For this assignment you will need to read the article, ‘Treating anxiety disorders in a school setting’ included in this unit’s reading list and you may also want to read about ‘FRIENDS Program in B.C. Schools’ in the British Columbia website.
Write a short paper on managing student anxiety in the classroom based on the following scenario:
Imagine that in your classroom there are a few students who are showing visible signs of anxiety and you feel you need help handling the situation. Your school is offering free training in the FRIENDS Program, whereby teachers would then implement the program in their classrooms.
- Examine the signs of anxiety shown by some of the students in your classroom and why you feel you need help handling the situation. (If you are not currently teaching, use a hypothetical classroom or observe a classroom in your community).
- Analyze the FRIENDS program
- Analyze the reasons why it would be worthwhile implementing in your classroom or not.
- Examine whether or not you would attend the training.
What is anxiety disorder (AD)?
It is a condition in which a child experiences intense irrational fear and anxiety. The danger of this disorder is that it can greatly affect a child's emotional and physical health. If left untreated, it can lead to sleep disturbances, digestive problems, the onset of depressive symptoms (and progression to anxiety-depressive disorder), and other mental health problems (Lane, 2007).
Classification
There are many types of childhood anxiety disorders, differing in symptomatology (Lane, 2007). Their common manifestation is prolonged anxiety, inadequate to the existing situation, which negatively affects the child's daily life, reduces the sense of psychological comfort. Taking into account the peculiarities of the clinical picture distinguish:
- Generalized anxiety disorder. With generalized TR, children are constantly worried about various spheres of life - about health, safety, relations with peers and parents, the success of studies. Of all the options for the future, the negative one seems the most likely.
- Obsessive-compulsive disorder. In OCD, anxiety is manifested by compulsive behaviors and thoughts. Rituals for a short time provide a sense of calm.
- Phobias. A premonition of danger can form into a stable fear (phobia) of certain objects and situations. Often children are afraid of heights, the dark, imaginary monsters, social contacts.
- Panic attacks. Intense anxiety is sometimes manifested by an increase in autonomic symptoms - dizziness, palpitations, respiratory spasm, muscle overstrain, which constitute the clinic of panic attacks. The child begins to avoid events that can provoke panic.
- Post-traumatic stress disorder. This variant of anxiety arises as a result of experiencing a traumatic event that does not fit into the framework of the usual experience. PTSD in children is manifested by a sudden influx of memories and nightmares.
Symptoms
The main symptom is persistent, marked anxiety. Patients feel emotionally stressed, unable to distract themselves from negative experiences and relax (Ehrenreich et al., 2008). Due to anxiety, they have difficulty concentrating, and adolescents report feeling “empty in the head.” Increased nervousness is manifested by irritability, tearfulness, and fearfulness. Flinching at unexpected sharp sounds, changes in light, sudden touch is characteristic. Behavior becomes avoidant (restrictive): children refuse to communicate, walks, active games, travel, eating certain foods.
Among the physical symptoms of anxiety disorders, gratuitous fatigue and rapid exhaustion predominate (Ehrenreich et al., 2008). Patients complain of dizziness, weakness, headaches and muscle aches, discomfort in the abdomen and chest. There may be increased sweating, especially in stressful situations, palpitations, difficulty breathing, tremors and shivering, a feeling of a lump in the throat, hot flashes, chills. Appetite is more often decreased, but sometimes voracity with subsequent nausea and vomiting develops. Sleep disturbances include difficulty falling asleep, waking up in the middle of the night, and nightmares.
Symptoms of phobic disorders are persistent fears (Ehrenreich et al., 2008). Fear of situations that are not really threatening or may be threatening only under certain conditions is formed. Young children are afraid of the dark, heights, separation from their mother. Preschoolers actively develop imagination, fears are associated with fairy tale or imaginary monsters - dragons, dinosaurs, reanimated skeletons, zombies, werewolves. In schoolchildren, social phobias come to the forefront - fear of communication, acquaintance, public speaking. Teenagers experience fear of loss of control, death, insanity, and shame. Anxiety after experiencing psychotrauma is characterized by “flashbacks” - uncontrollable frightening influxes of memories, nightmares at night.
In obsessive-compulsive disorder, anxiety is accompanied by the formation of intrusive ideas of a frightening nature (Ehrenreich et al., 2008). Children mentally replay negative variants of events, experiencing fear. Ritualized actions - compulsions - partly help them cope with emotional tension. The most common are frequent hand washing, fumbling with the edges of clothing, nail biting, walking around the perimeter of the room. With panic attacks, anxiety occurs for no apparent reason and instantly increases, manifesting itself with autonomic symptoms. Feelings worsen - there is dizziness, darkening of the eyes, a sense of alienation of one's own personality, unreality of objects and events. Fear of another panic attack and avoidant behavior is formed.
Cognitive Behavioral Therapy (CBT)
Friends Program (FRIENDS for Life Liaison Manual Sponsored by the Ministry of Children and Family Development in Cooperation with School Districts, Independent Schools, First Nations Schools Association and the Ministry of Education, n.d.).
The Friends program is a form of CBT for children with anxiety disorders that is delivered in a 10-session group format and is delivered on two levels: therapy and universal preventive intervention. FRIENDS is an acronym from (Hall, n.d.):
F - Feeling worried?
R - Relax and feel good;
I - Inner thoughts;
E - Explore plans;
N - Nice work so reward yourself;
D - Don't forget to practice;
S - Stay calm, you know how to cope now.
The program contains all the basic elements of CPT, including also cognitive restructuring for parents. Parents are asked to practice skills daily and to practice positive reinforcement when doing the drills. The program encourages families to form supportive social networks and children to form friendships with group members by talking about their problem situations and learning from peer experiences. This program also includes some elements of interpersonal therapy. Shortt et al (Barrett et al., 2001) conducted an RCT that examined the use of the Friends program in children aged 6 to 10 years with TRTR, generalized anxiety and social phobia, obtaining a remission rate of 69%. Therapeutic success was maintained over the following year.
Impressive results make this program very attractive for professional development.
References
Barrett, P. M., Shortt, A. L., Fox, T. L., & Wescombe, K. (2001). Examining the Social Validity of the FRIENDS Treatment Program for Anxious Children. Behaviour Change, 18(02), 63–77. https://doi.org/10.1375/bech.18.2.63
Ehrenreich, J. T., Santucci, L. C., & Weiner, C. L. (2008). SEPARATION ANXIETY DISORDER IN YOUTH: PHENOMENOLOGY, ASSESSMENT, AND TREATMENT. Psicologia Conductual, 16(3), 389–412. https://doi.org/10.1901/jaba.2008.16-389
FRIENDS For Life Liaison Manual Sponsored by the Ministry of Children and Family Development In cooperation with School Districts, Independent Schools, First Nations Schools Association and the Ministry of Education. (n.d.). https://www2.gov.bc.ca/assets/gov/health/managing-your-health/mental-health-substance-use/child-teen-mental-health/friends_liaison_manual.pdf
Hall, K. (n.d.). Separation Anxiety Disorder DESCRIPTION OF SEPARATION ANXIETY DISORDER Definition. Retrieved October 8, 2024, from https://www.counseling.org/docs/default-source/practice-briefs/separation-anxiety.pdf?sfvrsn=ca7dc9f7_1
Lane, K. L. (2007) Identifying and supporting students at risk for emotional and behavioral disorders within multi-level models: data-driven approaches to conducting secondary interventions with an academic emphasis. Education & Treatment of Children, 30 (4), 135-164.