In the US, we have what are called 504 plans. These accommodation plans are the result of an important federal statute (Section 504 of the Americans with Disabilities Act) that guarantees all children have equal access to educational opportunities. I have learned during my recent visits to Canada that similar educational plans are created through IPP planning. If you’ve ever heard me speak or are familiar with my approach to treating anxiety, what I’m about to say will come as no surprise: Regardless of what we call them, almost every accommodation plan I have ever seen for an anxiety disorder actually makes the anxiety stronger. I’m not exaggerating.
Why? Because schools and parents act in a loving, caring, helpful manner…and seek to provide the student with the comfort and certainty that anxiety feeds upon. Of course concerned adults want to keep anxious kids in school, but when the plan focuses on allowing a child to avoid anxiety-provoking situations, the child never learns the skills necessary to step toward challenges rather than away from them.
Think of it this way: anxious children already know how to get out of things. That’s anxiety’s main coping strategy. If the accommodation plan is based on creating escapes, avoiding challenges and keeping the classroom “safe” (which to anxiety means keeping the environment predictable and comfortable) then adults are actually making the anxiety stronger and more permanent. To manage anxiety in a new way, the child must learn how to stay in the situation and thus respond differently to the thoughts, feeling and sensations that worry and anxiety create.
When creating, updating, or reviewing an accommodation plan for anxiety, keep these guidelines in mind:
- All plans for anxiety should be based on teaching the skills of managing anxiety when it arrives, rather than eliminating or avoiding triggers.
- Plans should have a “weaning off” component that moves the child toward more independence and less accommodation. And in my experience, weaning can happen quickly (weeks) once the skills are in place and everyone is working together.
- If a plan has been in place for several months or even years with no changes in a positive direction, then the approach to the child’s anxiety disorder should be evaluated.*
- If a plan allows a child to leave the classroom, there must be a plan for HOW the child will deal with the anxiety and return as soon as possible… and adults must be aware of the plan.
- A child will benefit greatly from an adult to coach and support her as she moves into anxiety provoking situations. That coach must be familiar with the plan that, in a nutshell, expects anxiety to arrive, externalizes it (steps back from it, talks back to it, reacts differently to it) and experiments with the anxiety by taking steps toward the anxiety rather than away from it.
I heard recently of an accommodation for a high school student with social anxiety. He was not to be called on in class and was exempt from doing presentations in front of his peers. This plan had been in place since seventh grade. This bright 17 year old was now looking ahead to college, but his plan had excused him from learning HOW to feel anxious, manage that process, and take a risk. His anxious behavior had been cemented, not challenged. I wonder how he’ll be able to get through a college course on his own.
Am I asking a lot of schools? Absolutely. I do the same of parents. But I’m only so bossy because anxiety is so treatable and I just can’t stand to watch it take charge! The great news is that the workshops Reid Wilson have been doing in Canada and in the United States have been PACKED with teachers, guidance counselors and school nurses hungry for information on how to help their anxious students.
Everywhere I look–websites, books, internet articles, even Pinterest–I see accommodation plans that make anxiety applaud and cheer. “Make sure your anxious child has all the information ahead of time.” “Send a note home a day ahead if there’s going to be a change in the school routine.” “Warn anxious children of fire drills and allow them to skip noisy assemblies.” “Find a safe place for the child can go until she feels comfortable and ready to return to the classroom.”
Hurray! says Anxiety.
Boo! says Lynn.
Please trust me when I tell you that such well-meaning and short-term solutions are the opposite of what we need to do for anxious children.
* The school, the parents, and the treating therapist must be working together with the child on the same “step into it” plan. Recommendations from a therapist or parents that accommodate the anxiety are virtually impossible for the school to contradict.
Other articles written by Lynn Lyons:
Spring Time Worries | View Here
Lynn Lyons has been a psychotherapist for over 23 years and specializes in the treatment of anxious children and their parents, with a special interest in interrupting the generational patterns of anxiety in families. She is the coauthor with Reid Wilson, Ph.D, of Anxious Kids, Anxious Parents: 7 Ways to Stop the Worry Cycle and Raise Courageous and Independent Children and the companion book Playing with Anxiety: Casey’s Guide for Teens and Kids.