anxiety in the school setting: A Teacher

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anxiety in the school setting A Teachers Guide

• Lindsay Gasparovich, B.A.
• What educators need to know about anxiety.

Photo used with permission of Crystal Leigh Sheann
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Anxiety in a Nutshell

• Everyone feels worried sometimesBut some
  worries dont go awayKids who have trouble with
  worries find that their worries get stuck. Even
  if their mom or dad is always there to get them
  off to soccer practice, even if they arent due
  for a shot at the doctors office, or even if
  they have had fun with the sitter in the past,
  the worries just go on and on (p. 14-15)
• Huebner, D. (2006). What to do when you worry too
  much A kids guide to overcoming anxiety.
• Washington, DC Magination Press.

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Learner Objectives

• Participants in this seminar will be able to
• Describe anxiety and its subtypes
• Identify the signs and symptoms of anxiety in the
  school setting
• Learn techniques to prevent or manage anxiety in
  the school environment

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Our Agenda

• Begin with a case illustration
• Review vocabulary and acronyms that will appear
  throughout the presentation
• Provide an overview of anxiety (and some of its
  subtypes), related problems, and contributing
  factors
• Research review
• Explore effective techniques to prevent or manage
  anxiety

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A case illustration

• Please see handout
• Case Illustration I

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What contributes to anxiety?

• Three main factors
• Biology
• Genetic predisposition
• Cognitive-emotional influences
• A persons experiences, level of self-confidence,
  and ability to handle stress
• Chronic stress

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Behaviors associated with anxiety

• Behavior commonly associated with anxiety
• School avoidance or truancy
• Lower academic performance
• Irritability
• Social withdrawal
• Acting out/general disruptions
• Inability to cope with stress or certain
  situations
• These behaviors range from major to minor rule
  violation.
• Behaviors may also go undetected

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Prevalence of Anxiety Disorders

• Anxiety disorders are the most common disorder to
  occur in childhood and adolescence (SAMHSA,
  2008).
• 13 of every100 children and adolescents (ages
  9-17) is currently dealing with an anxiety
  disorder (SAMHSA, 2008).
• Test anxiety affects children of all academic
  achievement and intellectual levels(Sarason et
  al., 1960 as cited in Beidel, Turner,
  Taylor-Ferreira, 1999, p. 631).

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Glossary

• Anxiety Disorders mental illnesses that involve
  excessive worry can range from feelings of
  uneasiness to immobilizing terror and fear upset
  normal functioning
• Cognitive Behavioral Therapy approach to
  therapy that focuses on changing negative thought
  patterns and beliefs
• Diagnostic and Statistical Manual of Mental
  Disorders (DSM-IV) Manual of mental health
  disorders published by the American Psychiatric
  Association. It provides mental health workers
  with descriptions and criteria of mental health
  disorders. This manual is used to officially
  diagnose mental health disorders

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Glossary

• Positive Behavior Support (PBS) strategies used
  to change behavior Punishment is not used,
  instead PBS respects the communicative function
  of behavior and works to strengthen and teach
  desired behaviors
• Substance Abuse and Mental Health Services
  Association (SAMHSA) national organization
  provides relevant information and also funds or
  performs research
• Universal Interventions procedures, programs,
  or rules that apply to a classroom setting.
  Universal interventions may also be applied
  school-wide.

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Most Common Types of Anxiety in Children and
Adolescents DSM-IV-TR Overview

• Generalized Anxiety Disorder
• Worry about everyday life activities excessive
  worry especially related to school performance
• Difficult to control the worrying
• Worrying is unrealistic
• Symptoms include
• Trouble concentrating
• Irritability
• Muscle tension
• Multiple physical complaints (headache, etc.)

