Since it is Mental Health Awareness Month, I decided to write a post regarding a common mental health disorder that students are exhibiting in school.  Unfortunately, school counselors are often unaware of how to help students and families who face this disorder.  In this post, I hope to give some insight to school counselors about the mood disorder anxiety.
A few weeks ago, a colleague shared her concerns about a ninth grader who was skipping class and failing several of her courses.  When my friend confronted the student about her grades and skipping, the student told her that she suffered from anxiety and felt uncomfortable around large groups of students.  My colleague decided to meet with the guardian of the student to come up with a plan to help her when she was feeling anxious.  During the meeting, the guardian was resistant to many of my colleague’s suggestions and felt that the student was truly unable to properly function in a classroom.  My colleague told the guardian that she understood her concerns for her child, but she was worried for the student’s safety as she was constantly missing class and no one knew her whereabouts.  When the guardian asked the student where she was going, the student burst into tears and accused the guardian of not caring about her, threatened to run away, and got up to leave the room.  Instantly, the guardian backed down and told the counselor that her child needed time to regain her composure.  Calmly, my colleague listened to the parent,  but insisted a plan was needed to make sure the student was safe and academically successful.  Frustrated, the parent excused herself and left with her child leaving my colleague scratching her head.

What is Anxiety?

According to Healthy Place, anxiety disorders are a group of illnesses including generalized anxiety disorder, phobias, panic disorders, post-traumatic stress disorder, social disorder, and obsessive compulsive disorder. Researchers believe that anxiety is a biological disorder that runs in families and may manifest from a series of risk factors like brain chemistry, genetics, personality, and life events. 

How to Help a Student Who Suffers from Anxiety?

School counselors are generally the first line of defense when identifying mental health disorders in teens.  Being able to properly identify and refer families to proper treatment is imperative for student recovery.  Although anxiety is treatable, 80 percent of youth are not getting treatment! Also, anxiety disorders are generally accompanied by other disorders like depression, ADHD, or eating disorders.

In my opinion, I don’t think the student or parent was trying to be difficult. In their research, Hanie and Stanard found that students with anxiety are often misunderstood by parents and school staff. Students with anxiety typically try to avoid difficult situations, desperately want their anxiety to stop,  and often feel people are against them.  In fact, this student was using the same ineffective coping mechanisms she has probably used over and over to deal with her anxiety.    Dr. Katharina Manassis found that school refusal is a major concern of students who have mood disorders. She found that when students begin to miss school for long periods of time, they need to work with a professional (therapist) to create a plan to return to school. 

So, how can counselors assist students who miss school due to their anxiety? Some suggestions from Dr. Manassis include:

  • Escort the student to class.
  • Create a plan for helping the student to catch up in his or her class.
  • Remain calm and thoughtful with the student and family.
  • Schools should be flexible and allow variations in student’s schedule.
  • Allow a staff person to be available to assist the student when he or she is having anxiety.
  • Schools should be flexible with academic expectations as the student adjusts back to school. 

In addition to assisting students in school, school counselors should refer the student to an outside referral.  Dr. Manassis suggests that students should see a therapist regularly regarding their anxiety.  Some therapies for students with anxiety often include:

  • Cognitive Behavior Therapy
  • Motivational Interviewing
  • Family Therapy

Dr. Manassis warns that home school should not be a recommendation for students as it often becomes a lifestyle for the student. Also, changing schools may not always be the best solution as transition can be stressful for the student.  Dr. Manassis says that changing schools should only be considered if the school is toxic (i.e. bullying is present).

Helpful Tips When Students Are Having Anxiety

Therapist and Mental Health Vlogger, Kati Morton, gives some additional tips school counselors can give students. These suggestions include:

1.  Stay busy!  Anxiety often appears when students are quiet and allow their minds to run with thoughts.

2.  Help students focus on the area where they feel the worry and use deep breathing.

3.  Suggest that students begin to exercise – anxiety thrives when we have a lot of pent up energy.

4.  Suggest the student have an emergency contact list to reach out when he or she is anxious. Having at least five people is important so that if someone cannot answer, the student has a back up contact.

