Glenbrook Practice introduces and new skills programme aimed at students struggling with social anxiety. Alongside our other two DBT skills based programmes for adolescents and tweens we felt the need to also address social anxiety in the academic arena.
It is common for teenagers to be self-conscious and to care about what others think of them. Adolescence is a time of constant flux, with increasing academic demands, shifts in friendships, and changing physical appearance, all of which present new challenges and insecurities. A focus on peer relationships and worries about fitting in or gaining approval from others are central to this developmental period. Therefore, some nervousness in social situations during this time is typical and expected. However, some teenagers have more significant fears of social and performance situations that cause them to avoid these situations or endure them with great distress. This social anxiety is greater than the well-known social angst of the teenage years because it interferes with quality of life and healthy development.
Understanding how social anxiety differs from typical teenage nervousness and recognizing when students require intervention is crucial for fostering academic and social success in teenagers within the school environment and beyond.
Social anxiety disorder is characterized by excessive fear of social and performance situations due to concern about being rejected or humiliated in front of others (American Psychiatric Association, 2013). In essence, social anxiety is an intense fear of negative evaluation or disapproval from others. Students with social anxiety commonly fear situations such as speaking with new or unfamiliar people, answering questions in class, giving verbal presentations, initiating conversations, attending parties or school activities, speaking to teachers or other authority figures, performing in musical and athletic activities, and extending social invitations to others (Mesa, Nieves, & Beidel, 2011; Hofmann et al., 1999). These situations are either endured with intense distress or avoided (e.g., remaining silent rather than initiating conversations with teammates or sharing thoughts in class). Often the avoidance occurs across a wide range of mainstream activities, causing pervasive limitations in social and academic functioning (Wittchen, Stein, & Kessler, 1999).
Social anxiety is conceptualized as involving three systems (Lang, 1968): cognitive, physical, and behavioural. The cognitive or mental component is wrought with worry about poor social performance or negative evaluation both in anticipation of and during social situations. Physical reactions to social events include tachycardia, blushing, shaking, and sweating. Finally, avoidance is the defining feature of the behavioural system.
With adolescence come new challenges, including separating from family and assuming more responsibilities for establishing and maintaining peer relationships. Unlike in childhood, it is no longer acceptable for parents to schedule playdates. Party invitations also become more selective. Therefore, a socially reticent child who functioned well in elementary school may begin to struggle in middle school when faced with new challenges like transitioning friendships, cliques, romantic connections, and increased expectations from teachers and coaches. From adolescence, social anxiety disorder tends to run a chronic, unremitting course into adulthood (Pine, Cohen, Gurley, Brook, & Ma, 1998), meaning that socially anxious teenagers who do not receive intervention typically continue to struggle with social anxiety as adults.
The debilitating impairment from social anxiety disorder that persists into young adulthood further contributes to exigent college transitions, underemployment, compromised professional attainment, impaired interpersonal relationships, and continued risk for depression and substance use problems throughout adulthood (Beesdo-Baum et al., 2012; Wittchen et al., 1999). While there are effective treatment strategies to help these youths, the majority of students with social anxiety disorder do not receive mental health services, partially due to misconceptions that social anxiety is part of an individual’s personality, like shyness, or an expected adolescent experience that will be outgrown.
Socially anxious students are also overlooked because they do not typically exhibit overt behaviour problems (Beidel et al., 1999; Fisher, Masia Warner, & Klein, 2004; Ryan & Masia Warner, 2012). Parents and teachers are therefore less likely to refer socially anxious adolescents to treatment unless teens specifically disclose their anxiety (Colognori et al., 2012). This unmet clinical need has motivated efforts to develop novel treatment models, such as employing the skills of school personnel, to better transport evidence-based interventions into the community (Schoenwald & Hoagwood, 2001).
Fortunately, school practitioners are in a valuable position to increase treatment access and provide clinically meaningful care for students. Equipping front-line school practitioners with effective interventions has the added benefit of providing adolescents with sustained access to these therapeutic resources within the school setting (Masia Warner et al., 2016).
Outline of programme, both for professionals and students
I. Recognizing and Addressing Social Anxiety at School
1. What Is Social Anxiety?
2. Why Treat Social Anxiety at School?
3. Identifying Students Struggling with Social Anxiety
II. Promoting Skills for Academic and Social Success (SASS)
4. Educating Teenagers about Social Anxiety
5. Socially Anxious Thinking 101
6. Realistic Thinking
7. Go Ahead, Start the Conversation
8. Maintaining Conversations and Extending Invitations
9. The Secret to Meaningful Conversations: Listening to What Others Say
10. