This week let’s talk about what a parent can do to help their child overcome anxiety.  First, take your son or daughter to his/her pediatrician and seek a recommendation to a mental health professional in your area who works with children.  The mental health professional will give your child a comprehensive evaluation.  The evaluation will reveal the reasons behind the school refusal and can help determine what kind of treatment will be best. 

If you can’t get into the mental health specialist quickly there are some things that a parent can do while waiting for an appointment.

The Anxiety Disorders Association of America recommends the following tips to help your child develop coping strategies for school anxieties and other stressful situations:

1. Expose children to school in small degrees, increasing exposure slowly over time.  Eventually this will help them realize there is nothing to fear and that nothing bad will happen.
2. Talk with your child about feelings and fears, which helps reduce them.
3. Emphasize the positive aspects of going to school and being with friends, learning a favorite subject, and playing at recess.
4. Arrange an informal meeting with your child’s teacher away from the classroom.  For middle and high school students, arrange a meeting with the guidance counselor.
5. Meet with the school guidance counselor for extra support and direction.
6. Try self-help methods with your child.  In addition to a therapist’s recommendations, a good self-help book will provide relaxation techniques.  Be open to new ideas so that your child is, too.

As a counselor who has worked with at least 10 students with severe school avoidance anxieties over the past 24 years, I would add to the above recommendation by the ADAA that families work together as a cohesive group and not allow the student to sabotage the work of the mental health professionals and counselors. Be very patient as results do not come quickly in some instances.

There are many reasons why anxiety takes hold of a person or specifically a student who refuses to attend school because of it. Starting school, moving, and many other stressful life events may trigger school refusal. Some other reasons include the student’s fear that something will happen to a parent while he or she is in school. Sometimes the fear can be that the student will not do well in school or the student may fear other students whether the fear is real or not. There is a deeper problem of anxiety-based school refusal that affects between 2 to 5 percent of school-age students. According to the Anxiety Disorders Association of America, it usually occurs between ages 5 and 6 and between 10 and 11, and at times of transition, such as entering middle and high school.

Often students who suffer from anxiety related to school refusal will have average or above-average intelligence. These students may develop serious educational or social problems if their fears keep them from school and friends for any length of time.

Last week we talked about students who experience anxiety related to school. Let’s continue discussing anxiety related to school attendance. Students who refuse to attend school may complain of physical symptoms just before it is time to leave for school or repeatedly ask to visit the school nurse. Parents will often notice that when these students are allowed to stay home, the symptoms quickly disappear, but will reappear the next morning. This behavior can eventually graduate to the point where a student will refuse to leave the house. 

Here are a few symptoms to look for if one of your children is have trouble handling nervousness or anxiety. Common physical symptoms include headaches, stomachaches, nausea, or diarrhea. You may also see other symptoms such as tantrums, inflexibility, separation anxiety, avoidance, and defiance.

Last month we addressed the issue of stress and looked at some ways to help manage it. This month we will talk about anxiety and some basic symptoms to look for. Also, towards the middle of the month I’ll offer parents some suggestions on what to do to help your sons/daughters or even yourself with anxiety. 

Nervousness and anxiety are normal and most students are likely to experience anxiety at the beginning of the school year or even before each test or project. Anxiety becomes a problem when you experience persistent and excessive nervousness that interferes with everyday activities. For students, excessive anxiety can interfere with academic, behavioral, emotional and social development. One example of severe anxiety is when a student begins to experience nervousness and anxiety at the beginning of a school year and can’t seem to get over these jitters. This student may refuse to attend school or has problems staying in school. Often students may complain about feeling sick on school days or ask to stay home from school with physical complaints, such as stomachaches or headaches that are not related to a physical illness. These symptoms could point to an anxiety disorder and a proper evaluation by a doctor would need to take place in order for diagnoses to be made. 

Another way to keep situations from becoming too stressful is effective communication skills.

What is communication? Communication is an exchange between two people. One speaks and the other listens. The goal of good communication is to have the person receiving information receive it accurately or exactly as intended by the giver. Below are ways to communicate effectively:

Verbal Communication (through the spoken or written word)
1. Be direct. People who hint at what they are trying to say are seen as being evasive.
2. Think before you communicate. What do you really want to say?
3. Communicate as soon as you are ready. Don’t let negative emotions or anxiety build up.
4. Be clear, precise and brief. Don’t risk being misunderstood.
5. Be honest. This earns you respect in the long run.
6. Listen. Ask questions to clarify.

Nonverbal Communication
The way you send unspoken messages is the most basic from of communication. Your hand gesture, eye movements, facial expressions, posture, and tone of voice are all types of nonverbal communication.
1. Be aware of what others are communicating to you nonverbally.
2. Don’t contradict your words with your body language.