5.  Consider seeing a psychiatrist if his or her anxiety is not improving.

Worry Wise Kids has a list of accommodations that schools can put into place if a student is exhibiting symptoms of anxiety.  Some tips include:

  • Seat students away from other students who may be disruptive or distracting.
  • Allow the student to present class presentations to the teacher alone or allow the student to videotape the lesson at home to show to the teacher.
  • Allow extended time on tests.
  • Create a cool down pass (with a time limit of 5-10 minutes) for the student to wash his or her face or get water.

See more suggestions in this article, Sample Accommodations for Students with Anxiety.

Additional Resources 

Do you need additional resources for assisting students with mood disorders?  Here are some resources you may find helpful to use with your students.

Youth Mental Health First Aid 

Mental Health First Aid is designed to work with adolescents between the ages of 12-18 and introduces the participants to the unique risks and warning signs of those who work with adolescents. In addition, the course helps build understanding of the importance of early intervention and teaches participants how to work with youth experiencing a mental health crisis. Not only is this course appropriate for those who work with youth, but the course is also appropriate for older adolescents (ages 16 or older) as to encourage peer to peer interaction.

work with adolescents between the ages of 12-18 and introduces the participants to the unique risks and warning signs of those who work with adolescents. In addition, the course helps build understanding of the importance of early intervention and teaches participants how to work with youth experiencing a mental health crisis. – See more at:

Coloring Books for Teens with Anxiety

 Check out my post on how to use coloring books to help calm anxious students. 

Mental Health Resources for School Counselors

Check out resources from my post about Mental Health Awareness Week, 2014.
Additional Resources:
Ten Things to do for a Panic Attack
What is Generalized Anxiety Disorder? 
Anxiety and Depression Association of America 
Resources and Training for School Counselors 
Top Anxiety Blogs
Kids Crisis Booklet with Crisis Plan 
SPRC Safety Plan Template 
Crisis Wallet Card (great example)
SAMSHA Guidelines in Responding to a Mental Health Crisis  
Tips to Promote Social-Emotional Health Among Teens
How to Work Effectively with Police When Youth Are in Mental Health Crisis.pdf

Training Opportunities for Schools 

Description of Mental Illnesses
Songs About Mental Illness 
300 Famous People Who Suffer From Mental Illness 
Famous People Who Suffer from Mental Illness PowerPoint
CDC Mental Health Resources
CDC Human Development and Disabilities Resources
National Institute on Drug Abuse
Free Resources for High School Staff on Teen Drug Abuse
Office of Juvenile Justice and Delinquency
National Child Traumatic Stress Network
ACA Crisis Counseling
ACA Suicide Assessment
Disaster Mental Health Training for School Counselors
Youth Mental Health First Aid Training
The Current State of School Based Mental Health
Training on Teen Mental Health Concerns and Strategies for High School Staff
Way s for Teachers and Schools to Build Resilience in Youth
Understanding and Reducing Aggressive Behavior in Youth
Many Youths With Autism Lack Options After High School
Adolescents with a History of Maltreatment Have a Unique Service Need That May Affect Their Transition to Adulthood
Mental Health and Drug Abuse
Adolescent Mental Health Information
The Role of High School Mental Health Providers in Preventing Suicides
Webinar on Working with Homeless Youth and Runaways
Building Resilience in Teens 

Resources for Students

Anxiety Fact sheet for Adolescents and Teens

Strength of Us-online community for young adults created by NAMI and other young adults. Young adults receive peer support and resources for issues that they are facing due to their mental health issues.

Some resources include:
Active Mind Mental Health Resources for College Students
Managing Your Depression
JED Foundation-Organization for the Emotional Health of College Students
Must Have Personal Information
Transitioning to College with a Mental Health Condition
Helping Families Support Students with Mental Health Issues in College
Resources for Families
Foster Club-Resources for foster students who want to attend college
Getting Accommodations in College
Must Dos Before Applying to College
Managing Your Mental Health Condition in College
The Why, When, What and How of Disclosure in an Academic Setting
What Happens to my Social Security When I Turn 18?
Things No One Told Me When I Left Foster Care
Vocational Rehab
Financial Tips
When to Disclose your Mental Health Condition in the Workplace
Applying for a Job
Resilience Card 

Organizations focusing on Mental Health
Youth M.O.V.E

NAMI-National Alliance on Mental Illness
Center for Health and Health Care in Schools-School Based Mental Health
NIMH-National Institute on Mental Heath

Hope you found some helpful information to assist you in working with anxious students.  If you have resources, please feel free to share and I will add them to my resource lists!

Getting Accommodations in College

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