Anxiety in the Classroom: Educators and Health Care Professionals Must Work Together

Available with English captions and subtitles in Spanish.

A conversation with Yudelki M. Firpo-Perretti, PhD, and Abigail Stark, PhD, on how we can support kids and teens at school when they are struggling with anxiety and OCD.

Addressing Anxiety at School

For kids and teens living with anxiety and OCD, the idea of going to school or being in a classroom can present challenges. Firpo-Perretti and Stark explore how teachers, parents, and health care professionals can work together to create safe spaces for anxious students.

Watch now to learn more about:

  • How anxiety and OCD may show up in the classroom
  • What school avoidance is and how to address it
  • How adults can collaborate to help anxious kids at school

In their talk, Firpo-Perretti and Stark describe different forms of anxiety that can show up in the classroom setting, and how teachers and other professionals can recognize an issue.

For example, in the classroom environment, young students with OCD might feel compelled to repeatedly check and recheck their work. This behavior can leave them stuck while other students have been able to move on. In the meantime, kids and teens with social anxiety struggle to participate in group projects or make friends, which can lead to them being bullied or ostracized.

According to Stark, “School has rigorous demands, and when you struggle with anxiety, not only getting through the school day, but also activating those parts of our brain involved in higher-order thinking, while feeling anxious, can be so challenging.”

The experts speak of how important it is for teachers, caregivers, and health care professionals to reinforce actions that will help these students thrive and avoid engaging in actions that aren’t related to positive outcomes.

They also cover the topic of school refusal. While not a diagnosis itself, students may be avoiding school due to issues related to anxiety, OCD, depression, and other mental health challenges.

“One of the things that we see with school refusal or school avoidance is that when kids start to avoid school, the harder it is to get back into school,” says Stark. As is the case with other forms of anxiety treatment, addressing school refusal is a gradual process that involves exposure.

Firpo-Perretti points out, “A lot of families are struggling to get the resources, the connections, and are even strongly struggling with a sense of belonging to certain school environments.” She states that several factors—even acculturation, beliefs, and values can play a part in the greater picture of one child.

Both experts acknowledge the hard work that parents and teachers already do to care for young people and offer tips on how parents and teachers can work together. They suggest possibilities to explore, such as 504 or IEP plans, which allow students with anxiety, OCD, or other health concerns to follow the academic curriculum and engage socially.

By working together, adults can play a crucial role in helping students with mental health challenges not only succeed academically but also feel supported and connected in their school environments.

Audience Questions

  • What can the spectrum of school-related anxiety challenges look like?
  • How common is school-related anxiety?
  • How can social anxiety come into play in a classroom environment?
  • What should teachers and educators know about anxiety and OCD symptoms that may be more difficult to perceive, or may look like other problems?
  • What should we know about students dealing with perfectionism in the classroom?
  • What do we know about how excessive anxiety impacts a student’s ability to take in and process information?
  • Especially in younger students, self-awareness may be tricky. How can parents, educators, and clinicians help a child articulate what they are feeling?
  • What should we know about school refusal and how it factors into this conversation?
  • How can educators teach parents and caregivers about accommodation and how that can factor into their child’s anxiety-avoidance cycle?
  • What are some of the common co-occurring mental health challenges that are associated with school anxiety?
  • How important is communication as a strategy to support students dealing with anxiety at school?
  • Where should lines be drawn for teachers and parents when it comes to sharing their concerns about a child’s anxiety and asking for support?
  • What can you do if your child’s school or teacher is dismissive or not very understanding of your child’s mental health condition?
  • What are “safe spaces” in schools? How are they used?
  • What are some OCD challenges that might be exacerbated by being in a classroom? What can parents and professionals do to help facilitate treatment for the student?
  • Generally speaking, does it seem that teachers are equipped with the training and support that they need to recognize some of these challenges in the classroom?
  • Are there recommended evidence-based, group-focused approaches for teens that could be implemented in the school setting?
  • Does mental health stigma get in the way of constructive conversations between parents and educators?
  • What’s the trend line for dialogue around anxiety and OCD in school environments? Do you find that communication is improving?
  • How can parents, teachers, and clinicians work together on a treatment plan to address the challenges a student is facing in the classroom?
  • Where do formal school accommodation plans come into play with anxiety and OCD? How are they best implemented?
  • How much should clinicians involve issues that come up during the school day in treatment? How is that best facilitated with treatments such as exposure and response prevention?
  • Can OCD and anxiety show up as rigid rule-following? How can adults support a child dealing with that stress?
  • What should we know about panic attacks in the classroom or at school?
  • How might a school nurse be part of an anxious student’s treatment support team?
  • What should we know about how specific phobias might come up in a classroom environment?
  • What role can coaches play in supporting a student with anxiety or OCD?
  • What are some practical first steps that a parent might take to engage with a teacher, school, or clinician to help their child navigate these challenges during the school day? Where’s the starting point?

The information discussed is intended to be educational and should not be used as a substitute for guidance provided by your health care provider. Please consult with your treatment team before making any changes to your care plan.

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About Dr. Firpo-Perretti

Yudelki M. Firpo-Perretti, PhD, is the program director of McLean’s School Consultation Service, which focuses on enhancing the use of evidence-based practices in schools via consultation and training for school staff and educational webinars for caregivers. Dr. Firpo-Perretti is a clinical psychologist who specializes in delivering evidence-based treatments for children, adolescents, and adults in individual, group, family, and school consultation settings.

About Dr. Stark

Abigail Stark, PhD, is a staff psychologist at the McLean Anxiety Mastery Program. She is an instructor in psychology in the Department of Psychiatry at Harvard Medical School. Dr. Stark is interested in providing evidence-based care for children and adolescents with a focus on chronic emotion dysregulation, anxiety, and OCD.

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