Information For Therapy Providers:
Working In The Food Allergy & Allergic Disease Counseling Niche
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Are you an allergic individual or parent/caregiver curious about therapy? Check out Allergy Counseling Information for Patients |
Are you an allergist or healthcare provider curious how allergy counseling could help your patients? Check out Allergy Counseling Information for Allergists |
Brief Overview:
- Allergy Counseling Providers: Licensed behavioral healthcare providers, including counselors, therapists, psychologists, social workers, marriage and family therapists, and psychiatrists. [Coaches are not licensed behavioral healthcare providers unless the coach holds a specific behavioral health licensure as well]
- Scope of Work: Therapy/counseling providers working with the allergic population offer psychosocial, quality of life, and mental health support to those managing a number of allergic conditions, most notably food allergy (FA). A multidisciplinary approach to allergy counseling/therapy is highly encouraged, collaborating with allergists, physicians, and other allied healthcare providers involved in the allergic patient's care.
- Knowledge Set: Due to the unpredictability and uncertainty of allergic reactions, it's important for therapy/counseling providers to understand the medical aspects of allergic conditions, as well as the components of allergy-related anxiety and the behaviors it can trigger.
- Reputable Sources of Allergy & Immunology Information: Visit the American Academy of Allergy, Asthma and Immunology, and the American College of Allergy, Asthma and Immunology to learn more.
Life-Impacting Health Conditions Are A Mind-Body Experience!
Managing chronic and life-impacting health conditions is a mind-body experience. It impacts not only your physical health, but also your mental health. While other chronic health communities, such as diabetes, have already established the importance of providing mental health support for the diagnosed, this is a newer focus for the allergic disease community. However, even though it's a newer focus, it's growing quickly!
Keep scrolling to learn more about the food allergy and allergic disease counseling/therapy niche, what the research shows about the demand/need for this niche, how this niche is growing, and input from the allergy-informed providers already working in this niche.
Keep scrolling to learn more about the food allergy and allergic disease counseling/therapy niche, what the research shows about the demand/need for this niche, how this niche is growing, and input from the allergy-informed providers already working in this niche.
What Conditions Does The Allergy Counseling Niche Focus On?
The food allergy and allergic disease counseling/therapy niche focuses on supporting those with a variety of allergic diagnoses, most notably, food allergies. Other common allergic conditions include: asthma, eosinophilic esophagitis (EoE), food protein-induced enterocolitis syndrome (FPIES), seasonal allergies, and drug allergies.
Allergic conditions are a result of the immune system's efforts to keep you healthy by fighting off infections and other dangers to your health. In the instance of food allergy, a reaction occurs when your immune system overreacts to a food or a substance in a food because it interprets it as a danger and triggers a protective response. This protective response is known as an allergic reaction, which sometimes leads to anaphylaxis, or life-threatening allergic reactions (note: anaphylaxis can be triggered by more than just food allergens).
According to the American College of Allergy, Asthma and Immunology (ACAAI), "Epinephrine (adrenaline) is the first-line treatment for anaphylaxis, which results when exposure to an allergen triggers a flood of chemicals that can send your body into shock. Anaphylaxis can occur within seconds or minutes of exposure to the allergen, can worsen quickly and can be fatal. Specifically for food allergy, this is why allergists do not like to classify someone as “mildly” or “severely” food allergic – there is just no way to tell what may happen with the next reaction. In the U.S., food allergy is the leading cause of anaphylaxis outside the hospital setting."
Sometimes those managing allergic conditions may also be managing other health diagnoses that may overlap with allergies, especially allergic conditions that present differently, and autoimmune and/or inflammatory conditions impacting various bodily systems. These conditions may include: eczema, Celiac Disease, Mast Cell Activation Syndrome (MCAS), gastroesophageal reflux disease (GERD), and Alpha Gal Syndrome (AGS).
You may also be wondering if food intolerances are the same as food allergies? The answer is no - but both can impact quality of life in different ways.
