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How Can Schools Help Kids With Anxiety?

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Many students struggle with anxiety. Their teachers, parents and other educators are looking for ways to help them learn to deal. (Kelly Heigert/KQED)

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I met Brianna Sedillo when she pitched my radio station a personal perspective on anxiety, a topic that comes up over and over as teachers and parents try to support young people.

“Everything kind of started with the anxiety and depression after the passing of my grandfather,” Brianna said. “He was kinda my safe space. And losing that was really big.”

Brianna missed her grandfather’s supportive presence acutely during her middle school years, which were difficult. Middle school can be a difficult time for anyone, but for Brianna it was particularly hard socially because her family moved several times. She had trouble making new friends and felt each change of school acutely. Despite all that, she was a good student; she made the honor roll all three years in middle school.

But everything got worse when she started at El Cerrito High School, just outside San Francisco. Brianna’s feelings of isolation intensified, and her depression and anxiety kicked into high gear. She knew that she should be doing her homework, participating in class, and trying to be more social, but she couldn’t bring herself to do any of it. By sophomore year, Brianna was barely passing.

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“It was just really rough for me,” Brianna said. She couldn’t stop worrying about what people thought of her, which made her so self-conscious she could barely function. “With my anxiety I tend to overthink everything. And I’m always aware of who’s looking at me and who’s talking about me, who’s judging me.”

Brianna remembers an endless cycle of waking up, going to school, taking work she couldn’t bring herself to do, and coming home to hide in her room and sleep. She lost a lot of weight and didn’t even enjoy playing soccer anymore, her favorite activity. She scrutinized her appearance every few minutes, and became so self-conscious she avoided answering questions she knew in class because she didn’t want people to look at her. When she got home, where she felt safe, all the anxiety she’d been bottling up all day came spilling out.

“It’s like something goes off and the anxiety kind of kicks in,” Brianna said. She would go over every tiny detail of the day. “Everything that I did that day. The way I pronounce something, the way I did something, The way I walked.” Then she would start thinking about her mom and how she should be working harder to make her mom proud, and that only made her feel worse.

“And then I start to panic and then it’s like, what am I going to do? Like, I’m going to disappoint my mom. And then I can’t breathe and then I get shaky, and I end up in a ball on the floor just trying to get my breathing back on track,” she said.

More On Dealing With Anxiety

Brianna is just one of many young people around the country experiencing anxiety, and often the depression that comes with it. Teachers and parents all over the country are noticing an increase in mental health issues, including anxiety, among students.

There isn’t much research directly surveying adolescents on their anxiety. In 2004, the National Institute of Mental Health estimated that about a third of adolescents (ages 13-18) have been or will be seriously affected by anxiety in their lifetimes. More recently, a study published in the Journal of Developmental and Behavioral Pediatrics, based on parent surveys for the National Survey of Children’s Health, concluded that more than one in twenty U.S. children (ages 6-17) had anxiety or depression in 2011-2012. And a UCLA survey of college freshman conducted each year, found in 2017 that close to 39 percent frequently felt “overwhelmed by all I had to do.” Parents and educators are scrambling to understand why kids seem to be more anxious and how to help them.

One School’s Attempt to Dispel the Isolation That Accompanies Anxiety

Brianna is far from the only student at El Cerrito High suffering from anxiety. In fact, counselors at the James Morehouse Project, the school’s wellness center, began noticing a few years ago that more and more students named anxiety as a chief concern. Most felt completely alone.

“A lot of students [were] coming in saying, ‘people don’t get this. Other students don’t experience this. People don’t know what it’s like,’” said Rachel Krow-Boniske, a social work intern at the James Morehouse Project. “And seeing that from so many different students made me want to be like, ‘Actually, this is really common! And if you all got to talk with each other and connect with each other over the experience, it might feel less alienating.’”

So Krow-Boniske and another intern, Forest Novak, started an anxiety group in the 2018-19 school year. They recommended some students they were seeing individually, and spread the word among teachers, who also recommended students who might benefit from participating.

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The group includes students from all grades and fluctuates in size from eight to ten. It meets once a week so students can discuss their anxiety, gain confidence that they aren’t the only ones struggling, and learn coping strategies. Krow-Boniske and Novak want students to become more aware of the signs of their anxiety, what triggers it, and how they can tell themselves a different story about what’s happening.

The course is broken down into sections. The first several weeks the two counselors facilitate a process of self-discovery for students. They do writing exercises with students to help them think carefully about how their bodies feel when they’re getting anxious, what’s happening around them, and what messages their anxiety tells them about themselves. After they validate that a lot of people are having similar feelings, the curriculum moves on to dig into seven types of coping strategies: grounding, distraction, emotional release, thought challenging, self-love, and accessing the truest parts of oneself to help hold all the other coping mechanisms.

“I’ve been amazed by how much they know about their own anxiety,” Krow-Boniske said. “They seem so aware of what’s happening for them and just haven’t quite had the words or the space to talk about it.”

Part Of a Broad Strategy to Support Students Where They’re At

The anxiety group is just one of many student wellness services offered at the James Morehouse Project, or the JMP as everyone at El Cerrito High calls it. The center is named for a former staff member who had a gift for connecting with students. Jenn Rader, a former history teacher, started the JMP when she realized that her students were struggling with far more than academics in her classroom.

“Those things were taking up so much space that there was really nothing left over to receive what was being offered in the building,” Rader said.

