A STUDY has discovered that exposure-based interventions are beneficial for both children with food allergies and their caregivers. Targeted cognitive behavioural therapy (CBT) has been shown to lessen food allergy-related anxiety significantly.
Often, children with food allergies, and their parents or caregivers, experience heightened anxiety regarding the risk of casual contact with their allergens. Anxiety also exists around social situations involving food, which could again expose the child to risk, and whether interventions in the medical space, such as oral immunotherapy and oral food challenges, are safe.
Participants were 10 children between the ages of 8 years and 12 years (80% female), all of whom had been referred by their allergists for the evaluation and treatment of food allergy-related anxiety. All participants had at least one confirmed and well-controlled IgE-mediated food allergy, along with excessive anxiety. They were also recorded to have medically unnecessary and anxious avoidance related specifically to their allergy. The CBT offered to this cohort included 5–8 ‘proximity exposure sessions’, with a duration of 30–90 minutes each. All were led by an allergist or mental health provider, and varied between group and individual sessions.
During the study, the children were exposed to their allergen. In each session, they sniffed, touched, or ate a needlessly feared food, and these tasks were also assigned at home. Following treatment, children or their caregivers completed a questionnaire of their satisfaction. All participants were rated either as much improved or very much improved following completion of their CBT. The study also gave participants a follow-up assessment after 2–4 months had passed since the active treatment. Results suggested that gains were maintained.
Co-author of the study Jonathan Spergel, Children’s Hospital of Philadelphia, Pennsylvania, USA, stated: “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).” Spergel also noted that to the knowledge of the researchers, theirs is “the first study of an outpatient use of a CBT in a sample of children diagnosed with an anxiety disorder related to their food allergy.”
Shortcomings of the study included a small sample size, and the lack of randomised trials. However, allergists and others who work with children who have food allergy-related anxiety can use CBT as part of their treatment for patients. The treatment used in the study consisted of just six sessions, and is able to be given by nurses, or other healthcare providers.