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Most Common Types of Anxiety in Children and
Adolescents DSM-IV-TR Overview

• Separation Anxiety Disorder
• Characterized by excessive anxiety concerning
  leaving ones home environment or caregiver(s)
• Symptoms include
• Preoccupation with thinking of reunion
• homesick
• clinging behavior
• Physical complaints
• Headaches, stomachaches, nausea

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Most Common Types of Anxiety in Children and
Adolescents DSM-IV-TR Overview

• Panic Disorder
• Marked by the presence of panic attacks
• Persistent worry about having another panic
  attack
• May be set off by situational triggers (p. 434)
• Panic attacks appear to come from nowhere
• Avoid situations/places panic attack may occur
• Symptoms include
• Sweating
• Dizziness
• Shortness of breathe
• Increased heart rate

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Most Common Types of Anxiety in Children and
Adolescents DSM-IV-TR Overview

• Post Traumatic Stress Disorder
• Develop symptoms after exposure to a traumatic
  stressor
• Physical, verbal, or sexual abuse
• Natural disasters
• Re-experience the trauma in various ways
• Symptoms include
• Low startle tolerance
• Flashbacks or intrusive recollections/memories of
  the event, nightmares
• Repetitive play in children (relive trauma)

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Other Types of Anxiety

• Academic Anxiety (Test Anxiety)
• Can be observed by a gap between a students
  abilities and a students actual performance on
  exams (Peleg-Popko, 2002)
• Student is preoccupied with level of academic
  performance (worry, negative thoughts)
• Symptoms include
• Cognitive
• Uncontrollable worry/negative thoughts about
  academic performance
• Constantly comparing own performance to other
  students
• Physical
• Loss of appetite/ sleep
• Panic, difficulty concentrating
• Emotional
• Panic, confusion
• Feelings of nervousness and dread

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Identifying the Problem

• Indicators that might suggest a school might have
  concerns about the behavior
• Low academic performance
• Academic performance gradually declining
• Student is preoccupied with thoughts of academic
  performance
• Poor attendance, skipping class
• High level of irritability (talking back,
  aggressive)
• Low self-confidence
• Frequent statements of I cant or Im not good
  at this
• Social withdrawal
• Student frequently experiencing stomachaches,
  headaches, etc.
• Student having difficulty concentrating

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Related Problems

• School avoidance
• Students may skip school/class to avoid taking an
  exam or avoid social interactions
• Low academic performance
• Irritability
• Easily angered by changes in routine
• Increased aggressive feelings
• Behavioral disruptions
• These behaviors may be another attempt at
  avoiding exams, school work, or uncomfortable
  situations.
• Behaviors may include walking out of the
  classroom, nervous tapping of pencil, etc.

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Related Problems

• Social withdrawal
• This may include little or no class participation
  or little to no interactions with teacher/peers
• Interrupts social skill development
• Physical complaints
• Stomachaches
• Headaches
• Nausea
• Sweating
• Dry mouth
• Muscle tension

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Contributing Factors

• What may trigger or exacerbate anxiety?
• Genetic predisposition
• Adults in the students life set excessively high
  standards
• Chronic stress/stressors
• Life events
• The student must suppress his/her feelings
• Adults frame the world as threatening and
  dangerous
• Restricts risk-taking in children

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What NOT to do

• Some things to avoid when working with the
  anxious student
• Set excessively high standards for children
• Implement only strict and rigid rules
• Scream or yell at the student
• Single a student out in front of the class if
  he/she is having behavioral difficulties or other
  anxiety-related problems
• Give pop-quizzes
• Making statements like Look who decided to come
  to class!
• Enforce strict time limits during exams
• Discourage the use of relaxation techniques or
  strategies
• State directions once and refuse to review them
• Punish the student for behaviors he/she may not
  be able to control

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Current Research What Works

• Preventive interventions targeting anxiety in
  schools may reduce the onset of anxiety-related
  symptoms and, more important, promote healthy
  developmental outcomes (Greenberg, et al., 2001
  as cited in Tomb Hunter, 2004, p. 88).

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Current Research What Works

• Anxiety disorders and general levels of anxiety
  have been shown to respond to preventative
  interventions and programs (Barrett, Farrell,
  Ollendick, Dadds, 2006 Barrett Turner, 2004
  Farrell Barrett, 2007 Tomb Hunter, 2004
  Wood, 2006).
• Preventive programs and interventions include
• Cognitive Behavioral Therapy (CBT)
• Universal interventions/Positive Behavior Support
  (PBS)
• Relaxation strategies

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Current Research What Works

• Teaching coping skills to children and
  adolescents as early as possible may help them
  develop effective strategies to deal with stress
  and minimize anxiety (Tomb Hunter, 2004, p.
  89).
• Tomb, M. Hunter, L. (2004). Prevention of
  anxiety in children and adolescents in a school
  setting The role of school-based practitioners.
  Children Schools, v. 26, 2, 87-101.

