a follow-up to our previous post on helping parents not pressure, I (Jo) introduced some ideas from the field of counseling and psychotherapy, and anticipated a common question I sometimes hear from supervisees, “This sounds a lot like therapy – isn’t it a...

Recent Posts

  • Exploring parent resistance to change in feeding therapy
  • I’m a feeding therapist, not a counselor!
  • Working with Pressure Series – part 1
  • “Help! My preschooler is obsessed with food!” Food Preoccupation in Pediatric Feeding
  • Juice Isn’t “Bad” and May Be Good For Children With Feeding Challenges

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If you’re working to support children with feedi If you’re working to support children with feeding differences or struggles, and they are fixated or anxious around sweets, this tip can be one part of a healing and helpful strategy. Sometimes children who have sensory differences and eat a limited variety can become fixated on sweets, if they are limited, or sweets are used as rewards to try to motivate eating nonpreferred foods. Consider how permission and decreasing the anxiety and scarcity mindset around high interest foods can help children to relax into felt safety and be more able to access intrinsic drives around eating. #feedingdisorder #pickyeating #feedingtherapy #pediatricot #pediatricslp #responsivefeedingtherapy
Hope to see you there! #pediatricfeedingdisorders Hope to see you there! #pediatricfeedingdisorders #arfid #feedingtherapy #responsivefeedingtherapy #pediatricfeedingtherapy #pediatricslp #pediatricot #pediatricdietitian
We often hear along the lines of, “Sensory play We often hear along the lines of, “Sensory play isn’t enough,” or, “SOS isn’t making changes at home.” Desensitization and sensory play, hierarchies and protocols help us and parents feel like we/they are DOING something when they often feel helpless. Sometimes it’s challenging to focus on felt safety and connection, and supporting appetite and comfort, rather than focusing on bites or kissing a food. When RFT is new, there can be a sense of wanting to DO more. And that’s hard. Sensory play or a food science experiment can help our anxiety by giving us something to do. Can you relate? #responsivefeedingtherapy #responsivefeeding #feedingtherapy #pediatricslp #pedoatricot #pediatricdietitian #arfid #pediatricfeedingdisorder
#Repost @katjarowellmd with @use.repost ・・・ #Repost @katjarowellmd with @use.repost ・・・ This is an excerpt from a really fun conversation I had with @wholeheartedeatingpod recently. It’s at 1 1/4 speed. I don’t know about you, but I’m so impatient I listen to most of my podcasts that way! But I’d you don’t, the podcast is at a slower pace. This excerpt touches on the notion of what parents say and why at eating times. It feels so natural to want to teach and mold the process of what and how much our kids are eating, but the reality is it usually backfires. What has your experience been? Do you help parents unpack what they are saying and why? It doesn’t have to be, “try a bite,” gentle pressure, even attention or casual comments can invite resistance for many children. Link in bio to podcast. And I’ll link in stories. #responsivefeeding #lovemefeedme #pickyeating
#Repost @thrivewithspectrum with @use.repost ・・・ Internal Motivation! The change maker in pediatric feeding therapy. So often overlooked. It’s frequently assumed that kids can’t find their inner fire for food. We couldn’t disagree more. #responsivefeedingtherapy #responsivefeeding
Where do parents feel most defeated around feeding Where do parents feel most defeated around feeding or mealtimes? ⁣ ⁣ When do they get stuck in negotiating or bribing? How do they feel after meals?⁣ ⁣ Do they feel calm and connected at eating times, does the child?⁣ ⁣ These are opportunities for healing that can make a big difference in a child’s comfort at eating times. Felt safety promotes their ability to tune in (interoception), impacts the sensory threshold, improves access to internal drives such as curiosity, hunger, and desire for connection. ⁣ Conflict, emotional distress, and dysregulation are big red flags waving “look here” for opportunities to support healing. ⁣ #responsivefeedingtherapy #responsivefeeding #feedingdisorder #pediatricfeedingdisorders #arfid #pediatricslp #pediatricot #pediatricdietitian
