Effective Evidence-Based Interventions for Anxiety in Cyber School Students
This post aims to identify how anxiety and Obsessive Compulsive Disorder (OCD) present in students, explain the highly effective evidence-based treatment for anxiety, and emphasize the importance of a strong support system in maintaining positive treatment outcomes.
In order to learn how to treat anxiety and OCD, one must first be familiar with the clinical understanding of the term. Anxiety is a pervasive feeling that interferes with daily life. It is chronic with increasing severity across time. Anxious thoughts and fears are quite unrealistic and are hard to keep under control. Since anxiety is so intrusive, reassurance is ineffective, leaving those affected and their loved ones helpless.
Typically stress and anxiety are used interchangeably, however there is a difference in severity. Stress is not as pervasive as anxiety and is usually elicited by stressful stimuli; stressful fears are based in reality and can be easily managed so daily activities will only be slightly hindered. Reassurance is effective in reducing stress. There are many forms of anxiety; the most common among children include social and performance anxiety, panic attacks, avoidance of situations, anxiety after traumatic incidents, separation anxiety, and specific fears. Common OCD types include fear of contamination, perfectionism, fear of harm to self or others, aggressive obsessions that often scare the child, religious obsessions, ‘not quite right’ OCD, and intrusive sexual thoughts.
Anxiety manifests itself through high and low emotional reactions. High emotional reactivity refers to overt signs of a student feeling anxious as well as more conventional coping mechanisms such as avoidance. Examples of anxiety include excessive worrying, tantrums, crying, frequent absences, tardiness, and requests to leave the school or classroom. Conversely, low emotional reactivity is more unassuming; those who possess it often exude a quiet demeanor, perfectionism, a tendency to skip lunch, and a tendency to take an excessive amount of time to complete tasks. Anxiety can also manifest itself physically due to arousal of the sympathetic nervous system. This can cause pain in the child because the autonomic nervous system increases heart rate, restricts the diaphragm, disrupts digestion, and elicits other unsettling symptoms. The sympathetic nervous system cannot distinguish between a real and imaginary threat; therefore, anxiety is induced in unsuitable settings.
Anxiety is very uncomfortable, so as humans we try to avoid or alleviate it as much as possible. Anxiety triggers or obsessions reoccur and produce anxiety. To combat these triggers individuals utilize maladaptive means called responses, rituals, or compulsions. These are characterized as thoughts or actions that individuals perform which cause anxiety to decrease. These acts reduce anxiety in the moment but allow anxiety to permeate other facets of life. An example of a trigger could include a child’s fear of imperfection and the maladaptive response or ritual could be to take extraordinary measures to be perfect.
Empirical evidence has demonstrated that Cognitive Behavioral Therapy, specifically Exposure with Response Prevention is a highly effective treatment for young students and adults struggling with anxiety. ERP is also found to be more beneficial than medication alone. The goal of treatment is to reduce anxiety and build a tolerance of fears that produce anxiety. Furthermore, treatment aims to implement a more embracing attitude of anxiety, much like how humans embrace other emotions and learn to effectively cope rather than avoid them.
It is important to include proper family and school interventions when treating children with anxiety, which will improve the likelihood of a positive outcome. Students who present with anxiety symptoms typically have too little or too much support from family. This can perpetuate avoidance, anxiety rituals, and negative behaviors. Therefore, the family must be committed to treatment otherwise their child could continue to experience debilitating anxiety. Additionally, the school should provide accommodations for children with psychiatric disorders. Plans of accommodations such as the 504 plan can help the child demonstrate aptitude unencumbered by the effects of anxiety. A plan of accommodations should remain flexible and be modified to continue to meet the child’s changing needs. Sometimes schools underaccommodation or over utilize accommodation plans, both of which interfere with treatment progress. Communication and alliance among the treatment provider, the school, and the parents can ensure a most effective plan of accommodations.