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Current Research What Works

• Praising students for positive performance has
  been found to be effective
• Muller Dweck (1998)
• Performed a study that looked at performance vs.
  intelligence praise on exams
• The study found those praised for performance
  chose subsequent tasks that allowed them to
  demonstrate their ability (Muller Dweck, 1998
  as cited in McDonald, 1991, p. 91).
• Effective preventive programs
• ReadySetR.E.L.A.X. (Allen Klein, 1996, as
  cited by Tomb Hunter, 2004)
• The Queensland Early Intervention and Prevention
  of Anxiety Project (Barrett Turner, 2001, as
  cited by Tomb Hunter, 2004)

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Current Research What Works

• Research also supports the role MODELING plays in
  teaching students positive ways to prevent or
  manage anxiety
• Students, through observation, learn to use
  appropriate behaviors in similar situations
• Modeling generalizes outside of the classroom

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Implications for Practice Teaching Students to
Lessen/Manage Anxiety

• As explained, research has found effective ways
  to manage and/or lessen anxiety.
• These methods can be adapted for classrooms and
  used universally or on an individual basis.

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What You can do to Help Students Lessen/Manage
Anxiety

• In general
• Educate students about anxiety and effective ways
  to manage stress
• Provide students opportunities to exercise these
  strategies
• Teach and discuss positive coping skills with
  students
• Allow students to share with the class the
  positive coping skills they may currently utilize
• Provide opportunities for practicing positive
  coping skills

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What are positive coping skills?

• Positive coping skills are ways students can
  effectively manage levels of anxiety or stress
  without resorting to negative coping skills or
  behaviors
• Examples of positive coping skills include
• Allowing students to use stress balls in class
• Listening to music in order to lower ones state
  of anxiety
• Journaling
• Exercise

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What You can do to Help Students Lessen/Manage
Anxiety
PRAISE!
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What You can do to Help Students Lessen/Manage
Anxiety

• Teach students to visualize success through
  mental rehearsals
• Example Taking an exam
• Have the student envision each aspect that
  involves taking an exam positively
• Learning new material
• Completing class assignments
• Reviewing material
• Taking the exam, etc.
• The student envisions him/herself taking the exam
  in a relaxed stated and performing to the best of
  his/her ability.
• Continue to repeat this on a daily basis and
  prior to exams.

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What You can do to Help Students Lessen/Manage
Anxiety

• Academic/Test Anxiety
• Inform students of upcoming exams in advance
• Review test material with students
• Allow students to study in groups
• Ask the class if they are worried about any
  particular sections of information. If
  appropriate, review this material once more.
• Allow students the use of stress balls, music,
  etc., during exams
• Perform a relaxation technique with the entire
  class prior to exams (i.e. jumping jacks, focused
  attention, etc.)

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Helpful Resources

• Websites
• Anxiety Disorders Association of America
• http//www.adaa.org
• Childrens Disabilities Information
• http//www.childrensdisabilities.info
• Cornell University Center for Learning and
  Teaching
• http//www.dt.cornell.edu/campus/learn/lsc_resour
  ces/testanxiety.pdf
• National Alliance on Mental Illness
• http//www.nami.org
• Substance Abuse and Mental Health Services
  Administration
• http//mentalhealth.samhsa.gov
•  

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Helpful Resources

• Books
• Brantley, J., Kabat-Zinn, J. (2007). Calming
  your anxious mind (2nd ed.) Oakland, CA New
  Harbinger Publications, Inc.
• Bourne, E.J. (2005). The anxiety phobia
  workbook. (4th ed.) Oakland, CA New Harbinger
  Publications, Inc.
• Forsyth, J.P., Eifert, G.H. (2007). The
  mindfulness acceptance workbook for anxiety A
  guide to breaking free from
• Anxiety, phobias, worry using acceptance and
  commitment therapy. Oakland, CA New Harbinger
  Publications, Inc.
• Huebner, D. (2006). What to do when you worry too
  much A kids guide to overcoming anxiety.
  Washington, DC Magination Press.

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Case Illustration II

• Please see page 7 of handout.
• Case Illustration II Derek

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References
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References
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References
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Contact Information

• Lindsay Gasparovich
• L_Gasparovich_at_verizon.net
• Please contact me if you would like to use the
  information presented.