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Mastery and
                                                Confidence
Kootenay Lake School District #8
                                                Recognizing students’
Nelson, British Columbia
Learning Support Capacity Building Day          anxiety and helping them
December 7, 2012
Todd Kettner, Ph.D. , Registered Psychologist   overcome their fears
We want students to:
Learn well
Be socially competent
Be successful in life
Other wishes for our students?
                  Copyright 2012 Todd Kettner, Ph.D. 250-505-7019
QUIZ AT END
Unfortunately,
Anxiety gets in the way of…
Learning
Social Competence
Lifelong Success
UNDERSTANDING
ANXIETY
Anxiety
Some Examples
Thoughts




Actions




                                             Emotions


Managing our anxiety and depression AND improving our physical health outcomes
Prevalence of anxiety disorders
  in children and adolescents


        10% to 20%
Neuroanatomy of Anxiety
Main Types of Anxiety Disorders

  Panic Disorder
  Agoraphobia
  Specific Phobia
  Social Phobia (Social Anxiety)
  Obsessive Compulsive Disorder
  Posttraumatic Stress Disorder
  Generalized Anxiety Disorder
           Copyright 2012 Todd Kettner, Ph.D. 250-505-7019
RECOGNIZING WORRY
AND ANXIETY IN
CHILDREN AND TEENS
Physical Symptoms
Cognitive Symptoms
Behavioural Symptoms
Emotional Contagion



   Laughter
Emotional Contagion


  Anxiety and Stress
peers
parents
educators
Classroom Strategies




Helping our students gain mastery
Yerkes Dodson Law
Classroom Strategies

    Teacher and peer
       modeling
Classroom Strategies

  Relaxation Exercises
Graduated Mastery




Classroom Strategies
Classroom Strategies

     Structure and
     Predictability
Classroom Strategies

     Gentle Logic
Classroom Strategies

        Tests
Help
 Outside
   the
Classroom
Parental Supports
Sleep hygiene
Exercise
Information
Resolve real issues
Referral for support
      Copyright 2012 Todd Kettner, Ph.D. 250-505-7019
School Supports
Learning Support Teacher
School Counselor
Psychologist
Community Supports
Nelson Community Services
Child and Youth Mental Health
Private counselors
Family physician
Referral from family physician to
pediatrician
Photos credits (mostly from Flickr)

1.    Anxious Teen by Holly
2.    Learning by woodleywonderworks
3.    Social Competence by Purhoor Photograpy
4.    Lifelong Success by Jorge Franganillo
5.    Amygdala - unknown
6.    Spider by Dincordero
7.    Spider on eye blog.ericlamb.net
8.    Beach by Zanzibar
9.    Yerkes Dodson – secretgeek.net
10.   Scared Child by Espon Faugstad
11.   Distressed Teen in Car by PLCjr
12.   Peers by teapics
13.   Parents by phub.com.au
14.   Educators – apa.org
15.   Classroom by horizontal.ingegration
16.   Counselor in chair by Parker Knight
17.   Staircase by Gwenael Piaser
Anxiety BC’s Excellent Website
  Resources. Results. Relief.

Information for Children, Teens,
      Parents, and Adults
    http://www.anxietybc.com/
Resources for Teachers:
Fostering Resilience in Students
   with Mental Health Issues
http://keltymentalhealth.ca/education
Handouts for:
      Relaxed Breathing
  Building Social Confidence
      Overcoming Fears
Progressive Muscle Relaxation

http://youth.anxietybc.com/resources
Empirically Validated Quick
   Screening Measures for:
         Depression
            Anxiety
            Stress
         Alcohol Use
        Social Anxiety
           Drug Use
http://www.mindcheck.ca/mood-stress
QUIZ
1.   What three main things did we discuss that anxiety gets in the
     way of for our students? (must name all 3 for 2 points)
2.   True or false. A recent student published in the Canadian Journal
     of Public Health showed anxiety is more prevalent among female
     than male students. (1 point)
3.   One studied showed adolescent anxiety or depressive disorders
     predicted a ____ risk of adult anxiety or depressive disorders.
     a) 50% b) 100% c) >200% (1 point)
4.   Explain emotional contagion and the role it plays in the
     maintenance of anxiety in students. (3 points)
5.   Which two of the classroom strategies discussed do you feel is
     most important or relevant to your students? Why? (2 points)

                       Copyright 2012 Todd Kettner, Ph.D. 250-505-7019

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Mastering Anxiety - Teaching Strategies for Building Student Confidence

