Anxiety at school is complicated
When Tellmi is commissioned in an area, delivering workshops in schools is a core part of our engagement strategy. We know that for teachers and pastoral support teams, managing student anxiety is a complex task. In this article, psychologist Lucy Foulkes and clinical psychologist Dr Jennifer highlight their concerns about the fact that teachers are not adequately trained to distinguish between typical anxiety, clinical anxiety and anxiety in the context of neurodivergence, so they often err on the side of caution and interpret all anxiety as the first symptom of a more significant and enduring mental health problem.
Foulkes and Sole have identified three questions that can help teachers to assess students who present as anxious.
(1) Is this anxiety a ‘normal’ part of development, a symptom of a mental disorder, or linked to neurodivergence?
It is very common for young people to feel anxious about peer relationships, family members or school performance. Less frequently, symptoms of anxiety can become pathological and would likely merit an anxiety disorder diagnosis. In neurodivergent students, sensory overload and overwhelming social demands can induce anxiety. Figuring out what kind of anxiety the young person is dealing with is fundamental to ensuring that actions and accommodations are helpful rather than harmful.
(2) What action is appropriate?
Many of the accommodations that teachers make enable students to avoid situations that make them anxious. Allowing a young person to avoid the thing that makes them anxious reduces their anxiety in the short term, but ultimately it robs them of the opportunity to become more resilient by learning to challenge their fears. Exposure to the thing that makes a young person anxious can help them to realise that they are stronger than they think, but if a young person is anxious at school because they’re being abused and humiliated by their peers, it is cruel and inappropriate to tell them to force them to spend time with classmates who bully them. For neurodivergent young people who struggle to focus in class, no amount of repeated exposure to the classroom is going to adjust their levels of distractibility and not offering accommodations will simply reduce their self-esteem.
(3) How long should adjustments be in place?
It may be appropriate for a neurodivergent student to have permanent reasonable adjustments for exams, but in general, adjustments such as non-attendance to particular lessons, special exam arrangements, permission to not be asked questions in class, or freedoms to leave classrooms using ‘exit cards’ or ‘time out cards’ should be reviewed regularly to check they are still appropriate. Open-ended accommodations for anxiety are often inappropriate and they can lead to young people diagnosing themselves as anxious, rather than recognising that they had a period of time when they felt anxious and needed a bit of additional support.
Lucy Foulkes is a psychologist at the University of Oxford researching adolescent mental health. She is the author of Coming Of Age: How Adolescence Shapes Us
Dr Jennifer Sole is a Clinical Psychologist. She has 15 years' experience in NHS Child and Adolescent Mental Health Services working with children, young people and their families presenting with a variety of difficulties.