Published Online: March 2016
Food allergy is rapidly becoming one of the most common chronic conditions diagnosed during childhood. Current estimates indicate that 4-8% of children in the United States are diagnosed with food allergy. Food allergy requires daily management, which may affect multiple domains of child and family psychosocial functioning and quality of life. The rise in the number of children diagnosed with food allergies may lead to an increase in the number of children and families who experience mental health concerns related to food allergy and would benefit from food allergy-related psychosocial interventions.
In a review recently published in The Journal of Allergy and Clinical Immunology: In Practice, Herbert et al. provide an overview of common psychosocial concerns among children with food allergy and their families and offer guidance to medical providers regarding their identification and treatment. The authors report that children with food allergy and their parents tend to report a range of psychosocial concerns that include parenting stress, anxiety, and worries about bullying. For many families, the primary question that must be addressed is how to balance the vigilance and preparedness required of a potentially life-threatening chronic illness with anxiety management and engagement in developmentally appropriate activities.
The authors reported that many families with psychosocial concerns benefit from having a medical provider listen to them and normalize their feelings, from being provided educational materials, and from being connected to other families of children with food allergy. However, when patients need additional psychoeducation about food allergy, need assistance problem-solving food allergy management, experience elevated anxiety about food allergy, and/or meet criteria for a mental health disorder; they should be referred to a mental health professional for consultation and provision of appropriate services. The mental health professional will conduct a clinical interview to determine if the child would benefit from short-term versus long-term psychotherapy and/or medication management. Psychotherapy is typically cognitive-behavioral therapy, a well-validated and frequently used treatment for children with chronic illness that is goal-oriented, collaborative, and typically short-term.
As the number of children diagnosed with food allergy increases, it is likely that medical providers will encounter a growing number of parents who have questions about how to manage everyday food allergy-related psychosocial concerns. Medical providers can validate patients’ feelings, normalize the challenge of balancing food allergy management with participation in developmentally appropriate activities, and provide early education about food allergy and its psychosocial impact on daily life, but may need to refer to a mental health professional for consultation when indicated. Additional research is needed regarding clinical interventions in order to further refine the psychosocial care that is provided to these families.
The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.