#Repost @katjarowellmd ・・・ Thanks @fatblack #Repost @katjarowellmd ・・・ Thanks @fatblackandgettinit for this powerful reel and caption, and hiking inspo!⁣ ⁣ First do no harm. Please don’t predict dire outcomes for higher-weight kids (or adults) as a misguided way to try to scare them into losing weight. It doesn’t work and it actively harms body and soul.⁣ ⁣ The power of nocebo is real. (I share a study in my book where adults were told they had genes predisposing them to decreased exercise capacity and “overeating” and o*esity and there were measured PHYSIOLOGICAL changes in oxygen carrying capacity and changes in the hormone level of ghrelin based on falsely believing what they were told. The bodymind is amazing.) Don’t make kids sick. ⁣ ⁣ Don’t rob bigger kids of the healing of placebo: kindness and belief are health-promoting and harnesses the body’s healing properties. I also shared research from the book Suggestible You where a kind demeanor from a health care provider led to measurable improved outcomes. Placebo healing can make a measurable and positive improvement in depression, anxiety, Parkinson’s, functional gut problems, chronic pain, blood pressure and more. ⁣ ⁣ Repeated dire warnings are stressful, and are essentially an overdose of nocebo and contribute to poor health.⁣ ⁣ Health care providers: Weight-neutral care is effective and compassionate care. Help all your patients, including higher-weight kids, to do all the things they want to do and achieve. Don’t let your bias and ignorance harm another child. (I’ve been there, the unlearning is work that I continue to do).⁣ ⁣ My favorite resource for health professionals is @ragenchastain and her weight and healthcare substack. Also @v_solesmith and her upcoming book Fat Talk is likely to be an amazing resource.⁣ ⁣ Check out my highlights: Bigger Kids and Weight Bias. I try to share helpful info in the stories here, so stay tuned.⁣ ⁣ Also, I cover a lot of info in Love Me, Feed Me (second edition) around misperceptions around weight, growth, health and feeding and how to support kids in bigger bodies.⁣ ⁣ #lovemefeedme #antifatbias #weightbias #weightneutral #antidiet #haes #intuitiveeating #bodyliberation⁣
#Repost @katjarowellmd with @use.repost ・・・ #Repost @katjarowellmd with @use.repost ・・・ Do you anticipate this with clients? Is this something you observe? It’s so relatable! This!!! Especially if your child is an anxious or avoidant (picky eater) it’s tempting to buy lots of something they express an interest in… but kids will likely feel it as pressure and it may close the door to curiosity. It also sends the message that it’s a big deal. For kids who are demand avoidant or with sensitive nervous systems, this can feel like a challenge or demand and invite resistance. I warn parents to be prepared for this and try not to get sucked in by the excitement! Example…If your child enjoys a brand of say, ramen at a friend’s house, make note, maybe pick some up and serve nonchalantly in a few days. Don’t… 1. go out and buy the mega pack of 64 and serve it for dinner or the next day 2. remind them how much they liked it 3. react when they reject it or say they changed their mind If your child requests it, go for it! Maybe serve it with some other accepted choices. Have you done this? You are so not alone!!! #responsivefeeding #lovemefeedme #pickyeaters #pediatricfeedingdisorder #feedingdisorder #adoption #fostercare #demandavoidance I’m recovering in bed from a procedure… don’t usually do reels from bed. 🩹
Lovely video. Pressuring kids to eat can have lif Lovely video. Pressuring kids to eat can have lifelong impact. #responsivefeeding #feedingftherapy #responsivefeedingtherapy
