Hi there, I have found the principles I learnt doing the SPACE training to be invaluable when working with children with anxiety. I am working with a family now, following the full procedure and just wanted to bounce around a few ideas with other practitioners (being in Australia, I don't have other colleagues using this approach). The case I have is an 8 year old boy who has a peanut allergy. He ate a chocolate bar with peanuts in it about 18 months ago and had an anaphylactic reaction. Since then he has had growing anxiety about eating at home as well as outside the home. This anxiety was extending to many other situations, including school and generally making him anxious about leaving the home altogether (six weeks spent primarily at home during COVID lockdowns did not help him either). The two part statements and general education about anxiety and accommodation have already been effective in reducing anxiety for 'John' in general, and the parents have chosen 'eating outside the home' as the accommodation they are choosing to target. See the letter the parents have written below for more information:
We love you so much and are proud of the way you have handled everything this past few months. We also see that it's hard for you to eat food in places other than home, especially when we are out all day. We now realise that our behaviour, for instance, making you a packed lunch or feeding you before we go out so that you don’t have to eat out, is not helping you at all. We think it is actually making things worse because we are not giving you a chance to see that you can enjoy other safe foods other than what’s provided to you at home.
That’s why we have decided that from now on, we will not pack a lunch or let you choose to go hungry. We will ensure to check new foods as needed but we will be buying food and eating out with you more often.
This might sound hard at first, but we are 100% sure that you can handle this. We are not angry at you or trying to punish you. We simply care too much to see you go hungry and not enjoy yourself out because you may need to eat.
We are always here to help you, but our help can’t be by giving in to your fears.
We love you so much John,
Mum and Dad
My question is really in regards to the bold section above. Not packing a lunch for him is fine, but I am just concerned that saying "or let you choose to go hungry" is going to end up in a bit of a fight - are they going to force him to eat when they are out? I'm thinking this relies more on his will and cooperation, rather than a reduction in their own accommodation. What are your thoughts about this, and any suggestions for how else to reduce accommodations without setting up a battle.