School-aged anxiety: what’s typical and when should we ask for help?

1. School-aged anxiety:what’s typical and when should we ask for help? Melissa A. Them, Ph.D. Licensed Clinical Psychologist Specialist in Assessment and Treatment of Childhood Mental Health Disorders

2. Goals for Tonight • Differentiate between typical and atypical anxiety • Understand signs and symptoms of anxiety • Discuss strategies for encouraging students to cope with stress • Provide guidelines for parents • Question & Answer

4. Typical Anxieties by Age

5. When has anxiety crossed over to disordered?

7. Signs of Significant Anxiety • Worry is excessive over seemingly insignificant situations • Worry and associated avoidance become the automatic responses in many situations • Subjective experience of feeling “on edge” or irritable • Support and coaxing are no longer effective • Perfectionism and extreme self-criticism

8. Signs of Significant Anxiety • Anxiety occurs most days for weeks or months • Physical ailments are recurring (headaches, stomach aches, nausea, vomiting) • Avoidance is interfering with normal activities (e.g., going to sleep, attending school) • Child seeks excessive reassurance that does not appear to relieve the anxiety • Parents find themselves becoming extremely frustrated with child’s worries or avoidant behaviors

9. So, what do we do???

12. Be Proactive • Develop Healthy Habits and Routines • Family Mealtimes • Bedtime Routines and Reasonable Bedtimes • 7-12 years  10-11 hours • 12-18 years  8-9 hours • Homework Routines and Time Management • Exercise • Relaxation and Down Time

13. Listen to your Child • Listen quietly and attentively • Acknowledge his/her feelings with a word or two • Give the feeling a name • Understand that the fear is real to your child and don’t minimize it • All feelings can be accepted. Certain behaviors must be limited. • “I can see how worried you are about this test, but you have to go to school. Let’s work together to find a way.”

14. The Anxiety Game • Anxiety is all offense and no defense • Anxiety tells you there is something to fear and – worse – you can’t handle it. • Anxiety tells you to stay away • Anxiety = AVOIDANCE • Winning the Game • To beat anxiety, we must not avoid it • Better yet, we could APPROACH it

15. Maintain Expectations • Keep things as typical as possible • For instance, set and keep your expectations that your child will attend school • Don’t cater to fears • Support your child and provide encouragement for approaching them • Provide reinforcement • Verbal praise • Non-verbal signs of approval • If helpful, positive contingencies

16. Where Can We Turn for Help? • School Personnel • Guidance Counselors • Social Workers • School Psychologists • Outside Treatment Options • Cognitive-Behavioral Therapy • Medications

17. Some Common Concerns • Test Anxiety • What is test anxiety? • Test anxiety is NOT a lack of test preparation • Test anxiety occurs when a student is well-prepared, but is excessively worried about an exam or enters an exam and his/her mind goes blank • Can include shakiness, nausea, light-headedness, etc. • What to do • Study in advance • Ask for help • Challenge negative thinking • Healthy habits (eat and sleep) • Encourage compassion for mistakes

18. Some Common Concerns • Social Media • Facebook, Twitter, Instagram, gChat • Distraction from homework  Failure to prepare • Cyber-bullying  School avoidance • Cell Phones • Texting  distraction, disruption of sleep, cyber-bullying

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