This has been an important tool working with famil This has been an important tool working with families. Many feel understood, having struggled for months or years. It starts with the child to help address parent feelings of guilt and blame. Have you found this diagram that illustrates a well-known phenomenon around non-responsive feeding useful? #responsivefeeding #responsivefeedingtherapy #pediatricfeeding #pediatricfeedingdisorders #pediatricfeedingtherapy #pediatricslp #pediatricot #pediatricdietitian
Live April 18th. Link in bio. If you can’t watch Live April 18th. Link in bio. If you can’t watch live, you will have access to the recorded session, including Q&A for a year. It will also be available on demand. With 3 to 4,000,000 children involved in CPS investigations in the US every year, it is critical for those of us who work with children to be aware of how the system functions, how biases harm children and families, and specific advice on how to not add to harm and bias. #feedingtherapy #earlyintervention #pediatricslp #responsivefeedingtherapy #feedingtherapist #pediatricot #pediatricdietitian
Warning for stigmatizing language: ⁣ ⁣ If you Warning for stigmatizing language: ⁣ ⁣ If you work with children and food and feeding you need to know that BMI is bunk. ⁣ ⁣ The study was cited in the Amer Acad of Pediatrics guidelines on treating o*esity in children to justify using BMI. ⁣ ⁣ Wilkes M, et al Relationship of BMI z score to fat percent and fat mass in multiethnic prepubertal children. Pediatr Obes. 2019⁣ ⁣ “Use of BMI in intervention studies as an outcome measure to establish efficacy of the dietary and physical activity interventions, is woefully inadequate… the use of BMI in studies has the potential to miss positive effects of interventions on health-related outcomes.”⁣ ⁣ This post is focused on BMI as a screening tool for fatness. Even if you believe fatness and health are linearly related, here are a few studies showing how inaccurate BMI is.⁣ ⁣ - Brann LS. Classifying preadolescent boys based on their weight status and percent body fat produces different groups. J Am Diet Assoc. 2008 ⁣ ⁣ 12/50 8-10 year old boys mischaracterized per BMI. 6/25 in high BMI group had lower percent body fat, 6/25 average BMI had higher percent body fat⁣ ⁣ - Vanderwall C, et al. BMI is a poor predictor of adiposity in young overweight and obese children. BMC Pediatr. 2017 ⁣ “cautions the use of BMIz as a predictor of %FAT in children younger than 9 years.” ⁣ ⁣ - Wright CM, et al. Body composition data show that high BMI centiles overdiagnose obesity in children aged under 6 years. Am J Clin Nutr. 2022 ⁣ BMI cutoffs over-estimate “excess” fat in 41% of children in “o*erweight” and “o*ese” range ⁣ ⁣ - Weber DR, et al. 2013. Fat and lean BMI reference curves in children and adolescents and their utility in identifying excess adiposity compared with BMI and percentage body fat. Am J Clin Nutr.⁣ Black and brown youth age 8-20 are mislabeled and subjected to harmful interventions more often. ⁣ ⁣ Follow @ragenchastain and her weight and healthcare substack for more.⁣ ⁣ RFPro webinars for more:⁣ What You Need to Know About Growth ⁣ Diet Culture at the Family Table⁣ ⁣ #responsivefeedingtherapy #responsivefeeding #weightneutralhealthcare #haes #pediatricdietitian #pediatrifeedingtherapy #pediatriot #pediatricslp
Responsive feeding and eating are flexible. A flex Responsive feeding and eating are flexible. A flexible routine is helpful for most kids (reduces anxiety), and flexibility helps to ensure that kids get enough and their needs can be met. Beware of “shoulds” and absolutes that don’t take into account access, past experiences, felt safety and more. When we think about the RFT values, we also need to consider autonomy, relationship, competence, intrinsic motivation, and the whole child lens. “Don’t” and “should” can rob families of the flexibility to respond to their child and support them on their journey with eating. With a focus on the child’s felt safety and connection, this can help guide accommodations and flexibility in positive ways. (I’m not a pelvic floor therapist, and I’m sure there is merit to the message not to pee “just in case,” but there needs to be way more nuance than a 60 second reel can provide...) #responsivefeeding #responsivefeedingtherapy #pediatricfeedingdisorder #pediatricslp #pediatricot #pediatricrd #feedingtherapy #feedingtherapist
