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July 2014
Vol 11 No 7
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The Selected Mental Health Disorder Overview – Part 1: Anxiety Disorders

By Lisa Bundrick, LMSW. and Alicia Backus, LCSW
 

Educators appear to be faced with a growing number of students who have mental health needs. While it is not the educator’s job to diagnose a student with a mental health diagnosis, it is helpful for educators to have a general understanding of mental health disorders and the treatment options available to better understand their student’s needs.

This series of articles will provide the reader with the key features, causes, common treatment options and classroom strategies for the selected mental health disorders (Generalized Anxiety Disorder, Obsessive-Compulsive Disorder, Attention Deficit/Hyperactivity Disorder, Oppositional Defiant Disorder, Conduct Disorder, Pervasive Developmental Disorders, Bipolar Disorder and Depression). However, when reading this information, one must understand that it is not meant to be a diagnostic tool or treatment guide, but rather as a resource to provide the reader with a very basic understanding of the selected mental health disorders.

This month: Generalized Anxiety Disorder and Obsessive-Compulsive Disorder

 

1. Disorder: Generalized Anxiety Disorder (GAD)

 

Key Features

  • Exaggerated worry and tension (occurring more days than not), even though there is little or nothing to cause it.
  • Physical symptoms such as frequent bouts of tears, fatigue, sleep disturbances, difficulty concentrating, “mind going blank,” headaches, nausea, sweating, diarrhea, muscle aches, exaggerated startle response and irritability may be present.
  • Examples of anxiety: overly conforming, perfectionist, unsure of self, overzealous in seeking approval and excessive reassurance about performance.

 

Possible Causes

  • Biological factors (i.e. a “chemical imbalance”).
  • Psychological factors (symptoms can worsen during periods of stress i.e. relationship issues, increased demands).

 

Common Treatment Options

  • Psychotherapy (especially cognitive and behavioral techniques).
  • Medication.

 

Classroom Strategies

  • Be consistent with rules, expectations, routine, schedules and responses.
  • Preset for anticipated changes.
  • Provide a supportive environment and validate the student’s feelings.
  • Allow choices.
  • Create a place where the student can go talk to someone if overwhelmed.
  • Model calmness and confidence.
  • Engage the student in activities to improve self worth, self concept, self-esteem.
  • Teach alternative ways to cope with situations that produce anxiety, (i.e., ask for help, walk away from conflict, try something else, talk with counselor, etc.).
  • Teach alternative ways to cope with situations that produce anxiety, (i.e., ask for help, walk away from conflict, try something else, talk with counselor, etc.).
  • Have the student check with the teacher or have the teacher check with the student to make sure that assignments have been written down correctly.
  • Have the student use a visual daily schedule, so students know what to expect. Keep this schedule a predictable as possible and utilize presets for change.
  • Encourage regular school attendance.

 

2. Disorder: Obsessive-Compulsive Disorder (OCD)

 

Key Features

    • Continual and powerful obsessions and/or compulsions that cause severe discomfort and interfere with day-to-day functioning (recurrent obsessions or compulsions that are severe enough to be time consuming (i.e. take more than one hour a day) or cause marked distress or significant impairment.

 

o        Obsessions are recurrent and persistent thoughts, impulses, or images that are unwanted and cause anxiety. Obsessions can be unrealistic and/or irrational.

§         Common obsessions are:

  • Aggression
  • Contamination (i.e. dirt, germs, illness)
  • Sexual thoughts
  • Loss
  • Religion or religious issues (e.g., death, afterlife)
  • Need for order and precision
  • Fears of causing harm to self or others
  • Lucky and unlucky numbers

 

o        Compulsions are repetitive behaviors or rituals.

§         Common compulsive behaviors are:

  • Cleaning and washing (i.e. grooming rituals such as showering or hand washing, cleaning rituals)
  • Hoarding or collecting
  • Touching
  • Avoiding
  • Seeking reassurance
  • Checking, rechecking and re-doing
  • Counting
  • Repeating (i.e. need to do things in a precise order, take a certain route, repeating words)
  • Ordering or arranging  (i.e. putting objects in specific places or order, )
  • Doubt and the need for constant reassurance
  • Religion (i.e. praying)

 

Possible Causes

The exact causes of OCD are still unknown, but these factors may contribute to the onset of OCD:

  • Biological factors (i.e. a “chemical imbalance” with brain chemicals).
  • Genetic factors, some evidence suggests that OCD may be inherited.
  • Psychological factors, such as stress.

