Category: Food Allergy Management

Tips for managing oral food challenge anxiety

4/19/2021

You've likely heard the term "oral food challenge" mentioned by your allergist or in online food allergy support groups. But if you haven't, here's a quick primer from the American Academy of Allergy, Asthma and Immunology on oral food challenges:

What is an oral food challenge?
An oral food challenge (OFC), or feeding test, is a medical procedure in which a food is eaten slowly, in gradually increasing amounts, under medical supervision, to accurately diagnose or rule out a true food allergy.

What are the reasons to perform an OFC?
OFCs are usually done when a careful medical history and allergy tests, such as skin and blood tests, are inconclusive. The OFC is a more definitive test because it will show whether the food ingested produces no symptoms or triggers a reaction.

Oral Food Challenge (OFC) Anxiety and Worry:

Given that during oral food challenges you are eating a food that you may potentially be allergic to or have previously been allergic to, it's no surprise that you may feel anxious and worried in anticipation of that appointment - many do. Our mind wants to keep us safe, so an oral food challenge can feel like a potential threat to our mind when we think about it. Therefore, it's normal and appropriate to experience anxiety about oral food challenges. However, it's important to remember that you don't need to interpret that anxiety to mean that the oral food challenge will result in the worst case scenario.

What Helps OFC Anxiety and Worry?

When you experience increased anticipatory anxiety - that is, anxiety about a future event, it can be helpful to prepare for the event in order to to increase readiness and decrease fear.

Here is a brief list of ways to prepare ahead of time for your or your child's oral food challenge:

Purpose/Process: Do you understand the purpose and process for the oral food challenge? It's important to have a good understanding of these things before the actual appointment, so reach out to your allergist if you're unsure.
Information: What other questions do you or your child have about the food challenge? Will you reach out to your allergist ahead of time to ask these questions? If not, what reputable sources can provide this information?
Motivation: Connect with your motivation for doing the food challenge, whether it's for yourself or your child. Reconnecting with hope and thinking about what you may gain from doing the challenge can help when feeling nervous.
Thoughts/Feelings: Notice what thoughts and feelings you're having about the food challenge. How do they make your body feel? If your child is doing the food challenge, help them notice and explore their thoughts and feelings, too. Develop a list of empowering replies to these thoughts such as "I can do hard things!" or "The allergist and nurses know what they're doing!"
Calming Strategies: Practice some calming strategies ahead of time so that you're familiar with them for the appointment. Here are a couple of simple calming strategies you can try:
- For teens or adults (Square or Box Breathing) - Exhale to a count of 4, then hold for a 4 count. Inhale to a count of 4, then hold air in your lungs for a count of 4. Exhale and repeat the pattern.
- For kids (Cupcake & Candle Breathing) - Inhale like you're smelling a yummy cupcake, and then exhale like you're blowing out the candle on it. Repeat as many times as necessary.
- 5-4-3-2-1 Activity - Notice 5 things you can see. Notice 4 things you can touch. Notice 3 things you can hear. Notice 2 things you can smell. Notice 1 thing you can taste. This helps stay present-focused rather than worrying about future things.
Logistics Preparation: What do you need to bring with to the oral food challenge appointment. Create a list of food items you may need (i.e. allergen, food to put allergen in for consumption) and fun or distracting games or activities. If the food challenge is for your child, have them help you brainstorm game or toy ideas for the appointment. Also be sure to bring along any comforting items that may help decrease anxiety and increase calm.

Additional Resources and Tips to Help Manage OFC Anxiety

PODCAST EPISODE:
Be sure to listen to Episode 14 of Exploring Food Allergy Families called, "Tips for Managing Oral Food Challenge Anxiety & Worry". In this episode, fellow allergy-informed therapist Fawn McNeil-Haber, PhD and I discuss helpful strategies for navigating oral food challenges. We offer preparation tips and guidance on navigating anxiety and mindsets prior to and during the food challenge. Here are specific topics we explore in this episode:

Strategies to navigate nerves during the actual OFC appointment
The importance of having a mantra
Tips to help determine anxiety versus allergic reaction sensations
How far in advance to tell your child about an OFC
Tips to encourage readiness and decrease anxiety for kids, teens, parents and adults
Answering the question "How does the allergist know what's happening in my body?"
A fun idea parents can prepare for the actual appointment

You can listen via your favorite podcast app, including Apple Podcasts, Spotify, and iHeartRadio. Don't forget to subscribe so you don't miss future episodes!

ORAL FOOD CHALLENGE PREPARATION WORKSHEETS:
Download these Oral Food Challenge worksheets which help prepare before the appointment, offer helpful reminders for the day of, and prompts for processing after the food challenge. (There are separate worksheets for kids and teens/adults).

You can find these worksheets below or on the Therapeutic Worksheets page here on the Food Allergy Counselor website.

FAWN McNEIL-HABER'S RESOURCES ON ORAL FOOD CHALLENGES:

Hopefully reading this and checking out the podcast, worksheets and other resources offers you some reassurance that oral food challenge-related anxiety is normal and manageable. Don't hesitate to reach out and let me know if these tips have helped you or your patients, or to share tips of your own! And if you're looking for an allergy-informed therapist in your state (many of whom provide telehealth to residents of their state), visit the Food Allergy Counselor Directory.