According to the American Academy of Allergy, Asthma and Immunology (AAAAI), "Some of the symptoms of food intolerance and food allergy are similar, but the differences between the two are very important. Eating a food you are intolerant to can leave you feeling miserable. However, if you have a true food allergy, your body’s reaction to this food could be life-threatening. A food intolerance response takes place in the digestive system. It occurs when you are unable to properly breakdown the food. A food allergic reaction involves the immune system. Your immune system controls how your body defends itself. Unlike an intolerance to food, a food allergy can cause a serious or even life-threatening reaction by eating a microscopic amount, touching or inhaling the food."
As these are different diagnoses, it's important for therapy providers (and their patients) to know the difference between food intolerances and food allergies, which allergists can help differentiate and accurately diagnose. And while both food allergies and food intolerances may impact quality of life, it's crucial for therapists to understand not just the medical differences between the two, but also have insights on how each may impact quality of life, and anxiety and stress levels, as the clinical work may differ.
In summary, while food allergy may be the most notable focus, the food allergy and allergic disease counseling niche helps individuals managing a number of allergic and related diagnoses. Therefore, therapy providers benefit from understanding the basic medical aspects of allergic conditions, as well as how they may impact quality of life and mental health in order to more effectively meet their allergic patients where they're at and help them with their clinical therapy goals.
Allergic conditions are a result of the immune system's efforts to keep you healthy by fighting off infections and other dangers to your health. In the instance of food allergy, a reaction occurs when your immune system overreacts to a food or a substance in a food because it interprets it as a danger and triggers a protective response. This protective response is known as an allergic reaction, which sometimes leads to anaphylaxis, or life-threatening allergic reactions (note: anaphylaxis can be triggered by more than just food allergens).
According to the American College of Allergy, Asthma and Immunology (ACAAI), "Epinephrine (adrenaline) is the first-line treatment for anaphylaxis, which results when exposure to an allergen triggers a flood of chemicals that can send your body into shock. Anaphylaxis can occur within seconds or minutes of exposure to the allergen, can worsen quickly and can be fatal. Specifically for food allergy, this is why allergists do not like to classify someone as “mildly” or “severely” food allergic – there is just no way to tell what may happen with the next reaction. In the U.S., food allergy is the leading cause of anaphylaxis outside the hospital setting."
Sometimes those managing allergic conditions may also be managing other health diagnoses that may overlap with allergies, especially allergic conditions that present differently, and autoimmune and/or inflammatory conditions impacting various bodily systems. These conditions may include: eczema, Celiac Disease, Mast Cell Activation Syndrome (MCAS), gastroesophageal reflux disease (GERD), and Alpha Gal Syndrome (AGS).
You may also be wondering if food intolerances are the same as food allergies? The answer is no - but both can impact quality of life in different ways.
According to the American Academy of Allergy, Asthma and Immunology (AAAAI), "Some of the symptoms of food intolerance and food allergy are similar, but the differences between the two are very important. Eating a food you are intolerant to can leave you feeling miserable. However, if you have a true food allergy, your body’s reaction to this food could be life-threatening. A food intolerance response takes place in the digestive system. It occurs when you are unable to properly breakdown the food. A food allergic reaction involves the immune system. Your immune system controls how your body defends itself. Unlike an intolerance to food, a food allergy can cause a serious or even life-threatening reaction by eating a microscopic amount, touching or inhaling the food."
As these are different diagnoses, it's important for therapy providers (and their patients) to know the difference between food intolerances and food allergies, which allergists can help differentiate and accurately diagnose. And while both food allergies and food intolerances may impact quality of life, it's crucial for therapists to understand not just the medical differences between the two, but also have insights on how each may impact quality of life, and anxiety and stress levels, as the clinical work may differ.
In summary, while food allergy may be the most notable focus, the food allergy and allergic disease counseling niche helps individuals managing a number of allergic and related diagnoses. Therefore, therapy providers benefit from understanding the basic medical aspects of allergic conditions, as well as how they may impact quality of life and mental health in order to more effectively meet their allergic patients where they're at and help them with their clinical therapy goals.
Data on Food Allergies & The Impacts on Quality of Life
According to the American College of Allergy, Asthma and Immunology (ACAAI), "allergies, including allergic rhinitis, affect an estimated 40 million to 50 million people in the United States. Some allergies may interfere with day-to-day activities or lessen the quality of life."
