Information For Allergic Individuals & Families:
The ​Benefits of Food Allergy & Allergic Disease Counseling

Are you an allergy-informed therapy provider?
​Check out Allergy Counseling Information for Therapy Providers 
​

Are you an allergist or healthcare provider curious how allergy counseling could help your patients? ​Check out Allergy Counseling Information for Allergists

Brief Overview: 

• Who Provides These Services: Allergy-informed clinical counselors/therapists provide food allergy and allergic disease counseling/therapy. The terms counselors/therapists in the phrase allergy-informed counselors/therapists refers to 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]
• Services Provided by Allergy-Informed Counselors/Therapists: Therapy/counseling providers working within this niche offer psychosocial, quality of life, and mental health support to those managing a number of allergic conditions, most notably food allergy (FA). These services may be proactive in nature, meaning they help people develop a workable approach to allergy life before any  identified concerns, or they can be focused on helping people through identified concerns and/or specific stressors. A multidisciplinary approach to allergy counseling/therapy is highly encouraged, so these providers will likely collaborate with your allergist, physician, and other healthcare providers involved in your allergy care.
• Helpful Knowledge for Allergy Counselors/Therapists to Have: 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. 

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. 

It's not uncommon for those managing allergic conditions to be managing other health diagnoses that may overlap, 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.

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 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 helpful 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 therapy goals may differ. 

So, while food allergy may be the most notable focus, the food allergy and allergic disease counseling niche helps individuals and families managing a number of allergic and related diagnoses. Therefore, it's beneficial to work with therapy providers that have an understanding of the basic medical aspects of allergic conditions, as well as how they may impact quality of life and mental health so that they can help you achieve your goals.

How Do Allergy-Informed Therapists Help Those With Allergies?

Research 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 (see the next section for more on this). So, how can licensed behavioral healthcare clinicians help those with food allergies and allergic diseases?

OVERALL GOAL 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. ​

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. 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
  
  

FAA and allergy-related anxiety IS NOT:

• built on irrational fears
• something to feel guilty about
• not a sign that someone isn't effective at living with their allergy

However, even though allergy anxiety may be common, 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. 

Allergy-informed therapy providers can offer a variety of supportive services, including addressing:

• the development of a workable allergy mindset
• allergy-anxiety management strategies focused on balancing quality of life and allergy anxiety/fear
• specific allergy-related fears and phobias
• ​oral food challenge and oral immunotherapy-related anxiety
• maladaptive and unhelpful behaviors that are as a result of allergy anxiety or in response to it
• a variety of QoL impacts, focusing on making adjustments that positively impact QoL
• parental/caregiver anxiety, focusing on management in order to limit its impacts on child development
• trauma as a result of allergic reactions and anaphylaxis
• learning how to live fully even with the diagnosis through counseling and coaching strategies  ​
• other intense emotions, such as guilt, grief, sadness, and frustration
• other related stressors, emotions, impacts and anxieties

How Can Living With Food Allergy Impact Quality of Life?

Allergy-focused psychosocial studies consistently show that living with the unpredictability and uncertainty of food allergies and allergic diseases impacts anxiety and quality of life (QoL). Recent research notes that "nearly 1 in 5 adults believe themselves to be food allergic, whereas only 1 in 20 are estimated to have a physician-diagnosed food allergy."

​Therefore, quality of life (QoL) impacts can occur even when someone hasn't officially even been diagnosed with a food allergy, and is living with a self-reported food allergy.

​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
• 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

*(Information sources include a variety of studies listed here and clinician experience working within this niche.)

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) 

Given the common QoL impacts and increased anxiety experienced by those managing food allergies and allergic diseases, it makes sense that therapy services are a beneficial source of support. And just as therapists well-versed in other chronic and life-impacting health diagnoses such as diabetes and cancer, the allergy community benefits most from therapists who are well-versed in the basics of allergic diseases and the psychosocial/QoL impacts on lives. 

The Need and Demand For Allergic Disease Counseling Is Clear!

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!

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, 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. 

Simply stated, the food allergy and allergic disease counseling/therapy niche is an example of "If you build it, they will come!" And we are building this niche for you, especially here with The Food Allergy Counselor Directory!

[Check out the next section, with answers to common questions about food allergy and allergic disease counseling]

Common Qs From The Allergy Community About Counseling: 

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Q: Should everyone managing food allergies and allergic conditions go to therapy? 

• A: No, not everyone managing allergies needs to attend therapy. The decision to consider therapy is based on a number of factors, which includes how well someone is dealing with uncomfortable thoughts/feelings, how they cope with stress, and how their daily functioning is impacted. People may also find that while they initially manage things well, specific experiences or phases of life may lead to the consideration of therapy. Check out this FARE article written by allergy-informed psychologist Paige Freeman, PhD called "Food Allergy Anxiety - When Is It Time to See a Therapist?" for more on this topic. 

​Q: What kinds of therapy services do allergy counselors/therapists offer? 

• A: As with any healthcare provider, it's important to ask therapists these questions when you connect with them. Therapy is typically offered via in-person or telehealth (virtual) methods, and may include individual, family, and parenting sessions depending on the specific goals of therapy. As far as therapeutic theories typically used in allergy counseling, common approaches are Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), Exposure and Response Prevention (ERP), and Family Systems. Some therapists may also run groups through their practices. When it comes to groups, it's important for providers to clarify the group purpose and type, as educational/support groups are not the same as group therapy - meaning, there are very different guidelines and protocols for these types of groups. 

Q: If I have allergies, should I only work with an allergy-informed counselor/therapist? 

• A: There's no rule that says those managing allergies and allergic conditions HAVE TO attend therapy with an allergy-informed therapy provider. Non-allergy-informed licensed behavioral healthcare providers may certainly be helpful as well! However, there are benefits to seeing allergy-informed counselors/therapists, as they will have the basic knowledge about your health condition(s), which may feel very validating. Additionally, these providers may be more skilled at identifying nuanced behaviors related to allergy anxiety and living with allergic conditions, which can help gain a more accurate picture to guide therapy. 

Q: Can I work with any allergy-informed therapist on The Food Allergy Counselor Directory? 

• Unfortunately, no. One of the main reasons The Food Allergy Counselor Directory was developed was to address the gap that the behavioral healthcare professional guidelines create, which state that these providers can only provide services to those in the state(s) in which they are licensed. This is the case even with telehealth. Therefore, you'll want to look for a provider listed in your state or country.

Looking For An Allergy-Informed Counseling/Therapy Provider?

Check out The Food Allergy Counselor Directory, the first and only directory of allergy-informed therapists.