You can connect with me on Twitter (@TherapistTamara and @FACounselor), Instagram (@TherapistTamara & @FoodAllergyCounselor) and Facebook (@FoodAllergyCounselor and @TamaraHubbardLCPC).

Thanks for reading!

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What's New with Food Allergy Behavioral Health in 2020?

1/17/2020

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A New Role For Me!
In addition to providing counseling services to women, young adults and those navigating life transitions, for the last couple of years in particular, I've focused on food allergy counseling - a clinical niche that I've been helping to highlight and expand.

To that end, I've been writing about, taking part in interviews, and developing therapeutic content focused on navigating the psychosocial aspects of life with food allergies. I'm also proud to be an allied healthcare member of both AAAAI and ACAAI, serving as a member of ACAAI's allied health committee.

Therefore, when the Food Allergy & Anaphylaxis Team (FAACT) asked me to join their Leadership Team as their Vice President of Behavioral Health, I was honored to jump on board!

With a passion for helping the food allergy community develop resilience and an empowered mindset, this position will allow me to create content that will be unique in nature and more widely distributed. These resources, which will come in various formats, will be useful not only for individuals and families managing food allergies, but also for allergists looking for reputable psychosocial resources for their clients. (Resources created for FAACT are reviewed by FAACT's Medical Advisory Board).

FAACT's Leadership Team

A couple of questions I've received since I announced my new position....

What projects do I have planned in this role for 2020?
You'll just have to stay tuned! But trust me, they'll be useful.

Will I still be seeing clients at my private practice?
You bet! Like many in the healthcare fields, I enjoy a mix of clinical work, both client facing and non-client facing in nature. In my private practice, in addition to working with those managing allergies, I also focus on providing support to women, young adults, those navigating life transitions, and those with other chronic health conditions. I'm lucky to be able to have the best of both worlds between my new FAACT position and my private practice.

Will you still be updating the Food Allergy Counselor Directory & website?
Rest assured, I'll still be updating and enhancing The Food Allergy Counselor Directory and website, so be sure to check back often.

Recent additions to the Food Allergy Counselor Directory include listings in Texas and Georgia, with more on the way. There have also been more resources added to the Food Allergy Mental Health Resource page as well, so be sure to hop on over there, too.

With gratitude,
Tamara Hubbard, MA, LCPC

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Food Allergy Mental health Thoughts & Thanks for 2019

12/29/2019

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CAN YOU BELIEVE THAT 2019 IS ALMOST OVER?! As this year comes to a close, I wanted to take a moment to reflect on the past year and give thanks to the food allergy community.

Food Allergy Mental Health Thoughts for 2019....

In starting this website over a year and a half ago, my goal was to emphasize the importance of exploring the psychosocial impacts of managing food allergies and allergic conditions. Additionally, I wanted to develop and share psychosocial resources to help those managing food allergies.

In that time, it's become even more clear to me that the food allergy community yearns for more focus and guidance on navigating the ups and downs of life with food allergies. I've also seen the allergists and allied healthcare professionals working within the field of allergy and immunology more frequently discussing the psychosocial aspects of food allergy life.

So what does all of that mean? Just as we're watching food allergy treatment trends grow and expand, we can hopefully expect to see a shift in food allergy mental health as well.

Trends I hope to see continuing to develop within this space:

Continued discussions and resources within the food allergy community on topics such as navigating food allergy anxiety, building resilience, developing confidence and empowerment, impacts to family systems, working through and finding acceptance with the diagnoses, and more;
An increase in number of sessions and scope of psychosocial content at allergy and immunology conferences;
Assessment of psychosocial stressors becoming a standard part of allergy care (even if only through brief questions at appointments);
Continued exploration of collaborative patient care, allowing for various disciplines/healthcare providers working together to provide resources for patients (i.e. allergy/immunology, nutrition, counseling, etc).

Giving Thanks to the community....

I'm a big believer in paying it forward, whether through actions or words, and truly believe that we don't do enough of this. Additionally, none of us live in a vacuum alone. We're all part of various systems: the family system, the community system, and in this instance, the food allergy system.

Therefore, I'd like to give thanks to the food allergy community as I write my final post for 2019.

To The Food Allergy Community:
Thank you for....

Helping to bring awareness to very important food allergy mental health and psychosocial topics by sharing your stories and asking questions, as this helps the treatment community better understand these needs;
Being open and honest about the highs and lows of life managing food allergies and/or parenting kids with food allergies, because by acknowledging both, we can find our way to acceptance, empowerment and resilience;
Showing kindness, support and understanding to one another within the community, because none of us are alone;

and for....

So warmly welcoming my voice, resources and the Food Allergy Counselor Directory & website into the community over the past year and a half!

I look forward to continuing to develop food allergy mental health and counseling resources, and positively impacting the food allergy community in 2020 and beyond!

With gratitude,
Tamara Hubbard, MA, LCPC
Licensed Clinical Professional Counselor
Founder/Creator of the Food Allergy Counselor website

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Tips for managing oral food challenge anxiety

What's New with Food Allergy Behavioral Health in 2020?

Food Allergy Mental health Thoughts & Thanks for 2019

Food Allergy Mental Health Thoughts for 2019....

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