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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:
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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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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
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Three main factors:
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Biology
 Genetic predisposition
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Cognitive-emotional influences
 A person’s experiences, level of self-confidence, and
ability to handle stress
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Chronic stress
(Brantley, 2008)
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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
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These behaviors range from major to minor
rule violation.
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Behaviors may also go undetected
(Bourne, 2005; Morris, 2004)
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Anxiety disorders are the most common
disorder to occur in childhood and adolescence
(SAMHSA, 2008).
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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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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
Definitions retrieved from SAMHSA's
Mental Health Dictionary and Kerr and
Nelson's (2006) text companion
website.
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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.
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Generalized Anxiety Disorder
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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)
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Separation Anxiety Disorder
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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)
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Panic Disorder
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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)
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Post Traumatic Stress Disorder
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Develop symptoms after exposure to a traumatic
stressor
 Physical, verbal, or sexual abuse
 Natural disasters
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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)
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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)
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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
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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
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School avoidance
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Irritability
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Students may skip school/class to avoid taking an
exam or avoid social interactions
Low academic performance
Easily angered by changes in routine
Increased aggressive feelings
Behavioral disruptions
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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)
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Social withdrawal
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This may include little or no class participation or
little to no interactions with teacher/peers
Interrupts social skill development
Physical complaints
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Stomachaches
Headaches
Nausea
Sweating
Dry mouth
Muscle tension
(APA, 2000; Bourne, 2005; Morris,
2004)
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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
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 Restricts risk-taking in children
(Bourne, 2005; Cleveland Clinic, 2008)
Some things to avoid when working with the anxious
student:
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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)
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“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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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).
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Preventive programs and interventions
include:
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Cognitive Behavioral Therapy (CBT)
Universal interventions/Positive Behavior Support
(PBS)
Relaxation strategies
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“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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Praising students for positive performance has
been found to be effective
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Muller & Dweck (1998)
 Performed a study that looked at performance vs.
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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:
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Ready…Set…R.E.L.A.X. (Allen & Klein, 1996, as cited by Tomb & Hunter,
2004)
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The Queensland Early Intervention and Prevention of
Anxiety Project (Barrett & Turner, 2001, as cited by Tomb & Hunter, 2004)
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Research also supports the role MODELING
plays in teaching students positive ways to
prevent or manage anxiety
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Students, through observation, learn to use
appropriate behaviors in similar situations
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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.
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In general:
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Educate students about anxiety and effective ways to
manage stress
 Provide students opportunities to exercise these
strategies
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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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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:
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Allowing students to use stress balls in class
Listening to music in order to lower one’s state of
anxiety
Journaling
Exercise
PRAISE!
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Teach students to visualize success through
mental rehearsals
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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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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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Websites:
Anxiety Disorders Association of America
http://www.adaa.org
Children’s Disabilities Information
http://www.childrensdisabilities.info
Cornell University: Center for Learning and Teaching
http://www.dt.cornell.edu/campus/learn/lsc_resources/testanxiety.pdf
National Alliance on Mental Illness
http://www.nami.org
Substance Abuse and Mental Health Services Administration
http://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, 403411.
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.
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Lindsay Gasparovich
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[email protected]
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Please contact me if you would like to use the
information presented.