#Repost @katjarowellmd with @use.repost ・・・ #Repost @katjarowellmd with @use.repost ・・・ Serving family or buffet-style is really helpful for many families, and many children with feeding differences or challenges. It often reduces anxiey and pressure and supports felt safety. ⁣ ⁣ BUT, what if it doesn’t? I offered a few examples in the reel. Parents are not doing it “wrong” if family-style doesn’t work to prioritize felt safety and connection. There are responsive ways to serve and assist children with eating, and feeding and nutrition professionals are great at supporting families at eating times. ⁣ I go into “modified” family-style in Love Me, Feed Me: The Foster and Adoptive Parent’s Guide to Responsive Feeding (second edition), accommodations at mealtimes, what to do when shared meals don’t feel safe or are dysregulating for a child.⁣ ⁣ #responsivefeeding #responsivefeedingtherapy #feedingtherapy #pediatricfeedingdisorder #pediatricot #pediatricslp #pediatricdietitian #feedingtherapist
The parents and kids you work with may come to you The parents and kids you work with may come to you with the idea that being a supertaster is “to blame” for their avoidant/selective, or anxious eating - there certainly are many online articles that make that claim! ⁣ ⁣ Supertasting may play a role in avoidant eating, but it’s nuanced.⁣ ⁣ And we know Melanie Loomer PhD isn’t pushing kids to try food, but just like kids may have been told told they “can’t” sense hunger due to sensory and interoceptive differences or challenges, kids and parents may get the idea that they “can’t” try new foods, or won’t like them due to “supertasting.” ⁣ ⁣ This belief can be a barrier to curiosity and can increase anxiety and make kids feel LESS capable. (Note, this could be a good belief to explore using the Hot Cross Bun counseling tool Jo will share in a webinar on March 28th.)⁣ ⁣ Melanie offered some thoughts on how to frame it if it comes up. How do you talk about supertasting?⁣ ⁣ It may be an idea we would hesitate to introduce, as it can be misunderstood, but is a common topic that comes up. Hope this helps!⁣ ⁣ #responsivefeedingtherapy #feedingtherapy #pediatricfeedingdisorder #ARFID #pediatricOT #pediatricST #pediatricdietitian⁣
In just under two weeks, join Jo Cormack PhD (feed In just under two weeks, join Jo Cormack PhD (feeding specialist and researcher) for a discussion and examples on how to use the Hot Cross Bun tool to understand your clients, and WITH clients to support a responsive approach.⁣ ⁣ This is a practical session where you will learn how to work with parental beliefs in your practice, in a way that is non-judgmental and non-confrontational. ⁣ ⁣ Clinicians are often really good at identifying misperceived beliefs, and recognizing how these may influence feeding practices. However, supporting parents to adopt a responsive mindset can be difficult - especially where anxiety is high. ⁣ ⁣ And education alone is not enough. ⁣ ‘Hot Cross Bun’ is a simple and powerful tool (from the world of cognitive behavioral therapy) that will help parents untangle what they are feeling, what they are thinking, and how they interact with their children around food.⁣ ⁣ ⁣ *Note this tool is to be used with parents.⁣ ⁣ ⁣ DURATION: 1 hour (w/15 minutes Q and A)⁣ DATE: March 28th⁣ TIME: Noon ET, 17:00 UK time⁣ ⁣ link in bio⁣ #responsivefeedingtherapy #responsivefeeding #pediatricfeedingdisorder #feedingtherapy #pediatricot #pediatricslp #pediatricfeedingtherapy #pediatricdietitian