When it comes to food allergy, the current diagnosis rates in the United States are:
Here are common QoL impacts* for those managing food allergy:
Here's a snippet of what the current data shows about QoL impacts on lives:
When it comes to food allergy, the current diagnosis rates in the United States are:
- 32 million Americans manage food allergy
- One in thirteen kids manages a food allergy
- One in ten adults manages a food allergy
- 200,000 people require emergency medical care for food allergy reactions
Here are common QoL impacts* for those managing food allergy:
- Health-related impacts, including nutritional and medical
- Increased anxiety levels and fear of death, which may lead to unhelpful behavioral patterns
- Trauma and traumatic responses due to food allergy reactions and anaphylaxis
- Parent/child dynamics impacted by parental hypervigilance, anxiety, stress, and overwhelm
- Family dynamic and relationship impacts due to lack of trust in others' ability to safely manage allergies
- Life experience limitations, specifically including traveling, eating out, and social outings
- Lack of access to safe foods and necessary medications add additional burdens
Here's a snippet of what the current data shows about QoL impacts on lives:
- 92% of parents say they’re always or occasionally fearful of their food allergic child’s safety (KFWA, 2019)
- 75% of allergy parents reported that food allergies cause fear/anxiety for their family (KFWA, 2019)
- 1 in 4 parents report that food allergies causes a strain on their marriage (Gupta et al, 2010)
- Mothers rated their own psychological and physical quality of life worse than fathers rated theirs, and had higher scores than fathers for anxiety and stress (King et al, 2009)
- Greater maternal overprotection was associated with lower child QOL as well as greater dietary and social limitations independent of food allergy outcomes (Warren et al, 2016)
- 40% of parents reported experiencing hostility from other parents when trying to accommodate their child's food allergy (Warren et al, 2015)
How Do Allergy-Informed Therapists Help Those With Allergies?
Research clearly points to quality of life and mental health burdens for individuals and parents/caregivers managing allergic diseases, especially food allergies (which many allergy studies focus on). So how can licensed behavioral healthcare clinicians help those with food allergies and allergic diseases?
OVERALL GOALS FOR FOOD ALLERGY & ALLERGIC DISEASE COUNSELING:
The main overall goal for food allergy and allergic disease counseling is focused on helping individuals and families develop a healthy relationship with allergy anxiety and understand its usefulness in allergy safety, and to find their "just right" balance between the allergy anxiety and quality of life.
OVERALL GOALS FOR FOOD ALLERGY & ALLERGIC DISEASE COUNSELING:
The main overall goal for food allergy and allergic disease counseling is focused on helping individuals and families develop a healthy relationship with allergy anxiety and understand its usefulness in allergy safety, and to find their "just right" balance between the allergy anxiety and quality of life.
Hypothesized relationships between food allergy-related quality of life and anxiety according to “The Goldilocks Principle”
It's important to note that food allergy anxiety (FAA) and allergic disease-related anxiety are different kinds of anxiety than generalized anxiety, as there are several unique features to it. Specific to food allergy (FA), a review of the last two decades of data FA and anxiety found that FA is a growing public health burden affecting 5-10% of children worldwide, and that anxiety disorders are highly prevalent in patients with chronic disease, but remain undertreated despite significant negative consequences on patient health. Additionally, excessive food allergy anxiety (FAA) can lead to a diagnosis of specific phobia, which can include fear of anaphylaxis and the use of epinephrine autoinjectors. And during the pandemic, recent research found that general anxiety also increased in allergy parents due to the limitations and changes impacting safe food sources and emergency medical care.
FAA and allergy-related anxiety IS:
However, it is helpful for those experiencing FAA and allergy-related anxiety to learn how to manage it in a way that doesn’t keep them from living their best lives.
Just as therapists well-versed in other chronic health diagnoses such as diabetes, the allergy community benefits most from therapists who are well-versed in the basics of allergic diseases and the psychosocial/QoL impacts on lives.
