Keys to Helping Socially Anxious Teenagers
The problem of social anxiety disorder in teenagers
It comes as a surprise to many parents and educators that anxiety is the most prevalent mental health problem in children. According to the US Surgeon General's report on mental health , 13% of children and adolescents suffer from anxiety disorders, which is 1 in 8 children aged 9 to 17. Social anxiety is the most common anxiety disorder in teenagers, and is associated with significant impairment in functioning and long-term negative outcomes such as depression and alcohol use. Unfortunately, many teenagers with social anxiety go undetected and without appropriate treatment. Therefore, being able to identify the warning signs in youngsters is important to early detection and intervention efforts.
A typical case of a teenager with social anxiety disorder
Sean is a quiet 17-year-old who is easily "lost in the crowd." His grades are above average in school and he is compliant. and well-behaved in class He keeps to himself and does not speak to many peers. He has one or two friends he made in first grade. Sean avoids being around his peers and seems to be intensely uncomfortable in situations where there are large numbers of students, such as in the cafeteria or gym class. He has not joined any school clubs and goes home immediately after school. The teacher has encouraged him to speak up but he withdraws more or becomes angry.
Common symptoms of social anxiety disorder
- Intense fear of social and performance situations
- Avoids social situations or endures them with intense distress
- Fears situations such as unstructured interactions with peers, initiating conversations, performing in front of others, inviting others to get together, talking on the telephone, and eating in front of others
- Minimal interaction and conversation with peers
- Appears isolated and on the fringes of the group
- May sit alone in the library or cafeteria, hang back,
- Excessive shyness
- Concern about negative evaluation, humiliation or embarrassment
- Difficulty with public speaking, reading aloud, being called on in class, gym class
- Anticipation of a social event may provoke a panic attack
What treatment approach is most effective for social anxiety disorder?
The scientific literature supports the use of Cognitive Behavior Therapy (CBT) for treating social anxiety disorder. CBT uses practical and logical strategies directed at changing the factors that maintain anxiety such as negative thoughts or expectations, physical symptoms, avoidance, and the reactions and responses of adults to an anxious child. Children learn to think more realistically about fears and to confront the feared social situations. Training in social skills such as initiating conversations, inviting others to get together, and being assertive are also incorporated into treatment.
What can schools do to assist socially anxious teenagers?
- Provide Education and Training for school personnel that would increase awareness of anxiety disorders, identify specific criteria to determine need for intervention, recognize anxiety as a legitimate disorder rather than willful misbehavior, teach appropriate skills to manage anxiety in school and educate parents of children with anxiety about the problem.
- Establish Helping Partnerships between parents and school personnel. It is critical that both be involved so that progress made in one place is not undone by the other. A school counselor can organize all involved individuals.
- Maintain a Physically and Emotionally Supportive Environment for anxious teenagers at school by: 1) being inclusive in class activities and ensuring opportunities for shy children to participate, 2) using structured classroom activities or assigning partners so that shy children are not left out, 3) assigning a classroom buddy who provides support and assistance, 4) providing structured social activities and assisting the initiation of social interactions, and 5) rewarding efforts to initiate social interaction.
- Define Specific Problem-Focused Interventions that help address specific goals and increase confidence. For example, a student might be encouraged to ask two questions in class, ask two kids what they did over the weekend or start a conversation in the cafeteria about the food.
- Make Appropriate and Timely Referrals to Mental Health Professionals.
Reprinted with the permission of the NYU Child Study Center. © NYU Child Study Center.