Category: Food Allergy Worksheets

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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The Managing Food Allergy WorrY Worksheet

2/18/2021

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One of the most common questions I see being asked within the food allergy community is:

"How do I help my son or daughter with their food allergy anxiety or worry?"

The answer to that question isn't simplistic, as there are likely many factors contributing to the anxiety or worry. But at the core of the answer is the advice to help their child better understand the worry in order to develop strategies to help effectively manage it.

What exactly is worry?

The terms "anxiety", "worry", and "fear" are often used interchangeably. So do they mean the same thing? No, but they are definitely related.

Whereas anxiety typically stems from the uncertainty, unpredictability and unknown about future situations, worry is the thinking part of anxiety. It's what often leads our minds to dwelling on worst case scenarios, the "what ifs", or leads us into a thinking trap known as "catastrophizing".

Whether our worry is triggered by anxiety about the future or fear due to a threat in the here-and-now, it can lead us down the rabbit hole of thoughts. This may then trigger uncomfortable emotions and physical sensations, which often convinces us even more that our worried thoughts must be valid!

What helps to manage worrY?

There are a variety of therapeutic approaches to help people learn to manage or navigate life with their anxiety or worry. Whether through basic psychoeducation, or strategies based on approaches stemming from evidence-based therapies such as cognitive behavioral therapy, acceptance and commitment therapy, or exposure therapy, the goals are typically to help people change negative thought patterns, learn relaxation or grounding skills, and change behaviors that lead to the distressing impacts or outcomes.

The Managing Food Allergy Worries Worksheet

The following 3-page therapeutic worksheet was created to help older kids, teens, and even adults begin to address their food allergy-related worries. The goal of the worksheet is to help you identify practical strategies that effectively help you break free from those worry traps. It encourages getting to know more about the thoughts that fuel the worry. It also guides you to notice how the worry makes you feel physically since anxiety and worry often bring on physical sensations that may even trick you into thinking you're having an allergic reaction.

Find this 3-page therapeutic worksheet on the Worksheets page!

[Disclaimer: This therapeutic activity is meant to help understand and manage worries, but is not meant to take the place of counseling. Please reach out to a licensed clinical mental healthcare provider if you feel that your anxiety or worry is impacting your life in a way that feels unmanageable on your own. You can locate an allergy-informed therapist in your state via the Food Allergy Counselor Directory.]

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Thanks for reading,

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Moving forward after an allergic reaction

7/26/2020

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If you've ever experienced an allergic reaction, or witnessed your child experiencing one, then you're likely familiar with how it can feel afterwards - once the reaction is over. These emotions and thoughts may include feelings such as fear, worry, sadness, or even guilt, and explorations to try and understand what happened in order to prevent it from happening again.

For some, they may process through this phase quickly, while others take longer. Some may even find themselves becoming stuck along the way, unable to find their way back to navigating food allergies confidently.

New podcast episode on this topic!

In episode 9 of the Exploring Food Allergy Families podcast, I'm joined by fellow allergy-informed clinician, psychologist Fawn McNeil-Haber, PhD.

Together, we explore common feelings and thoughts that many may feel for days, weeks or even months after a reaction. We explore how those emotional reactions may lead to common behavioral changes and actions. Additionally, we share strategies to help people through this while on the journey back to confidently managing food allergies. [These tips may be helpful for parents and allergic kids, teens, and adults].

Listen to Episode 9 here, or find it via your favorite podcast app!