 

Common Treatment Options

  • Patient and family support with education.
  • Psychotherapy (especially cognitive and behavioral techniques).
  • Medication.

 

Classroom Strategies

  • If the student repeatedly erases and rewrites have him/her use a computer, and/or provide copies of notes or an outline.
  • Accept work that is not perfect in order to avoid reinforcing perfectionism.
  • Create a place where the student can go talk to someone if overwhelmed.
  • Have the student use a visual daily schedule, so students know what to expect. Keep this schedule a predictable as possible and utilize pre-sets for change.
  • Ask parents what works at home.
  • Try to redirect the student’s behavior. This works better than using “consequences.”

Try to accommodate situations and behaviors that the student has no control over.

References

American Academy of Child Adolescent Psychiatry (2009). Facts for Families. Available: http://www.aacap.org. Retrieved 8/3/10.

American Psychiatric Association (2000). (4th ed., rev.) Diagnostic and Statistical Manual of Mental Disorders -IV-TR. Washington DC.

Bundrick, L. (2008). Learning About Attention Deficit Hyperactivity Disorder (ADHD). Teachers.Net Gazette, 5(9). Available: http://teachers.net/gazette/SEP08/bundrick/. Retrieved 8/2/11.

Children’s Hospital Boston (2005-2010). Attention-Deficit / Hyperactivity Disorder. Available: http://www.childrenshospital.org/az/Site610/mainpageS610P0.html. Retrieved 8/3/10.

HealthyPlace.com (2009). Medications For Treating Anxiety. Available: http://www.healthyplace.com/anxiety-panic/treatment/medications-for-treating-anxiety/menu-id-1062/. Retrieved 8/3/10.

Minnesota Association for Children’s Mental Health (No Date). Children’s Mental Health Disorder Fact Sheet for the Classroom. Saint Paul, MN.

National Institute of Mental Health (NIMH) (2010). Mental Health Topics. Available:  http://www.nimh.nih.gov. Retrieved 8/3/10.

National Institute of Mental Health (NIMH) (2010). Mental Health Medications. http://www.nimh.nih.gov/. Retrieved 8/3/10.

PsychNet-UK  (1998-2009). Mental Disorders – Information Sheets. Available: http://www.psychnet-uk.com. Retrieved 8/3/10.

Wisconsin Department of Public Instruction (2004-2005). Child and Adolescent Mental Health Problems –Fact Sheets for School Personnel: Mental Health and Schools. Madison, WI

About the Authors:

Lisa Bundrick has a Master of Social Work Degree from the University at Albany, State University of New York, a Bachelor of Arts in Sociology Degree from Plattsburgh State University of New York and an Associate of Arts in Liberal Arts Degree from Adirondack Community College. She holds her New York State permanent certification as a School Social Worker for grades K-12 and her license in New York State as a Licensed Master Social Worker (LMSW). Her career related experiences in the field of education include working with students and staff in charter and public schools as well as in a community college. As a school social worker, Lisa works with students in individual, small group and classroom settings assisting them in developing skills and knowledge to enable their success in both academic and social settings. Lisa also consults with school staff, families and outside agencies to further help promote student success. In addition to her counseling experiences, she has experience with crisis intervention, developing functional behavior assessments and behavior intervention plans, staff professional development, academic advisement, career planning, and cover letter and resume writing. Lisa is a published author on topics relating to school social work. One of her articles is featured in the book, The Ultimate Teacher: The Best Experts’ Advice for a Noble Profession with Photos and Stories; she is also the author of the children’s book, Learning About Feelings. Lisa is currently employed as an elementary school social worker in a public school district.

Alicia Backus has a Master of Social Work Degree from the University at Albany, State University of New York, and a Bachelor of Arts in Psychology from Plattsburgh State University of New York.  She holds her New York State permanent certification as a School Social Worker for grades K-12 and she is a Licensed Clinical Social Worker (LCSW) in New York State. Her work experiences include working with children and families in the mental health setting, wilderness, hospitals and public schools.  As a school social worker, Alicia works with students in individual, small group, crisis intervention and group counseling settings.  In addition to her counseling experience, she has experience with crisis intervention, developing functional behavior assessments and behavior intervention plans, and staff professional development.  Alicia is currently a board member of the New York State School Social Workers Association and is employed as a middle school social worker in a public school district.



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This entry was posted on Thursday, September 1st, 2011 and is filed under *ISSUES, LMSW, September 2011. You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed.
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