A Strategy for Communication in Difficult or Stressful Situations
To generate successful communication and avoid blame, use an “I” message:
Avoid starting your statements with “you”.
1. I felt nervous when I came home and the door was unlocked because I want to feel safe when I come home.
2. I felt angry when you took my CD without asking because I want to be able to trust you.
3. I felt angry when you flirted with my boyfriend because I need to be able to trust you.

Here is the format:
I feel ____________when _______________ because I want (or need) ___________.

One way to keep from being over taken by stress is to set goals.

Identify a goal and your purpose!

GOALS WILL HELP YOU SEE YOUR PURPOSE CLEARLY.
What is a goal?  A goal is an object of what you aim or strive to attain.  We all have special talents.  We need to consider our personal strengths and work with them to attain good things.

WHY SET GOALS?
As humans we all are given energy to take care of ourselves.  It is easy to become overwhelmed by activities unless you begin to MAKE CONSCIOUS DECISIONS! 

You may set short-term goals like:

• I will earn passing grades
• I will get a part-time job
• I will make new friends

You may set long-term goals like:

• I will get along with my family
• I will do what is necessary for me to become a technician
• I will learn to write and spell better

Goals incorporate a few things like:

• Priorities
• Time management
• Set a schedule
• Stay flexible

What are some of your short term goals?

What are some of your long term goals?

First is to recognize that stress can be harmful. Persistent stress can often lead to anxiety and unhealthy behaviors like abuse of alcohol or drugs or negative eating behaviors.  Anxiety can also be accompanied by physical symptoms, including:

• Twitching or trembling
• Sweating
• Dry mouth
• Abdominal pain
• Muscle tension
• Headaches

If you are experiencing stress or anxiety you can begin seeking help by seeing your health care provider. You can also see your guidance counselor if you prefer to have help navigating the medical field. 
DISCLAIMER: Our mission is health education, particularly at the high school level. This is not medical advice. For help with a personal health concern, please consult your qualified health care provider.

This week let’s talk about ways to manage stress.
How can I manage my stress?

• Be realistic in your expectations of yourself and others.
• Manage your time.  Don’t put yourself in crunch time situations to study or get a school project completed.
• Develop healthy habits: eat well, get plenty of sleep, drink plenty of water, and avoid soda with caffeine.
• If you are having a problem, talk it over with a trusted friend or adult.
• Take appropriate action.

There are four keys to coping:

1. Problem solving – the ability to deal directly with, not avoid, the problems you face and make positive changes to resolve them.
2. Communication – the ability to honestly share thoughts and feelings with others to promote mutual understanding.
3. Closeness – a comfort level with others and the ability to connect with people in your environment.
4. Flexibility – an openness and ability to respond to change.

Healthy Coping skills are…

• Knowing that we control our lives
• If we have conflict or failure, we can change the situation.  (There is no such thing as a mistake.  If we learn something, it is a LESSON.)
• If we can’t get what we want, then we can make a situation the best it can be.
• Sometimes we have to ACCEPT that a situation IS the best it can be.
• Accepting an unfortunate situation causes us pain because we don’t want to lose something we want.
• Pain is temporary; IT PASSES WITH TIME.

The beginning of the school year can be very stressful. For this reason, I would like to address stress in general and the coping skills you will need to help you succeed.  If there is something that is making you worry; this is emotional stress. Another form of stress is caused by illness, lack of sleep or good nutrition. Even trying to help friends can cause stress.

What is stress?
It’s the pressure you feel when your body reacts to a threat or a challenge. Your heart beats faster and your palms may get sweaty. You feel tense, nervous, and even fearful. 

Let’s expand this definition. To your body, stress is anything that causes a change in your life. It can be a good change or bad change, none the less, to your body it’s all the same.

Why should I learn about stress?
If you experience too much stress over a long period of time, it can leave you burned out or even ill. Stress can:

• Interfere with your friendships an daily activities
• Make you less productive at school
• Create problems at home with your family
• Lead to serious health problems in your adult life

What are the causes of stress?

• Change of any type (moving, entering high school)
• Family problems
• Test taking
• Trying to “fix” something that is not really your business

To often people experience too much stress over a long period of time. When this happens and nothing is done about it, your body will begin to feel the affects by leaving you feeling exhausted, burned out, ill or very depressed. You can also begin to have anxiety attacks or even panic attacks.

Stress can interfere with your friendships and daily activities. For students it can make you less productive at school, create problems at home with your family and even lead to serious health problems immediately or later in life.

Talk to your parents or see your school guidance counselor if you have any concerns regarding stress.