Anxiety in Schools

This essay from National Association of School Psychologists past-president John Kelly, PhD, is a companion to “Understanding Anxiety,” the Child Mind Institute’s 2018 Children’s Mental Health Report.

Anxiety can be a major barrier to learning and functioning in school. Luckily, awareness of the impact of anxiety disorders on children is increasing and schools have many tools to intervene early, helping anxious children learn skills and thrive in school, at home and throughout life.

While home and community settings can present difficulties for children, the school environment brings its own challenges. The development of social relationships, managing conflicts, problem solving, and understanding one’s role in the larger social context are tasks presented to all children. Some are better at managing these tasks than others. Many children can feel anxious, ranging from mild to more severe clinical anxiety disorders. Mild anxiety may take the form of excessively worrying about a presentation or having minor somatic complaints. More severe forms of anxiety can manifest in the development of panic attacks in school or school refusal.

There is good news! Schools are vital in helping children develop social and emotional competencies, as well as infusing protective factors that can mitigate these challenges.

A growing number of schools are working to create cultures and climates that understand the impact of anxiety on student’s learning, as well as providing evidenced-based supports. School-employed mental health professionals, such as school psychologists and social workers, often work together with teachers and other staff to provide supports for students struggling with anxiety. They also work with parents to better understand the student’s needs and to implement appropriate supports. Open lines of communication between home and school are critical and should facilitate both parents’ ability to share concerns and ideas related to their child and collaborative problem-solving.

Many schools help anxious students through a Multi-Tiered Systems of Support (MTSS) framework. MTSS is designed to help all children feel safe physically, socially, emotionally, and academically. It provides levels of interventions of increasing intensity which reflect the needs of students. All students are provided “universal” supports. These develop social and emotional competencies, as well as skills for managing emotions and developing appropriate relationships.

Some anxious children do not respond to these universal supports and need more targeted intervention. The goal is to provide interventions that will prevent problems from becoming more severe. For these children, schools will often use an evidenced-based cognitive behavioral group intervention specifically designed to address factors that contribute to anxious behavior and teach coping skills. Schools also work with parents to generalize these skills to the home.

Finally, a smaller percent of students will struggle with anxiety on a chronic basis and will experience significant impairment in the school. For these students, intensive interventions are provided which are individualized to address their specific needs. These can include individual counseling with a school-employed mental health professional, classroom accommodations or modifications, and possibly special education services, as well as referral to community mental health providers for more intensive clinical services and medication.

Anxiety is the most commonly diagnosed psychiatric disorder in children and adolescents. While there are many factors which result in anxious behaviors, school psychologists and other school staff can play an important role in helping young people to manage their anxiety and thrive.

For more information on mental health and schools, visit www.nasponline.org.

John Kelly, PhD is a school psychologist in Commack, New York and Past-President (2017-2018) of the National Association of School Psychologists.