Supporting Students who Experience Anxiety at School Ellie L. Young, PhD Brigham Young University

Who is here? Teachers? Elementary Secondary School counselors/social workers/school psychologists? Administrators? Other Who am I?

Objectives Share an operational definition of anxiety State a basic theory of what causes and maintains anxiety Identify two classwide strategies for addressing anxiety in your classroom Identify two strategies for responding to intense anxiety in individual students

What is anxiety? Emotional dysregulation Intense fear in the absence of true threat.

What is Anxiety? Thought—Cognitions with errors Fight or flight gets activated Smoke detector example Physical Tense shoulders, fluttering heart Emotional Anger Fear Behavior Some type of avoidance

Cognitions

Prevalence Anxiety is the most common mental health concern in the US. ~18% of US adults experience diagnosable anxiety disorders. ~25% prevalence rate for 13-18 year olds. https://www.nimh.nih.gov/health/statistics/preval ence/any-anxiety-disorder-among-children.shtml https://www.nami.org/Learn-More/Mental- Health-Conditions/Anxiety-Disorders

Learning to be anxious •Classical Conditioning: Pairs a stimulus with a response. The stimulus occurs first, then the anxiety response. •Operant Conditioning: The anxiety response occurs and it is reinforced, increasing the probability that the anxiety response is frequently repeated. •Social Learning Theory: Children learn to be fearful by watching others.

Developmental Issues How does cognitive development influence anxiety? How would anxiety look different in a 6 year old vs. a 16 year old?

Guiding Principles for Interventions Address cognitive, behavioral, physical, and emotional simultaneously to the extent possible. Proactively teach and practice effective strategies before overwhelming anxiety happens. Collaborate with teachers, mental health providers (community & school) and parents to maximize outcomes.

Supports and Interventions

Proactively Teach What Anxiety Is and Practice Effective Coping Strategies What to Do When You Worry Too Much Evidence-based strategies for effectively coping with anxiety Appropriate for K-6 Read aloud to the whole class over time Easily understood and applied $9.14 from Amazon.com

Each Worry has a Lie I’m going to fail my chemistry exam and not get into my first choice university. Lies I will definitely fail the exam I won’t get into University X Healthy Thinking I studied a lot, and I can do my best If I don’t do as well as I hoped, I can do ask for help from my parents, teachers, or friends One chemistry test is unlikely to make or break whether I get into University X https://www.mcgill.ca/counselling/files/counselling/unhelpful_thinking_styles_0.pdf

Talking Back to the Worry Bullies Worries are like bullies, they keeping talking and telling us lies. Identify the lie in the worry. Create a plan for talking back to the worry. Let’s practice: Identify one of your worries or a worry you hear at school. What’s the lie in the worry? How can you talk back to the worry bully?

Creating a Classroom Culture of Safety Many children with anxiety are perfectionists Perfectionists fear embarrassment and making mistakes They do not want to look stupid Share with a neighbor some ways educators can create a culture of acceptance and safety at school.

Creating a Classroom Culture of Safety Create a culture where mistakes are valued as learning opportunities Model making and fixing mistakes Agree not to call on a student unless you give advance notice “Sam, Leah, and Joe--I want to hear your ideas about this story. Sam you go first and then Leah and Joy, please be prepared to share your ideas.” “Everyone write three ideas about the problem and be prepared to share.” While students are writing, go to the worrying student’s desk and ask him/her if she could share her ideas.

Creating a Classroom Culture of Safety Tell students their questions are good questions Set aside a specific time to ask questions “What questions do you have?” rather than “Who has a question?” Avoid drawing attention to me If I freeze, move on

Classroom Strategies Set clear and reasonable expectations Break tasks into manageable units Have specific evaluation criteria Provide opportunities for practice and rehearsal Reduce time constraints Move the the student to a quiet setting http://www.nasponline.org/resources-and-publications/resources/mental-health/mental-health-disorders/anxiety-and-anxiety-disorders-in-children-information-for-parents

Fight or Flight Response When we feel threatened, the fight or flight response is the amygdala is activated When the amygdala is activated, logical reasoning is often suspended Aggression may be a part of the fight or flight response

The Fight or Flight Response: I Can’t Problem Solve When My Worry is Intense Encourage me to take a break, breathe, take a walk and come back to the problem in a few minutes Avoid saying, “Calm down.” Give specific directions Let’s take three deep breaths together and slowly breathe out Go get a drink and take some deep breaths, then we can think of a solution together Give me some ideas about how to solve the problem Help me feel safe and supported

Hoberman sphere Can be done as a class or individually Helps to slow breathing

Worry Eaters Have the student write their worry on a card and put it in the Worry Eater. Just acknowledging the worry is helpful. Empathy “I can see this is upsetting for you because you are speaking very fast.” Physically putting the worry in another place helps us create distance and begin to calm ourselves.

Reinforce Effective Coping Rather Than Avoidance Provide time for practicing effective coping strategies Praise students for practicing the strategies Prompt students to use the strategies Recognize when avoidance is reinforced. Encourage students to try a difficult task for a short time (3 minutes), set the timer then praise progress. Practice with the student→”I’ll do the first problem with you and answer your questions as we do the problem.” Provide options and let the student decide what will work best Anxiety is about feeling powerless Be aware of how your anxiety and emotions may be influencing the child’s anxiety.

Objectives Share an operational definition of anxiety State a basic theory of what causes and maintains anxiety Identify two classwide strategies for addressing anxiety in your classroom Identify two strategies for responding to intense anxiety in individual students

Favorite Resources Hey Sigmund→ website with research-based ideas for understanding mental health issues. http://www.heysigmund.com/ National Association of School Psychologists http://www.nasponline.org/resources-and-publications/resources/mental-health/mental- health-disorders/anxiety-and-anxiety-disorders-in-children-information-for-parents What To Do When You Worry Too Much. Children’s book that gives evidence-based strategies for dealing with anxiety. https://www.amazon.com/What-When-You-Worry- Much/dp/1591473144/ref=sr_1_1?ie=UTF8&qid=1497629055&sr=8- 1&keywords=what+to+do+when+you+worry+too+much Website developed by Melissa Heath that share books and lesson plans to teach social skills http://education.byu.edu/buildingsocialskills/being-optimistic

Contact Information Ellie Young, PhD ellie_young@byu.edu