Notas del editor

  1. There will be a quiz!
  2. The Prevalence of Anxiety Among Middle and Secondary School Students in CanadaLucia Tramonte, PhD,1 Doug Willms, PhD2Can J Public Health 2010;101(Suppl. 3):S19-S22.ABSTRACTObjectives: Adolescents’ anxiety is associated with individual and contextual characteristics. The purpose of this study is to estimate the prevalence of anxiety among adolescent youth in grades 6 to 12 and determine whether it is related to socio-economic status and perceptions of learning skills and challenges.Methods: Nationally representative cross-sectional data from the Tell Them From Me survey – Fall 2008 assessment – were used for this study. Item response theory estimates and a cut-off point for anxiety were developed from six Likert items pertaining to anxiety. Csikszentmihalyi’s theory of flow was applied to create four different combinations of learning processes and students’ skills.Results: Females had a higher prevalence of anxiety than males in both middle and secondary schools. The prevalence of anxiety did not varysubstantially among schools for either middle or secondary schools. Less than one half of Canadian students can be considered “in flow”, that is, feeling confident in their skills and challenged in their classes. Students who lacked confidence in their skills were nearly twice as likely to experience anxiety.Conclusion: The relation between students’ skills, the challenges presented to them at school and anxiety problems deserves attention by parents and school staff. Further research could examine the relationship between direct assessments of students’ skills and measures of teaching practices andschool policies.Key words: Anxiety; adolescents; skills; learning challenge; flow; TTFM survey; schoolsCan J Public Health 2010;101(Suppl. 3):S19-S22.
  3. http://www.nimh.nih.gov/statistics/1SOC_CHILD.shtml Merkingas KR, he, J, Burstein M, Swanson, SA et. Al. J Am Acad Child Adlesc Psychiatry. 2-1 Oct:49 (10):980-989. 5.5% of 13 to 18 year olds would have Social Anxiety during their teens.
  4. “An epidemiologically selected sample of 776 young people living in upstate New York received DSM-based psychiatric assessments in 1983, 1985, and 1992 using structured interviews…In simple logistic models, adolescent anxiety or depressive disorders predicted an approximate 2- to 3-fold increased risk for adulthood anxiety or depressive disorders.”Arch Gen Psychiatry. 1998 Jan;55(1):56-64.The risk for early-adulthood anxiety and depressive disorders in adolescents with anxiety and depressive disorders.Pine DS, Cohen P, Gurley D, Brook J, Ma Y.http://www.ncbi.nlm.nih.gov/pubmed/9435761/ Extrapolating Canadian annual cost of anxiety disorders (direct and indirect) at $65 Billion from DuPont, R. L., DuPont, C. M. & Rice, D. P. (2002). Economic costs of anxiety disorders. In D. J. Stein & E. Hollander (Eds.). Textbook of Anxiety Disorders. AmericanPsychiatric Publishing: Washington, D.C. referenced in Invited Submission to the Standing Senate Committee on Social Affairs, Science and Technology, prepared by the Anxiety Disorders Association of Canada/AssociationCanadienne des Troubles Anxieux, June 2003. http://www.anxietycanada.ca/english/pdf/kirby.pdf This submission also states that anxiety disorders are the most common mental health problems among Canadians with a 12% one year prevalence and >25% lifetime prevalence.
  5. Approximately 40% of most psychological characteristics (anxious/easygoing, optimistic/pessimistic) are genetically related. Makes sense when we think of heritability of height, set-point for body weight, propensity towards heart disease and towards alcohol misuse.Huge amount of variance left for modeling, socialization, and learning.
  6. PsychiatrClin North Am. 2009 September; 32(3): 483–524. doi: 10.1016/j.psc.2009.06.002Anxiety and Anxiety Disorders in Children and Adolescents: Developmental Issues and Implications for DSM-VKatjaBeesdo, PhD,a,*Susanne Knappe, Dipl-Psych,a and Daniel S. Pine, MDbhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC3018839/Prevalence was found to be 15 to 20%. Other studies have shown somewhat lower prevalence rates.
  7. Serotonin, Glutamate, Dopamine, GABA, Aceytocholine http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1847471/ Neural Plast. 2007; 2007: 78171. Published online 2007 January 10. doi: 10.1155/2007/78171PMCID: PMC1847471Neurobiology of Memory and Anxiety: From Genes to BehaviorAllan V. Kalueff*Adrenaline and cortisol are also involved in motor and muscle responses to stress and anxiety, thus, to be simplistic, exercise helps “flush” these neurotransmitters out of the
  8. Relaxed breathing exerciseOrProgressive muscle relaxation
  9. Think of a discuss a student, using a pseudonym, in groups with your school colleagues.Who is one of the most visibly anxious students you’ve taught? How does this student view the world? What behaviors are evident?Who is on of the most quietly and unobtrusively anxious students you’ve taught? How does this student view the world? What behaviors are evident?
  10. CryingMuscle tensionHeadachesStomach achesNail bitingPicking at skinFidgetinessIncreased heart rateSweatingShallow breathingDizzinessFatigueDisrupted sleepFeeling of chokingFeeling nauseasTightness in chestTremblingNumbness or tingling sensationsExtreme anxiety can lead to hair loss, trichotillomania, rashes
  11. Difficulty concentratingFear of illness – “I must be having a heart attack”Fear of losing it – “I’m going crazy”Fear of abandonment – “My girlfriend might leave me”Fear of failure – “I’m going to flunk the exam”Fear of rejection – “Nobody will like me at Trafalgar”Fear of fear – “I know I’ll have a panic attack if I go the Bombers basketball game”Fear of criticism – “My teacher won’t like the story I wrote.” “My parents will think the money they spent on my new hockey equipment was a complete waste”Fear of success – “I don’t want to try out for choir because my friends think I have a good voice and if I made it, then I’d have to be on stage”Fear of death Fear of lossFear of catastrophy if something isn’t in the right order or sequence
  12. AVOIDANCESchool refusalSkipping classDropping out of sportsAlcohol, pot, other drugs to avoid anxiety or other challenging emotions“Losing homework”Not wanting friends overRefusal of overnights at friends, relatives, school trips, summer campsTantrumsYellingSometimes even physical aggression – “had to drag him kicking and screaming”
  13. Emotional Contagion (Studies in Emotion and Social Interaction) [Paperback] Elaine Hatfield , John T. CacioppoRichard L. Rapson 1993Popularized in Malcolm Gladwell’s 2002 Bestseller “The Tipping Point.”Examples: EMTs and ER nurses. Teachers who talk quieter and more calmly in order to “infect” their loud and boisterous students with their calm and quiet.
  14. PMR
  15. Practice in groups mixed of at least one elementary, one middle, one high school.
  16. Role-play example, then groups of 3. Teacher, student, observer.
  17. Learning, Social Competence, Lifelong Success (2 points if all three)True (1 point)C : 2 to 3 times more likely (1 point)3 points2 pointsTotal = 9 points