Understanding anxiety and avoidance
Anxiety and EBSNA
Anxiety is a key feature of EBSNA. While some anxiety is a normal part of growing up, it can sometimes escalate, particularly when tied to school avoidance. Young people may experience anxious thoughts and physical symptoms like nausea, shaking, and sweating, which can begin days before attending school. To avoid overwhelming emotions, students may react with "fight, flight, or freeze" responses, leading to avoidance behaviours that contribute to the persistence of EBSNA over time.​
Understanding development and impact of anxiety and avoidance
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Avoidance is a natural response to anxiety, providing immediate relief by allowing individuals to escape a distressing situation. However, while this is effective in the short term, it can create a vicious cycle. Avoiding anxiety-provoking situations prevents individuals from learning that these situations are often not as threatening as they seem, thereby reinforcing and worsening the anxiety in the long term.
For many children and young people, avoidance leads to their lives becoming increasingly limited, as the range of situations where they feel comfortable shrinks. As they withdraw from activities that previously brought enjoyment, achievement, and social connection, their mood can decline, leading to struggles with both anxiety and low mood, further compounding their challenges.
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Teaching children and young people to understand their experience
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Helping children and young people understand anxiety, its functions, how it is maintained, and how to manage it can reduce feelings of hopelessness often associated with EBSNA. Providing them with resources and information about anxiety and the strategies used to address it can be beneficial in these discussions, empowering them to take part in managing their situation effectively.
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School is not my enemy
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The Happiness Trap – understanding the functions of anxiety
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CAMHS resources on understanding anxiety and management
Using anxiety management tools
Teaching children and young people anxiety management techniques can help reduce their anxiety and support habituation. These techniques empower them to feel more in control of their responses. Reintegration planning should include time for teaching these skills so that they are prepared to use them when gradually increasing their exposure. It's important to tailor strategies to the child's developmental level and ability to use them effectively. Additionally, having an adult present to co-regulate and guide them through these techniques can be beneficial as part of the reintegration plan.
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You will find information about potential strategies for anxiety management on the following websites. You may also find other suggested activities online.
Be creative and explore a range of strategies to help the child or young person find those that work for them as an individual.
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Deep breathing activities and progressive muscle relaxation (suitable for all ages): Relaxation Exercises | Young Scot
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Guided meditation exercises (older children and adults): (83) Headspace - YouTube
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Mindfulness and yoga for younger children: (83) Cosmic Kids Yoga - YouTube
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Deep breathing, mindful colouring, yoga and other activities from the Anna Freud Centre: Coronavirus: resources for managing anxiety and improving wellbeing toolkit #4: Mentally Healthy Schools
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Self-care ideas and resources: Self Care, Anxiety, Depression, Coping Strategies | On My Mind | Anna Freud Centre