Common Food Allergy Counseling Questions


Hi Reader,

I often get asked the following questions about food allergies and counseling:

"Does everyone with a food allergy diagnosis need therapy?"
"If not, when would those managing food allergies most benefit from mental health services?"


Have you wondered about these questions, too? Let's explore....

Q: Does everyone with a food allergy diagnosis need therapy?

A: No, not everyone managing allergies needs to attend therapy. Whether someone feels they need therapy is based on a number of factors, which includes how well someone deals with uncomfortable thoughts and feelings, how they cope with stress, their allergy-related mindset, and how their daily functioning is impacted by managing their food allergy. Especially if someone was already managing a mood disorder such as Generalized Anxiety Disorder, they may find that their own or their child's food allergy diagnosis is difficult to adjust to.

Upon receiving a food allergy diagnosis, individuals are tasked with not only accepting the diagnosis, but also adapting to a lifestyle that includes ongoing food allergy management. Therefore, it's not surprising that some may struggle with this adjustment.

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/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)

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 food allergy management.

However, even with data showing that managing food allergy can feel stressful, that still doesn't mean everyone with food allergy should receive therapy.

Therefore, when an individual or caregiver managing 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.

For more on this topic, check out this FARE article written by allergy-informed psychologist, FAC member, and FAC Behavioral Health Advisor Paige Freeman, PhD: "Food Allergy Anxiety - When Is It Time to See a Therapist?"

Q: When would those managing food allergies most benefit from mental health services?"

A: Individuals and families managing food allergy may find that while they initially managed things well - having accepted and adapted to the diagnosis - specific experiences or life phases may have thrown them off course. This may then lead to the consideration of therapy 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 a FA reaction
  • As additional stressors impact FA management

Any of these transitions and experiences could trigger increased distress and anxiety. As mentioned earlier, depending on a number of variables including how the individual and family manage high levels of stress and anxiety, they may suddenly find it harder to cope. Therefore, the goal would be to help them find their way back to a more manageable approach to life with their food allergy. This might include working with them on the following:

  • Understanding how the transition/change impacted their existing FA management approach
  • Identifying FA knowledge gaps for them to follow up on with their healthcare team
  • Exploring specific FA-related anxiety triggers and fears
  • Evaluating information sources to discern if evidence-based and if triggering fears
  • Evaluating coping strategies for usefulness
  • Skill-building [both psychoeducational and FA management skills]
  • Providing psychoeducation, especially on anxiety [i.e. adaptive versus unhelpful]

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

For more on this topic, check out the following paper:

  • Herbert LJ, Marchisotto MJ, Sharma H, Gupta R, Bilaver LA. Availability of mental health services for patients with food allergy. J Allergy Clin Immunol Pract. 2019 Nov - Dec;7(8):2904-2905. doi: 10.1016/j.jaip.2019.04.045. Epub 2019 May 14. PubMed PMID: 31100556.

Stay tuned for updates coming soon about the launch of the COMPLETELY RENOVATED Food Allergy Counselor website. I can't wait to tell you more about it! I just know that the allergy community AND mental health professionals will find the new website even more useful than they do now!

And as always, don't forget to take good care of yourself, too, because we can't help others unless we're mindful of filling our own cups as well.

Founder & CEO, The Food Allergy Counselor
Licensed Clinical Professional Counselor
AAAAI & ACAAI Allied Health Member


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DISCLAIMER: The information provided here is for educational purposes only and is not intended to replace the medical or mental healthcare advice of your own healthcare provider. By reading this email, the reader acknowledges that there is no therapist-patient relationship between them and the author(s). If you think you are observing a medical or mental health emergency, call 911 immediately.

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The Food Allergy Counselor

As an allergy mental health expert, my emails share evidence-based information that you and your patients can apply in practical ways. At the same time, these emails are written in the same warm and relatable tone I use in all of my content. You'll feel as if we're sitting down, talking over a cup of coffee (or tea, since I'm not a coffee drinker)! And if you haven't visited my website, be sure to check out all of the evidence-based and life-impacting content that continues to help the allergy community find their *just right* balance between the overwhelm and quality of life. Subscribe so you don't miss any of this great content, including updates on my book (Navigating the Overwhelm of Allergy Parenting) to be published by Johns Hopkins University Press!

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