Understanding and supporting children with anxiety – with a focus on a programme of intervention

We’ve only just begun to see the light at the end of the tunnel with covid restrictions lifting in schools and the delicate hope of things beginning to improve. Then suddenly, we are hit with shocking, frightening and devastating news about the Russian invasion of Ukraine.

There is a huge sense of uncertainty, fear and worry for everyone and children often hear conversations and parts of what is going on and also have their own fears, worries and anxieties to contend with. Hearing snippets of information from the radio, social media, news, or the school gates can all be incredibly traumatic to a child.

We are also all too aware of how anxiety in children has been on the rise even prior to the pandemic and the situation in Ukraine. Recent figures present an alarming picture with a 77% increase in severe mental ill-health¹ and 1 in 6 children with a mental health difficulty.²

In this article we are looking particularly at anxiety. Anxiety and depression are two of the most common mental health disorders and anxiety or excessive worrying leaves many children in a position where even seemingly small worries can be debilitating for them.

“Anxiety is a feeling of worry or fear that is experienced as a combination of physical sensations, thoughts and feelings… Anxiety can become a problem when a young person feels stuck in it, or when it feels like an overwhelming, distressing or unmanageable experience.”³

77% increase in severe mental ill-health.¹

BBC Data Referals
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1 in 6 children have a mental health difficulty

Anxiety can have both physical and psychological symptoms.

  • a pounding heart or palpitations
  • breathing faster
  • being fidgety or unable to sit still

  • feeling sick
  • chest pains
  • headaches
  • sweating
  • loss of appetite
  • feeling faint
  • needing the toilet more frequently
  • “butterflies” in their tummy
  • feeling worried or uneasy a lot of the time
  • having difficulty sleeping, which in turn makes them feel tired

  • lack of concentration

  • being irritable
  • being extra alert
  • feeling on edge/not able to relax

  • needing frequent reassurance

  • feeling tearful

The difference between normal worry and anxiety is severity. Anxiety becomes a problem for children when it starts to get in the way of their everyday life. The worries become too big to manage and present in distressed behaviours such as seeking constant reassurance, withdrawal or more challenging, reactive behaviour that is hard to soothe or manage.

Children with severe anxiety may become withdrawn and go to great lengths to avoid things or situations that make them feel anxious. If a child refuses to participate in activities other children enjoy, feels sick or complains of aches and pains, becomes clingy, withdrawn or avoidant, anxiety may be the cause. Severe anxiety can harm children’s mental and emotional wellbeing, affecting their self-esteem and confidence.

Everyone feels anxious sometimes, and feeling anxious is a perfectly natural reaction to some situations. But if feelings of anxiety are constant, overwhelming or out of proportion to the situation then it can impact on their wellbeing and if this happens children need help from a trusted adult to talk to and feel heard, to regulate them to feel calmer, and able to think about and express their experiences.

Research tells us that half of all mental ill-health begins in childhood before the age of 14 and 75% by the age of 24 ³ so the case for early intervention and providing children with universal, as well as targeted opportunities for intervention has never been stronger.

Our ‘Calm me’ programme provides a framework and structure for pastoral staff to use for targeted intervention, either one-to-one or in small groups of children displaying anxiety.

It enables the children to begin to understand and recognise signs of anxiety within themselves as well as others, helps them to know they are not alone with these feelings, and provides strategies to help them to self-regulate. The range of activities helps the children express, talk about and begin to work through their feelings. You want to listen and be empathetic, help them understand what they’re anxious about, and encourage them to feel that they can face their fears. The intervention programme helps children to:

  • recognise and notice the sensations in their body and how they are feeling inside,
  • understand what is happening inside them when they are worried or anxious,
  • explore ways to self-regulate when they are feeling worried,
  • develop the language to express how they are feeling and know how to ask for help,
  • discover ways to help them feel calm.

Central to the resource is the opportunity for children to feel listened to, heard and understood by an attuned and empathic, trusted adult. The relational aspect of the intervention that creates an environment of safety, trust and relational enrichment is crucial in enabling children to feel valued and emotionally held. The programme is designed to give the trusted adults the language, confidence and resources to lead quality intervention.

The children each have their own sock puppet pet to help them to express, share and develop understanding of their own and others’ feelings and experiences. This provides a way to explore their emotions in a safe and distanced way.

Sock Puppet Primary Wellbeing Activity

“Calm me is a wonderful programme that teaches children strategies to overcome some of their fears and worries and in doing so equips them for future challenges and allows them to grow in confidence. Children love the characters Hamish and Milo and they enjoy creating their own sock puppet which allows them to express their feelings and emotions in a safe learning environment. The activities suggested in the programme are fun and engaging and the parent information leaflet provides parents with not only details of the weekly programme but with tips to support their child through the programme and beyond.”

Cathy Darby, Primary Phase SEN Advisor, Total Children’s Therapy

The programme is underpinned by a wellbeing profile tool to help identify underlying or presenting behaviours, to recognise changes in presentation, and as an impact measurement. It can be used to support signposting for further care and as part of Education Health Care Plans or additional intervention. Dialogue with parents is encouraged as a central element of the resource through parent leaflets which help provide information, raise awareness and to support the development of a working alliance and collaborative approach.

We know from research that a whole school approach and culture of wellbeing is crucial for children’s mental health and having access to a rich emotional literacy curriculum is a core part of this.

There is growing evidence too that schools can make a significant difference in the delivery of a well planned, structured and targeted intervention, not only in identifying need but in providing programmes of qualitative intervention.

Research highlights the importance of a whole-school approach to mental health that involves a targeted element, ensuring that teachers and staff recognise pupils with emerging mental health needs and provide early support.4

We invite you to explore our Calm me programme to enhance intervention programmes in your school to support your children and alleviate the growing numbers of children who are too worried, stressed, and anxious.

Calm me - Wellbeing Profiles
Calm me - Parent Information Booklet

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