Allergy-informed therapy providers can offer a variety of supportive services, including addressing:
[Have questions related to providing therapy services to the allergic population? Submit questions for Tamara Hubbard, LCPC, The FAC founder and licensed clinical therapist to answer via Psychwire's "Ask the Expert" section]
It's important to note that food allergy anxiety (FAA) and allergic disease-related anxiety are different kinds of anxiety than generalized anxiety, as there are several unique features to it. Specific to food allergy (FA), a review of the last two decades of data FA and anxiety found that FA is a growing public health burden affecting 5-10% of children worldwide, and that anxiety disorders are highly prevalent in patients with chronic disease, but remain undertreated despite significant negative consequences on patient health. Additionally, excessive food allergy anxiety (FAA) can lead to a diagnosis of specific phobia, which can include fear of anaphylaxis and the use of epinephrine autoinjectors. And during the pandemic, recent research found that general anxiety also increased in allergy parents due to the limitations and changes impacting safe food sources and emergency medical care.
FAA and allergy-related anxiety IS:
- often attributed to allergy-specific fears, including life limitations, anaphylaxis, epinephrine use, and death
- a natural response to the often uncertain and unpredictable nature of food allergy and allergic diseases
- sometimes short-lived and situation-specific, but can also be ongoing, excessive, and pervasive
- sometimes counterproductive, leading to excessive avoidance, which fuels more anxiety and unhelpful actions
- built on the very real possibility that an allergic or anaphylactic reaction could happen at any point, which results in living with high levels of ongoing emotional distress
- built on irrational fears
- something to feel guilty about
- not a sign that someone isn't effective at living with their allergy
However, it is helpful for those experiencing FAA and allergy-related anxiety to learn how to manage it in a way that doesn’t keep them from living their best lives.
Just as therapists well-versed in other chronic health diagnoses such as diabetes, the allergy community benefits most from therapists who are well-versed in the basics of allergic diseases and the psychosocial/QoL impacts on lives.
Allergy-informed therapy providers can offer a variety of supportive services, including addressing:
- allergy-anxiety management strategies focused on balancing quality of life and allergy anxiety/fear
- maladaptive and unhelpful behaviors as a result of allergy anxiety or in response to it
- a variety of QoL impacts, focusing on making adjustments that positively impact QoL
- other related stressors, emotions, impacts and anxieties
- parent/caregiver anxiety, focusing on management to limit its impacts on child development
- other intense emotions, such as guilt, grief, sadness, and frustration
- trauma as a result of allergic reactions and anaphylaxis
- learning how to live fully even with the diagnosis through counseling and coaching strategies
[Have questions related to providing therapy services to the allergic population? Submit questions for Tamara Hubbard, LCPC, The FAC founder and licensed clinical therapist to answer via Psychwire's "Ask the Expert" section]
The Need and Demand For Allergic Disease Counseling Is There!
Simply stated, the food allergy and allergic disease counseling/therapy niche is an example of "If you build it, they will come!"
Just as the rate of allergic disease continues to grow worldwide, the demand from the allergy community for psychosocial tools and support continues to grow as well. Allergic individuals and families want to learn how to more effectively navigate the unpredictability and uncertainty of allergies!
A recent study explored psychosocial coping in food allergy, surveying parents/caregivers of food allergic kids to gain insight into caregivers’ and their children’s emotions about FA, their current coping strategies, and their interest in testing new coping strategies to manage their FA-related emotions. In addition to offering a breakdown of coping strategies utilized most, over half (66%) of respondents said “yes” when asked if they were interested in trying new coping interventions for themselves and their children. This data is a clear indication for a need for behavioral healthcare professionals to address this gap in psychosocial support for food allergy families.
It's important to note that while other sources of allergy support, such as online support groups and allergy apps can be beneficial, as they offer opportunities for connection and anecdotal information, most are not monitored and/or guided by allergy-informed licensed clinical behavioral healthcare providers. As such, the foundation for such clinical guidance and messaging provided through these support sources may not be regulated, well-monitored or clinically sound, which can lead to additional QoL impacts for those managing allergies and, in some cases, even contradict the guidance allergic individuals are receiving from their allergist.
Therefore, even though the food allergy and allergic disease counseling niche is quickly growing and the demand is there, it's crucial to ensure that the foundation for allergy-related behavioral health guidance is clinically sound, and preferably led by allergy-informed licensed clinical behavioral healthcare providers.
Want to be part of this growing and impactful niche? If you're already an allergy-informed therapy provider, check out the benefits of being a Food Allergy Counselor member, which include being listed on The Food Allergy Counselor Directory and joining The Food Allergy Behavioral Health Network (FABHN). And if you're a therapy provider who would like to learn more and work with this population, fill out the form at the top of this page to be notified of upcoming webinars, workshops, and trainings!
