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A whole-school approach to managing anxiety in children and young people

Written By: Diana Ohene-Darko
8 min read

Introduction

Before we were out of the woods with the COVID-19 pandemic, we knew that additional support would be needed for the pastoral care, mental health and wellbeing of the children we teach. A whole school approach was needed to triage children and identify their needs, putting support in place at different levels, depending on the complexity. We had already seen an increase in levels of anxiety during the lockdowns and beyond. In general, children were less resilient, more anxious and found difficulty in resolving even small conflicts or perceived injustices between themselves. In short, social skills had taken a dive and with them, emotion regulation. More specifically, we saw an increase in anxiety.

Context

In 2021, our school took part in a ‘How Are You?’ survey that was completed by a number of different schools across our borough. This was partly to find out about the general mental health, physical health and wellbeing of young people but also to see what the main priorities might be in supporting them. From the survey, it was found that the percentage of young people who felt able to approach an adult at school or college was far lower than before the pandemic. The same was true for children and young people who felt teachers cared about them. This formed the basis for our work in terms of children knowing and being able to identify five key adults (three at school and two at home/in their families) that they could speak to if they had a worry or a concern – our top safeguarding and wellbeing priority and fundamental to all other safeguarding and wellbeing principles. The same survey found that 65 per cent of our children and young people often feel anxious or depressed. There was work to be done in addressing this more widely.

Strategic approach

Working across two schools, I had the fortunate position of being able to affect change in both. Initially we launched a ‘Be Safe Feel Safe’ (‘I Am Safe’ in another school) initiative in one school – a whole-school approach to safeguarding in the first instance so that our pupils knew how they were safe at school and could articulate this between themselves and others. First on the list – five trusted adults that they can tell a worry or concern to. By delivering a ‘safeguarding drop’ every week as part of assemblies, children were exposed to key messages week on week, including about their five trusted adults, their mental health and well-being, their physical safety on the premises and much more. Before long, this became an embedded part of practice at both schools, anchoring more specific, individual support for mental health and well-being more widely. This initiative alleviated anxiety on some levels both generally and for individuals, as observed by staff and parents, allowing children to actually feel safe and know the ways in which they are safe at school (see below for an example of ‘Child B’).

In line with this initiative, I was able to create a tiered approach to pastoral care across the school, with an initial triage strategy by our learning mentor. Children identified as struggling emotionally, socially or indeed with behaviour were referred to the learning mentor who undertook a strengths and difficulties task with the child, ahead of planning (often) bespoke support. Once this was complete, she and I would determine the type of support needed: 1-1 sessions for emotion regulation around their specific anxiety, small group work with others who share similar anxieties or a mixture of the two, or further support.

In the first instance, our model seeks to empower class teachers by giving that initial support in the class:

  • a visual timetable – this is a pictorial representation of the day, in chronological order, so that pupils can mentally prepare for what is next- this is especially useful for children on the Autistic Spectrum or those who exhibit anxieties for particular subjects/ times of the day
  • a worry box for children to anonymously (if they wish) raise any concerns
  • coloured card to signal feelings (red for I need to speak to you now, yellow for I need to speak to you but it can wait until break time)
  • strategies for communicating (TELL TELL TELL, talk it out to sort it out). These are in line with children knowing five adults they can speak to about a worry or concern- they should keep telling until they feel the matter has been sufficiently dealt with or resolved.

 

Tier One is the class teacher’s responsibility and includes quality first teaching to alleviate some of that initial anxiety that may be related to learning, social, emotional or behavioural needs or the special educational needs of a child.

Tier Two is very much in the hands of our Learning Mentor and Emotional Literacy Support Assistants (ELSAs). This work centres around identification of specific anxieties, social needs, behaviours or other mental health needs. At this level, children will have access to either 1-1 or group work designed to help them cope/deal with their anxiety independently. Some strategies include social stories, happy journal/worry book or check-ins by the adults. We have had a long-standing learning mentor for a number of years whose role it is to support children with early help for anxiety and other social, emotional or behavioural needs. The ELSAs are a new role created specifically to try and address the increased need for anxiety and emotional support in the first instance, particularly as a result of the pandemic. The learning mentor is more expertly trained and qualified in a number of different therapies. The ELSAs are trained specifically for low-level emotional and anxiety support. This was identified as a clear needs from when schools re-opened after even the first lockdown, such was the difference observed in children’s emotional health.

