CBT-AR · Telehealth across New York City
ARFID Treatment in NYC
Evidence-based therapy for Avoidant/Restrictive Food Intake Disorder in teens and adults, using Cognitive Behavioral Therapy for ARFID (CBT-AR). Delivered by video anywhere in Manhattan, Brooklyn, Queens, the Bronx, and Staten Island.
Request a consultation How CBT-AR worksWhen eating feels unsafe, overwhelming, or just not worth it
ARFID is not picky eating, and it isn't about weight or how your body looks. It's a pattern of avoiding or restricting food because of how food feels, what you fear it might do, or simply because hunger doesn't show up the way it does for other people.
“I've eaten the same five foods for years.”
“Ever since I choked, I can't swallow anything solid.”
“I forget to eat. Food just doesn't interest me.”
“Restaurants, dates, work dinners — I plan my whole life around avoiding them.”
Many people with ARFID have spent years being told to "just try it," or feeling embarrassed at every shared meal. The avoidance makes sense given what your nervous system has learned. It is also treatable, and your food world can get bigger.
ARFID presentations I treat
ARFID usually involves one or more maintaining mechanisms. Treatment targets the ones driving your avoidance.
Sensory sensitivity
Strong aversion to textures, tastes, smells, temperatures, or appearance, with a narrow range of "safe" foods or brands.
Fear of aversive consequences
Fear of choking, vomiting, gagging, allergic reactions, or GI distress, often after a frightening experience.
Low interest & appetite
Little drive to eat, early fullness, forgetting meals, or experiencing eating as a chore.
Adult-onset & long-standing ARFID
Whether symptoms began in childhood or emerged recently, it is never too late to start treatment.
ARFID with co-occurring conditions
ARFID alongside anxiety, OCD, autism, ADHD, or GI conditions, with treatment adapted to your needs.
Social & functional impact
Avoiding restaurants, travel, dating, work events, or family meals because of food.
How CBT-AR treats ARFID
Cognitive Behavioral Therapy for ARFID (CBT-AR) is a structured, evidence-based treatment developed specifically for ARFID. It helps you gradually expand what, how much, and how flexibly you eat by targeting the specific mechanisms maintaining your avoidance, rather than relying on willpower or pressure.
What treatment looks like
- Comprehensive assessment. We clarify which ARFID presentations are present, review eating patterns and medical history, and identify your goals.
- Psychoeducation and early change. You learn how ARFID is maintained and begin establishing more regular eating, increasing volume where it's needed.
- Treatment planning. We identify the foods and situations that matter most to you, such as eating out, family meals, or nutritional gaps.
- Targeting maintaining mechanisms. Structured food exposures for sensory sensitivity, graduated exposure for fear of choking or vomiting, and interoceptive work for low interest and appetite, practiced in session and in your own kitchen.
- Relapse prevention. You leave with a plan to keep foods in rotation and continue expanding independently.
When clinically indicated, I coordinate with your physician or dietitian to make sure medical and nutritional needs are addressed alongside therapy.
Specialized ARFID therapy anywhere in New York City
Few clinicians in New York are trained specifically in CBT-AR. Telehealth gives you access to specialized care without crossing boroughs, and it lets us do food exposures in your real environment: your kitchen, your foods, your routines.
Serving clients in: Manhattan (Upper West Side, Upper East Side, Harlem, Midtown, Chelsea, the Village, Lower Manhattan) · Brooklyn (Park Slope, Williamsburg, Bushwick, Crown Heights, Bed-Stuy) · Queens (Astoria, Long Island City, Jackson Heights, Forest Hills) · The Bronx · Staten Island · and throughout New York State.
Culturally responsive, affirming care
Food is tied to family, culture, and belonging. For BIPOC and LGBTQIA+ clients, ARFID can affect connection to cultural foods, holidays, and community. As a queer, Latinx clinician, I build treatment around the foods and settings that matter in your life, not a one-size-fits-all list.
About your therapist
I'm Ricardo Despradel, LMHC, a licensed psychotherapist specializing in eating-related conditions, OCD, and anxiety. I provide CBT-AR for ARFID and CBT-E for other eating disorder presentations, and I train other clinicians in evidence-based practice.
My approach is structured, collaborative, and paced with you. Nothing is forced, and every step is agreed on together.
Start ARFID treatment in NYC
If food avoidance is shaping your health, your social life, or your peace of mind, specialized help is available. Reach out for a consultation to discuss your concerns and whether CBT-AR is a good fit.
Request a consultationFrequently asked questions about ARFID treatment
What is the difference between ARFID and picky eating?
Picky eating is common and usually doesn't cause significant problems. ARFID involves food avoidance or restriction that leads to meaningful consequences, such as nutritional deficiencies, weight loss or faltering growth, reliance on supplements, or significant interference with social and daily life.
How is ARFID different from anorexia?
Both can involve restriction, but ARFID is not driven by concerns about body shape or weight. Avoidance in ARFID stems from sensory sensitivity, fear of aversive consequences like choking or vomiting, or low interest in eating.
What is CBT-AR?
Cognitive Behavioral Therapy for ARFID is a structured, evidence-based treatment developed specifically for ARFID. It uses psychoeducation, regular eating, and gradual food exposures tailored to each person's maintaining mechanisms.
Can adults have ARFID?
Yes. ARFID is often associated with childhood, but many adults live with it, sometimes for decades without a diagnosis. Adults respond well to treatment, and it is never too late to begin.
Does ARFID treatment work over telehealth?
Yes. Telehealth can be especially well suited to ARFID, because food exposures happen in your own kitchen with foods you actually have access to.
Do you work with teens?
Yes. I work with teens and adults. For adolescents, treatment typically includes family support to help with meals and progress at home.
Will I be forced to eat foods I'm afraid of?
No. CBT-AR is collaborative and gradual. We choose foods and steps together, starting where you feel able, and build from there.