Just as the rate of allergic disease continues to grow worldwide, the demand from the allergy community for psychosocial tools and support continues to grow as well. Allergic individuals and families want to learn how to more effectively navigate the unpredictability and uncertainty of allergies!
A recent study explored psychosocial coping in food allergy, surveying parents/caregivers of food allergic kids to gain insight into caregivers’ and their children’s emotions about FA, their current coping strategies, and their interest in testing new coping strategies to manage their FA-related emotions. In addition to offering a breakdown of coping strategies utilized most, over half (66%) of respondents said “yes” when asked if they were interested in trying new coping interventions for themselves and their children. This data is a clear indication for a need for behavioral healthcare professionals to address this gap in psychosocial support for food allergy families.
It's important to note that while other sources of allergy support, such as online support groups and allergy apps can be beneficial, as they offer opportunities for connection and anecdotal information, most are not monitored and/or guided by allergy-informed licensed clinical behavioral healthcare providers. As such, the foundation for such clinical guidance and messaging provided through these support sources may not be regulated, well-monitored or clinically sound, which can lead to additional QoL impacts for those managing allergies and, in some cases, even contradict the guidance allergic individuals are receiving from their allergist.
Therefore, even though the food allergy and allergic disease counseling niche is quickly growing and the demand is there, it's crucial to ensure that the foundation for allergy-related behavioral health guidance is clinically sound, and preferably led by allergy-informed licensed clinical behavioral healthcare providers.
Want to be part of this growing and impactful niche? If you're already an allergy-informed therapy provider, check out the benefits of being a Food Allergy Counselor member, which include being listed on The Food Allergy Counselor Directory and joining The Food Allergy Behavioral Health Network (FABHN). And if you're a therapy provider who would like to learn more and work with this population, fill out the form at the top of this page to be notified of upcoming webinars, workshops, and trainings!
What Therapists Working In The
Food Allergy & Allergic Disease Counseling Niche Want You To know!
Jennifer Koehler Fandray, M.Ed., C.R.C., L.P.C.
What feels most rewarding about working in this niche?
What feels most rewarding about working in this niche?
"The most rewarding part of being a food allergy counselor is helping others manage their food allergies and anxiety over foods. As a licensed professional counselor and fellow food allergy mom, I know how hard it is to navigate this. It can be so overwhelming, stressful and scary. Having been through this with our child 16 years ago and not having any counselor understand what we were going through, was rough. When I’m able to help another person and family adjust to this new lifestyle and reduce their anxiety, it gives such satisfaction. I must say it’s more than working with other clients in my practice. It’s a way of me giving back to the allergy community and trying to make it better than we had it 16 years ago. To see the relief in their eyes and the confidence they gain from therapy is very rewarding. They realize “I can do this” especially when I share our family story."
Do you feel there's a demand for allergy-informed therapists?
"There is a huge demand for allergy informed therapists. As a licensed professional counselor and allergy mom I started allergy counseling due to our personal experience. For example, at age 9 our daughter had a severe reaction to a new food had to go to ER in ambulance and became OCD. She was very restrictive in her foods to the point of becoming malnourished. The doctor recommended counseling and the first thing I asked was for one with food allergy experience. The doctor said she did not know of one but what a great idea. So we saw a counselor for her anxiety and OCD who told our daughter to put her hand in a toilet and gave us a germ exposure chart. I was livid explaining to the counselor this was not about a fear of germs but a fear of having a reaction to nuts. Because we had no other options I had them redo the exposure chart based on foods and nuts. I was directing her therapy. It was at that point I realized how this needed to change and I focused a portion of my private practice on food allergy counseling. To this day I hear horror stories from clients about how counselor do not understand food allergy anxiety and treat it as an irrational fear when in fact it is a real valid fear. We need more counselors to understand this. This need is great and the area is expanding. It’s this directory that assists so many find a food allergy counselor. My wish is that at some point every allergy office will have their own food allergy counselor because the need is there."
Allergy Counseling Tools You Should Know About
Looking for resources to help you with your allergic patients? These Food Allergy Counselor resources can will help you further understand and address their therapeutic needs!