Save the date and register for an hour with Erika Save the date and register for an hour with Erika Shira LMHC-MT-BC. 15 minutes Q and A. April 18th. Erika is a licensed mental health counselor, certified early intervention specialist, and board-certified music therapist, in addition to foster and adoptive parent. Roles over the decades have included foster care caseworker, early intervention clinician, arts instructor in emotional/behavioral special education, various community mental health supervisor and director rules, individual and family clinician in a private acute mental health setting, state-contracted parent and child evaluator, as well as a member of various advisory boards to organizations focused on trauma-informed care, social justice, cultural competence, and neurodiversity. Learn more about Erika and what you’ll take away from this discussion at responsivefeedingpro.com #linkinbio #responsivefeedingtherapy #responsivefeeding #fostercare #responsivefeedingpro #pediatricfeedingtherapy #pediatricot #pediatricslp #pediatricdietitian
Love this example of a deconstructed meal. This wa Love this example of a deconstructed meal. This way eaters with different preferences, skills, and sensory needs can find something they can eat. It supports autonomy and the child’s sense of capability. One child may only eat a plain crêpe, another child may eat a pile of cheese, and one blueberry. 🧡 offering a variety of choices 🧡 allowing children to self serve 🧡 offering different condiments 🧡 NOT commenting on what the child is or is not eating 🧡 focusing on the child’s felt safety and connection …can help to children to feel comfortable and more easily access curiosity and appetite at eating times. #responsivefeedingtherapy #responsivefeeding #pediatricot #pediatricslp #pediatricfeedingdisorders #pediatricfeedingtherapy #pediatricdietitian #pickyeating
Link in bio to blog with handout. #responsivefee Link in bio to blog with handout. #responsivefeedingtherapy #responsivefeeding #pediatricfeedingdisorders #pediatricfeedingtherapy #feedingtherapy #pediatricslp #pediatricot #pediatricdietitian
Maybe you’re an SLP, OT or RD and you’ve been Maybe you’re an SLP, OT or RD and you’ve been doing feeding work for a while, or you’re new to the field and…⁣ ⁣ ✅ sensory play or desensitization – or simply letting the child decide what to eat - doesn’t feel like enough.⁣ ⁣ ✅ perhaps you want to build on your core skill-set and deepen your practice.⁣ ⁣ ✅ maybe you sense that for a significant group of children, what you’re doing isn’t getting at the whole picture.⁣ ⁣ 🧡 The RFPro team have all been there. Early in our careers, we knew we were missing opportunities to help children heal their relationships with food and to empower parents to support the process.⁣ ⁣ Connecting with colleagues, developing and working in the RFT framework was what we were missing.⁣ ⁣ In this series of six webinars you will explore how the RFT values of autonomy, relatedness, competence, intrinsic motivation, and whole child care:⁣ ⁣ 🧡 empower parents to support healing for children who seem to progress in therapy but stay stuck at home.⁣ 🧡 offer new opportunities for assessment and treatment.⁣ 🧡 increase your comfort and confidence working with children and parents.⁣ 🧡 provide a cohesive framework for your work with children and families.⁣ 🧡 help you discover and address obstacles to progress that your families may face.⁣ ⁣ “The foundational webinar series has added so much depth to the way I work. The values are just so helpful for guiding families towards change and for not losing sight of the bigger picture.”�⁣ ⁣ Simone Mossop, Paediatric Clinical Nurse Specialist, Early Intervention Feeding Practitioner⁣ —-⁣ “It [RFT] really spoke to me as a new clinician who wasn’t feeling great about the practices I was seeing.”⁣ ⁣ Daphnée SLP, Canada⁣ ⁣ —-⁣ “I cannot speak highly enough of this approach.”⁣ ⁣ Thalia Prum RD⁣ ⁣ ⁣ #Responsivefeedingtherapy #RFT #feedingtherapy #pediatricfeedingdisorder #pediatricSLP #pediatricST #pediatricOT #pediatricdietitian⁣ —
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