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Common Food Allergy Counseling Questions

therapist and client talking

Being a food allergy-informed licensed therapist and thought leader in the allergy field, I often get asked the following questions about food allergy counseling:

  • Does everyone with a food allergy diagnosis need therapy?

  • If not, when would those managing food allergies most benefit from food allergy counseling?

  • What type of therapy should I look for to help me manage my food allergy anxiety?

Have you ever wondered about the answers to these questions, too? Let's explore....

Q: Does everyone diagnosed with a food allergy need food allergy counseling?

A: No, not everyone managing food allergies needs to attend therapy. Whether someone feels they need food allergy counseling is based on a number of factors, which includes but is not limited to:

  • how they cope with stress

  • what their allergy-related mindset is

  • how well they deal with uncomfortable and distressing thoughts and feelings

  • how their daily functioning is impacted by managing their food allergy

Especially if someone is already managing a diagnosed mood disorder such as Generalized Anxiety Disorder, they may find it even more difficult to adjust to their own food allergy diagnosis or their child's food allergy diagnosis.

Adjusting to life with a food allergy can be overwhelming for many. Individuals and families are tasked with not only accepting the diagnosis, but also adapting to a lifestyle that includes ongoing, daily food allergy management. Therefore, it's not surprising that some may struggle with this adjustment and could benefit from food allergy counseling.

Here is just a snippet of data illustrating the impacts that food allergy has on a family's quality of life:

  • 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 and 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 quality of life 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)

And for adult onset food allergies, the acceptance, adjustment and adaptation process can be even more difficult, as it requires a major lifestyle change after many years without managing a food allergy.

However, even with data showing that managing a food allergy can feel stressful, that still doesn't mean everyone with a food allergy should attend or needs food allergy counseling.

A note for licensed therapists: When an individual or caregiver managing a food allergy reaches out for therapeutic services, don't just assume they need therapy because of their food allergy diagnosis. Complete a thorough assessment and exploration of how living with food allergy impacts their daily functioning and what they're hoping to get out of food allergy counseling, paying special attention to how they've attempted to accept, adjust, and adapt to their food allergy thus far.

Q: When would those managing food allergies most benefit from food allergy counseling?

A: Individuals and families managing a food allergy may find it difficult from the get go. For others, while they may have initially managed things well - having accepted and adapted to the diagnosis - specific experiences or life phases may have thrown them off course and they now find themselves dealing with increased anxiety and stress. This may then lead to the consideration of food allergy counseling with an allergy-informed mental health professional.

Research focused on psychosocial and mental health impacts of food allergy notes that times of transition and change may be predictable times when someone may need extra support. These might include:

  • At the time of diagnosis, especially if trauma was experienced

  • Developmental transitions (i.e. changes in ages/stages)

  • School transitions (i.e. moving between elementary, high school, college)

  • Allergy management changes (i.e. addition of new allergies)

  • Onset of oral immunotherapy (OIT)

  • Prior to oral food challenge (OFC) appointments

  • Post-anaphylaxis or after an allergic reaction

  • As additional stressors impact food allergy management

Any of these transitions and experiences could induce increased distress and anxiety.

As mentioned earlier, depending on a number of factors including how the individual and family manage ongoing, high levels of stress and anxiety, they may suddenly find it harder to cope. Therefore, the goal of food allergy counseling would be to help them find (or find their way back to) a more manageable, balanced approach to life with their food allergy.

This might include working on the following:

  • Addressing specific food allergy anxieties, phobias, and fears

  • Evaluating coping strategies for usefulness

  • Learning stress and anxiety management strategies

  • Skill-building [both psychoeducational and food allergy management skills]

  • Exploring how transitions/changes impact food allergy management approaches

  • Identifying food allergy knowledge gaps and questions to discuss with allergist

  • Evaluating information sources to discern if evidence-based and if triggering anxiety

While not an exhaustive list of times and triggers that might encourage someone to explore food allergy counseling, it's a useful list to help understand why someone who might have previously managed food allergy-related stressors well suddenly pivots and decides they now need therapy.

Q: What types of therapy should I look for to help me manage my food allergy anxiety?

There are different approaches that can be used to help address food allergy anxiety. In addition to considering the type of therapy, keep in mind that having a good therapeutic relationship with your therapist (i.e. their approach and style feels like a good fit for you) is also a key component of successful therapy.

One of the most widely-researched therapy modalities for food allergy counseling is an evidence-based approach known as Cognitive Behavioral Therapy, or CBT. CBT focuses on identifying and adjusting unhelpful thoughts, feelings and actions, and can include exposure therapy work to decrease the intensity of anxiety and fears, which is especially helpful when addressing specific phobias and obsessive compulsive-related behaviors.

With that said, there are other evidence-based approaches that may not be as widely researched relating to food allergy counseling, but have shown to be effective in helping people manage anxiety and life with other chronic health diagnoses.

These modalities include:

  • Acceptance and Commitment Therapy (ACT) - Focuses on increasing psychological flexibility to allow people to act in accordance with their values, even during stressful and challenging moments in life. 

  • Exposure and Response Prevention Therapy (ERP) - A form of Cognitive Behavioral Therapy (CBT) developed specifically to treat obsessive compulsive disorder and related behavioral patterns and/or phobias.

  • Eye Movement Desensitization and Reprocessing (EMDR) - Enables people to heal from the symptoms and emotional distress that are the result of disturbing life experiences through the use of directed lateral eye movements, tapping, or audio stimulation.

Finally, when looking for a therapist for food allergy counseling, be sure to ask the following questions to ensure that the practitioner truly understands IgE-mediated food allergies and is familiar with evidence-based therapy approaches:

  • Are you familiar with potentially life-threatening food allergies and their impacts on quality of life? (Note: these are different than food intolerances)

  • What therapeutic approaches do you use to address food allergy anxiety?

  • Would you be willing to connect with my allergist to ensure I'm receiving collaborative care?

Want to begin food allergy counseling? Visit The Food Allergy Counseling Directory (which I founded) to locate a food allergy-informed therapist in your state!*

*(Due to licensing laws, therapists are only allowed to work with those within the states in which they're licensed to work, even when providing teletherapy, so be sure to look for therapists in your state).


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