• By Laura Whybra
  • Posted on Monday 14th September, 2015

Turning anxiety prevention into a “win-win” for students and schools

strong>Schools seem an obvious place to prevent anxiety and other, less common emotional problems among youth. Yet persuading teaching staff to make precious curriculum time available can prove difficult. Might a program that reduces test and exam anxieties prove the key to opening classroom doors? Chronic anxiety is among the most frequently found emotional difficulties among young people, linked to underachievement in school and an increased risk of adult anxiety disorders, clinical depression and substance misuse. Efforts to stop problems falling below the radar in schools have, nevertheless, been hampered by problems convincing policy makers and school officials that prevention efforts deserve priority.By offering schools an intervention that focused on anxiety about achievement tests and other examinations, Carl Weems and a team of researchers in New Orleans believe they are developing a “win-win” approach to prevention that students find acceptable and that schools can implement as a way to improve their results, reputation and funding. But crucially they also note that test anxiety is often only a manifestation of wider stress and highly correlated with symptoms of anxiety disorders. Thus, theoretically, a “test anxiety management” intervention would help to tackle a wider range of emotional problems. Building on studies concerned with preventing test anxiety among college students, Dr. Weems and his colleagues achieved promising results with an intervention seeking to improve academic achievement among high school students. This encouraged them to study their approach on a larger scale and with younger students – aged 8 to 17 – attending public schools in New Orleans.As an exceptional added dimension, their research took place three years after Hurricane Katrina had turned the city into a disaster zone, affecting a majority of the 1,048 young people initially screened for the study in potentially traumatic ways such as having their home badly damaged or fearing that someone might die. The students were predominantly African-American and from low-income families.Elevated anxiety levelsFrom the original group, 325 youth selected to take part in the intervention on basis of questionnaires revealing elevated levels of anxiety about school tests or, in some cases, because school staff considered they would benefit from the anxiety reduction program. Of these, 165 students took part in the intervention during a first wave and were compared to 118 students in a wait-list control group who received the intervention in a second wave. The study also tracked a group of 163 young people who had low test-anxiety scores in the screening exercise as a further comparison. Questionnaire measurements of test anxiety, child anxiety and depression, anxiety management and symptoms of post-traumatic stress disorder (PTSD) were carried out before the prevention program started, immediately after it ended and for three follow-up assessments over the next 23 to 29 months.The intervention was delivered as part of the school counseling curriculum and consisted of behavioral strategies, such as relaxation training and gradual exposure to anxiety-provoking situations related to achievement tests. The program also adopted tried and tested methods for improving students’ sense of self-efficacy, including praise and encouragement. Students, working in groups of 4 to 8 took part in five sessions over a 4 to 6 week period. These were led by advanced graduate students, who were purpose- trained and supervised. “Less afraid”The study found that 73 per cent of participants said they felt less afraid and anxious about tests following the program. Comparisons between the youth in the first wave and the wait-list control group not only pointed to significant reductions in test-based anxiety, but also PTSD symptoms and general anxiety and depression. Among older participants (those in Grade 9 and above) there was also an improvement in perceived control over anxiety. The follow-up analysis, comparing 157 young people who completed the program with the 163 low-anxiety students, suggested that positive benefits were being maintained. The youth who received the intervention (because of initially high levels of test anxiety) were improving at a faster rate than their non-anxious counterparts. The researchers do not consider that their intervention provides a first-line approach to dealing with PTSD and other severe anxiety disorders (where cognitive behavioral interventions show more promise). But they do suggest their model may provide a way of preventing anxiety, depression and other emotional problems among youth in a way that students find acceptable and will work with the grain of school organization and priorities:“A test anxiety indicated/selected program may be a unique avenue to decrease perceived stigma while providing cost-effective intervention.”While the study adopted a comparison design, it was not conducted as a randomized controlled trial – and there were other limitations that suggest important directions for further research and replication. These include testing the approach with students from other ethnic, cultural and socio-economic groups. The researchers’ view that a test anxiety focus is more likely to persuade schools to accept programs for screening and preventing emotional problems also requires further testing, not least an assessment of satisfaction among teachers, counselors, administrators and school principals.************ReferenceWeems, C. F., Scott, B. G., Graham, R. A., Banks, D. M., Russell, J. D., Taylor, L. K., Cannon, M.F., Varela, R.E., Sheeringa, M.A., Perry, A.M. & Marino, R. C. (2015). Fitting Anxious Emotion-Focused Intervention into the Ecology of Schools: Results from a Test Anxiety Program Evaluation. Prevention Science,16(2) 200-210. doi: 10.1007/s11121-014-0491-1.

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