Tier Three is for those children whose need has been identified as more significant and requires a long-term method of support. In these cases, children have already accessed Tier Two but remain anxious. At this level, children may access drawing and talking therapy, Lego therapy, sand therapy, a more bespoke programme for managing their anxiety, wellbeing sessions or even transition groups if the anxiety is related to moving on (e.g. to high school). In this way, specific anxieties can be addressed with the child, helping them to identify their own emotions that come with it and empower them with strategies for coping- treating the root cause if you like. Separate to this, should a child have anxiety related to a bereavement or other significant loss, we have a bespoke programme that we run (Rainbows for key stage two, Sunbeams for the Early Years Foundation Stage and key stage one); children access a fourteen-week course, run by trained and certified facilitators.

At Tier Four, external agencies become involved because of a high level of need. This could be a counsellor, the Child and Adult Mental Health Service or a GP/paediatrician, often with support from the Special Educational Needs Co-ordinator to liaise between families and these external services.

It has to be said, the idea is not to eliminate the anxiety, rather to help children and young people to be able to understand how they feel and why, and enable them to cope. Part of this is sometimes desensitisation; a gradual exposure of the anxiety-provoking source to the child. Another part is allowing their fears but not amplifying them; listening to the child, understanding where they are coming from whilst also giving them perspective in a nurturing and empathetic way. The end goal is to encourage and support children to engage with life, rather than allowing the anxiety to take control. With continued discussions with the child, a collaborative approach can be found in meeting their needs and bringing about the very best outcomes for them. Our ‘no learner left behind’ approach spans the entire school whether the need is related to mental health, well-being, behaviour, social or emotional needs, or indeed special educational needs.

In focus: Child B

Context

Child B enjoys school and has an incredibly supportive family. During the lockdown parents noticed changes in Child B’s mood. Child B is generally a happy child but can quickly become upset and/or angry. Parents made a valiant effort to talk to Child B about their feelings and suggested trying a counsellor. As this was during lockdown only online sessions were available and after trying a session Child B refused to engage with the counsellor again. As the school year progressed and children were being prepared to sit National Curriculum Assessments, Child B started becoming more anxious. Parents noticed Child B had started to self-harm and was having trouble sleeping. Parents were keen for Child B to see a counsellor, but there was still refusal from Child B. Parents made contact with the school to see what support could be put in place. It was agreed that initial sessions with the Learning Mentor, to build up a rapport, would be useful in providing a safe space for Child B to open up.

Barriers to learning
  • Setting own expectations to high
  • Wanting to be as good as or better than high achieving sibling
  • Sensory overload
  • Repetitive negative thoughts
  • Overthinking
  • Replaying worst case scenarios over and over.

 

A number of interventions and support was provided over the course of approximately two years. This included learning about emotions and emotion regulation (identifying the problem and an appropriate reaction in terms of the anxiety it provoked) as well as to think realistically, setting expectations that could be met comfortably. Additionally, Child B agreed to see a counsellor, whilst still accessing ongoing support from our Learning Mentor as part of her overall well-being. The Learning Mentor accompanied Child B to an initial session and then Child B took this on independently. In response to the support given, it was commented that: “I understand it’s not always going to be as bad as I think and that I can talk to adults that can help me, I have also found ways to help myself and keep me calm.”

With trauma-informed knowledge and understanding, as a leader, I come from the point of view of, ‘What happened to you?’(Perry and Winfrey, 2021), a key question to consider when thinking about the support needed for children. Anxiety presents in behaviours and both need to be understood in order for the best outcomes to be achieved. Our safeguarding (Be Safe Feel Safe) and tiered approaches allow no learner to be left behind because they are identified early and support is put in place, where the child is firmly at the centre of everything we do.

References
  • Perry BD and Winfrey O (2021) What Happened To You? Conversations on Trauma, Resilience and Healing. New York: Flatiron Books.
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