© 2001 Michael J. Rieser, MD, PSC

School Recommendations For Students With Anxiety Disorders

(Such As Obsessive Compulsive Disorder, Panic Disorder, Separation

Anxiety Disorder, Generalized Anxiety Disorder, Phobic Disorders)

At the time that the student is being reintegrated into the school setting, anxiety is likely to be at itís worst. These students feel afraid to go to school, afraid of what may happen while they are in school, and are sensitive to the taunts and provocations directed at them by the peer group. Failure to attend to the special needs of such students who are in the recovery process often leads to school absenteeism.

One way of reducing anxiety for them is to provide them with a "SAFE PLACE" to which they can retreat in the middle of the school day when an attack of anxiety is taking place. By simply knowing that there a safe place in the school, the child will receive substantial relief. Often its availability does not mean the child actually uses it. But the knowledge that the place is available is anxiety relieving.

Therefore I recommend a specific PROGRAM be developed for this student which would allow the student to have such a SAFE PLACE. I prefer to use the school counselorís office, but perhaps the Principalís or Vice Principalís office would do if the counselor was unavailable.

SUGGESTED PROGRAM:

  1. The PROGRAM will have a specific period of time during which the child is able to go to the "SAFE PLACE". For this student, I would recommend this be a period of two months.
  2. PROGRAM re-evaluation after one month should determine the effectiveness and need for its continued use.
  3. PROGRAM re-evaluation may also occur if the child appears to be using the SAFE PLACE excessively or in the event that continued school attendance is in jeopardy.
  4. Each of the student's teachers should be notified that this student will be participating in a special PROGRAM.
  5. Careful attention should be made to protect the student's confidentiality by not over-informing the teachers of the details of the studentís mental condition.
  6. The student should be able to retreat to the SAFE PLACE at any time during the school day.
  7. The student should not receive any disciplinary measures or restrictions as a result of going to the SAFE PLACE.
  8. The student may miss certain parts of the school day and will be required to make this work up at a later time.
  9. The student may miss homework assignments while out of the classroom. In this case, the homework will need to be given to the student for makeup at another time. The student should not be "down-graded" for getting this homework in late.
  10. When the student is having an anxiety attack they need to notify the teacher that they have to go see the school counselor and then simply leave the classroom for the SAFE PLACE. All teachers should be advised of this special PROGRAM for this student so they will support the student's departure.
  11. For a period of one month, the teachers should not call on the student unexpectedly in the classroom. However, the student may be called upon if they have their hand in the air. By knowing that the teachers are not going to call on the student, the social anxiety of the student should fall substantially.
  12. In the case of separation anxiety, I recommend that two school officials be present at the curbside when the patient arrives by private vehicle so that the student may be escorted from the vehicle without the parent having to get out of the car seat. The parent can then drive away without fear that the student is going to chase the car or jeopardize his/her safety. It is highly recommended that parents who live on a bus line strongly encourage the student to use the conventional school bus to go to school in order to help them actually be placed in moderately anxiety provoking situations rather than take them to school. This will help strengthen the childís coping skills with anxiety. The school may need to get a confederate on board the bus in the beginning if the child is reluctant.
  13. If the student is feeling anxious and needs to "talk to mom or dad on the telephone" I recommend that the student be encouraged to express these feelings to the school counselor. This student should not be allowed to call home except in the case of medical emergency or illness. They should not be allowed to call home in order to "hear their parent's voice" and be reassured. Anxious students who are gratified by getting their parent on the telephone do not develop self-calming skills as readily as those anxious students who are "forced" to cope with their anxiety using the help of the counselor at school.
  14. Students who take medications at school for their anxiety condition should be given a special place and time to do so.
  15. Conventional disciplinary measures should be utilized for anxious students who have minor acting out or provocative behaviors. I would encourage the teachers to ignore these behaviors to the extent that they do not interfere with classroom activities of other students. For more serious violations of rules, including any type of aggressive behavior or deliberately provocative behavior, conventional disciplinary techniques may be utilized.
  16. The anxious student may feel better sitting close to the exit of the classroom, and may not be quite as agoraphobic.
  17. Transitions for the anxious student may need to be pre-arranged in the beginning until the anxiety is better controlled. This might include letting the anxious student leave the classroom to go to the next class a few minutes early.
  18. It is sometimes helpful to keep the child near the teacher, because these children tend to be inattentive and may need frequent reminders to stay on task.
  19. It may be necessary to determine any specific anxiety provoking activities that bother the student, then to allow the student to skip these activities as long as ongoing psychotherapy and/or psychiatric treatment is being provided to assist the child in overcoming these impairments.