A new study in Annals of Allergy, Asthma and Immunology, the scientific journal of the American College of Allergy, Asthma, and Immunology (ACAAI), shows that targeted cognitive behavioral therapy (CBT) can significantly lessen food allergy-related anxiety (FAA) for both children and parents.
Parents and kids with food allergies frequently experience increased worry due to the potential dangers of accidental interaction with food allergens. Additionally, they question the safety of medical procedures like oral food challenges and oral immunotherapy, as well as if they should avoid social events involving food.
Participants in the study were 10 children (8–12 years old, 80% female) who had been sent by their allergists for evaluation and management of FAA. The kids had to have verified IgE-mediated food allergy/allergies that were under control, as well as too nervous avoidance linked to their food allergy that was both medically unnecessary and detrimental.
“To our knowledge, this is the first study of an outpatient use of CBT in a sample of children diagnosed with an anxiety disorder related to their food allergy,” said allergist Jonathan Spergel, MD, Ph.D., ACAAI member and co-author of the study. “We found that, although it was a small sample of 10 children, 100% of the children and their parents showed symptom improvement as reported by multiple sources (child, parent, therapist) and across multiple domains (food allergy-specific anxiety, general anxiety and health-related quality of life.)”
According to Katherine Dahlsgaard, Ph.D., a CBT therapist who worked with the families and the study’s primary author, a range of graded exposures, such as sniffing, touching, or eating an unnecessarily feared and avoided food, were conducted by the whole group during each session. One or both parents of each child answered a post-therapy survey about treatment satisfaction. The treatment was highly assessed as useful and satisfying by parents, and all 10 of the children were rated as very improved or very significantly better.
The patient participated in 5-8 “proximity exposure sessions” as part of the CBT. Depending on whether it was a group or solo session, the length of each session ranged from 30 to 90 minutes. The sessions were led by an allergist or mental health professional. The results of a follow-up examination conducted 2-4 months after the active treatment period in the trial indicate that the benefits were maintained.
Allergists and other professionals who care for children with FAA, including mental health experts, may be helped by CBT in their treatment efforts even if the sample size is limited and randomized studies still need to be carried out. According to Megan Lewis, CRNP and co-author of the study, this manualized treatment was brief—just 6 sessions—and can be provided in allergists’ offices by nurse practitioners or other healthcare professionals.
The testing, diagnosis, and management of food allergies are all specialties of allergists. Use the ACAAI allergist locator to discover a local allergist who can work with you to develop a personalized strategy to handle one child’s food allergies and help them live their best life.
Parvathy Sukumaran 
