Lindsay Gasparovich, B.A.

What educators need to know about anxiety.Photo used with permission of Crystal Leigh Sheann

“Everyone feels worried sometimes…But some worries don’t go away…Kids 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 aren’t due for a shot at the doctor’s 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 kid’s guide to overcoming anxiety. Washington, DC: Magination Press.

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

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

Please see handout: Case Illustration I

Three main factors: Biology

Genetic predisposition

Cognitive-emotional influences A person’s experiences, level of self-confidence,

and ability to handle stress

Chronic stress

(Brantley, 2008)

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

(Bourne, 2005; Morris, 2004)

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).

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 disordersDefinitions retrieved from SAMHSA's

Mental Health Dictionary and Kerr and Nelson's (2006) text companion

website.

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.

Definitions retrieved from SAMHSA's Mental Health Dictionary and Kerr and

Nelson's (2006) text companion website.

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.)

(APA, 2000)

Separation Anxiety Disorder Characterized by excessive anxiety

concerning leaving one’s home environment or caregiver(s)

Symptoms include: Preoccupation with thinking of reunion “homesick” “clinging” behavior Physical complaints

Headaches, stomachaches, nausea(APA, 2000)

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(APA, 2000)

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)

(APA, 2000)

Academic Anxiety (Test Anxiety) Can be observed by a gap between a student’s abilities and a

student’s 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

(Cornell University, 2008; McDonald, 2001; Peleg-Popko, 2002)

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 can’t” or “I’m not good at this”

Social withdrawal Student frequently experiencing stomachaches,

headaches, etc. Student having difficulty concentrating

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.

(APA, 2000; Bourne, 2005; Morris, 2004; Tomb & Hunter, 2004)

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

(APA, 2000; Bourne, 2005; Morris, 2004)

What may trigger or exacerbate anxiety? Genetic predisposition Adults in the student’s 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

(Bourne, 2005; Cleveland Clinic, 2008)

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 (Bourne, 2005; Cornell University, 2008; Kerr & Nelson, 2006)

“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).

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

“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.

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: Ready…Set…R.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)

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

(Fisak & Grills-Taquechel, 2007)

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.

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

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 one’s

state of anxiety Journaling Exercise

PRAISE!

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.

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.)

Websites:

Anxiety Disorders Association of Americahttp://www.adaa.org

Children’s Disabilities Informationhttp://www.childrensdisabilities.info

Cornell University: Center for Learning and Teachinghttp://www.dt.cornell.edu/campus/learn/lsc_resources/testanxiety.pdf

National Alliance on Mental Illnesshttp://www.nami.org

Substance Abuse and Mental Health Services Administrationhttp://mentalhealth.samhsa.gov

 

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 kid’s guide to overcoming anxiety. Washington, DC: Magination Press.

Please see page 7 of handout.

Case Illustration II: Derek

American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders

(DSM-IV-TR). (4th ed.) Washington, DC: American Psychiatric Association.

Anxiety Disorders Association of America (2008). Statistics and facts about anxiety disorders. Retrieved February 14, 2008 from http://www.adaa.org/aboutadaa/pressroom/stats&facts.asp.

Barrett, P.M., Farrell, L.J., Ollendick, T.H., & Dadds, M. (2006). Long-term outcomes of an Australian universal prevention trial of anxiety and depression symptoms in children and youth: An evaluation of the friends program. Journal of Clinical Child &Adolescent Psychology, 35:3, 403- 411.

Barrett, P.M., & Turner, C.M. (2004). Prevention strategies. In T.L. Morris & J.S. March (Eds.), Anxiety disorders in children and adolescents (2nd ed., pp. 371-386). New York, NY: The Guilford Press. Beidel, D., Taylor-Ferreira, J., & Turner, S. (1999). Teaching study skills and test-taking strategies to elementary school students. Behavior Modification, 23, 630-646.

Bourne, E.J. (2005). The anxiety & phobia workbook. (4th ed.) Oakland, CA: New Harbinger Publications, Inc.

Cleveland Clinic. (2008). “Treating anxiety disorders in children & adolescents”. Retrieved February 14, 2008 from

http://www.clevelandclinic.org.

Cornell University: Center for Learning and Teaching. (2008). Letting go of test anxiety. Retrieved March

10, 2008, from http://www.dt.cornell.edu/campus/learn/lsc_resources/testanxiety.pdf

Fisak Jr., B., & Grills-Taquechel, A.E. (2007). Parental modeling, reinforcement, and information transfer: Risk factors in the development of child anxiety? Clinical child and family psychology, 10, 3, 213-231.

Huebner, D. (2006). What to do when you worry too much: A kid’s guide to overcoming anxiety. Washington, DC: Magination Press. Kerr, M.M., & Nelson, C.M. (2006). Strategies for addressing behavior problems in the

classroom (5th ed.) Upper Saddle River, NJ: Pearson Education, Inc. http://www.wps.prenhall.com/chet_kerr_strategies_5.

McDonald, A. (2001). The prevalence & effects of test anxiety in school children. Educational Psychology, 21, 89-101. Mulvenon, S.W., Stegman, C.E., & Ritter, G. (2005). Test anxiety: A multifaceted study on

the perceptions of teachers, principals, counselors, students, and parents’, International Journal of Testing, 5:1, 37-61.

National Alliance on Mental Health. (2008). Anxiety disorders in children and adolescents. Retrieved February 14, 2008, from http://www.nami.org.

Peleg-Popko, O. (2002). Children’s test anxiety and family interaction patterns.

Anxiety Stress and Coping, 15:1, p. 45-59.

Substance Abuse and Mental Health Services Association. Children’s mental health facts: Children and adolescents with anxiety disorders. Retrieved March 15, 2008 from http://mentalhealth.samhsa.gov/publications/allpubs/CA-0007/default.asp. 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. U.S. Department of Health and Human Services. (1999). “Other mental disorders in children and adolescents”. Mental health: A report of the surgeon general. Retrieved February 14, 2008 from http://www.surgeongeneral.gov/library/mentalhealth/chapter3/sec6.html.

Wood, J. (2006). Effect of anxiety reduction on children’s school performance and social adjustment. Developmental Psychology, v. 42, 2, 345-349.

Lindsay Gasparovich

L_Gasparovich@verizon.net

Please contact me if you would like to use the information presented.