When it opened more than 20 years ago, the James Morehouse Project focused on providing health services and a little bit of counseling to students. Now, it offers an impressive array of services. It has a free, full-service medical clinic where students can get physical exams and an array of reproductive health services. It also has a dental clinic for students with MediCal, California’s Medicaid program.

It offers a youth development program aimed at cultivating students’ leadership and activism. Its staff provide one-on-one counseling services, as well as groups dedicated to almost everything a struggling student would need: support for queer-identified young people of color, an Arabic-speaking girls group, a support group for Muslim students, another support group for students who’ve suffered a catastrophic loss, and social skills groups for students who have a difficult time connecting with other young people.

“I think there’s been kind of a culture shift, a growing awareness and a growing commitment to ensure that children and young people arrive in a building with what they need in order to enter a classroom ready to learn,” Rader said.

More than 1,500 students attend El Cerrito High. Rader says almost a third of them have a meaningful interaction with the JMP each year either through groups or counseling. That’s only possible because the JMP runs a robust clinical social work internship program.

All those extra adults make a big difference in the lives of kids. When Brianna first came to the JMP, she saw an intern counselor who she says changed her life.

“She didn’t tell me what I was supposed to be, who I was supposed to be,” Brianna said. “She sat there and she listened, and she helped me just discover who I was. She helped me get deeper with myself and realizing things I hadn’t realized before. By the end of that, I was a much happier person. It was like a weight was on my shoulders, and piece by piece, she helped me take it off.”

How Parents Can Help Their Kids With Anxiety

Many students I spoke with for this story feel misunderstood by the adults around them. Their anxiety makes it difficult for them to complete assignments or be proactive, and that can look like procrastination. Brianna, for example, felt she was letting her mother down when she couldn’t bring herself to do her homework. Feeling inadequate made the anxiety and depression worse.

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Nina Kaiser is a child psychologist based in San Francisco who has been working with anxious kids for over 15 years. She says the feelings Brianna describes, as well as the misunderstandings that can arise with parents, are common. If parents want to get to the bottom of the problem, the first step is to understand how anxiety works.

“Your brain is constantly scanning your environment, looking for danger,” Kaiser explained. “It’s true for all of us, every single one of us, but when you are experiencing anxiety, it’s like a smoke detector or alarm that goes off more frequently.”

Kaiser likes working with anxious kids because there are effective treatments. One of the most effective ways to treat anxiety is with cognitive behavioral therapy. She helps her patients address both their physical responses to anxiety, as well as their distorted thoughts or “cognitions.” These thoughts often tend towards catastrophizing or ruminating on something that happened in the past, or could happen in the future.

“You’re teaching kids strategies around noticing those thoughts and being able to push back against them, or to shift gears instead of getting stuck in that pattern,” Kaiser said.

But it takes a lot of practice to step back from the panicked feelings and to look at them with a little more objective distance. She describes anxious thoughts to her clients as junk mail or spam. She directs them to look for evidence that supports the negative thoughts, or disproves them. So, if a student is anxious about failing a test, Kaiser will coach them to think about their past performance on tests, their grades overall, and whether this one test even matters that much.

But, she adds, “Those [anxious] thoughts tend to be really powerful and really automatic. They’re coming into your mind really quickly, really loudly, and it’s challenging to step back and notice that there are other ways to think about the situation.”

Kaiser says anxiety can be tricky for parents to handle because they may see it as laziness on the part of their child. But rather than judging them for not doing their homework or not wanting to go out with friends, she recommends they try to approach the situation with curiosity. When parents don’t assume they know what’s happening with their child, they can open up more space for the child to confide what’s really going on.

Kaiser also says that one of the hardest parts about treating anxiety is confronting the things that make a person anxious. Kids aren’t going to want to do that, and a parent’s first instinct is often to protect their child from things that cause them distress. Kaiser reminds her clients and their parents that anxiety is trying to control them and the best way to get out from under that is to push back.

“So if a kid is really spiraling about something, if parents are overly reassuring, they’re also sending a message that there’s something valid about that anxiety,” Kaiser said.

She recommends parents and their kids read reputable sources about anxiety ahead of time, when tensions aren’t high. Then, when a panic attack hits or a student is particularly anxious, it’s easier for parents to gently push them without making their child feel they aren’t emotionally supported. Kaiser knows this is hard for parents to do, but she says having a collaborative relationship established ahead of time will make it easier.

It’s All About Resilience

After Brianna got help with her depression at the James Morehouse Project, she also developed coping strategies for her anxiety. She still gets panic attacks sometimes, but now she knows how to handle them. And she’s headed to community college in the fall, a new phase of life that excites her.

James Morehouse Project director Jenn Rader says it’s no surprise students are anxious in today’s world. Her students are dealing with a lot of trauma from the world around them. Their families are struggling to make ends meet in an economy that is increasingly unequal. They are worried about their futures in an insecure world. Many feel that if they aren’t perfect, they’ve failed. And they’re constantly comparing themselves to others on social media. They are terrified of school shootings, immigration raids, violence in their neighborhoods, and even not getting into a good college.

Nina Kaiser says she’s seeing patients with serious anxiety at younger and younger ages. She’s even started an anxiety group, called Mighty Minds, with elementary school-aged children to help kids build up the resilience they’ll need to face middle and high school stress before they get there.

“Why are we waiting until kids are already struggling? These are really life skills. The ability to calm yourself down, to notice when you’re feeling stressed. I’m practically 40 years old. These are still skills that I’m practicing day by day.”

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She hopes with these tools available to them, kids will have skills to fall back on when they run up against adversity.

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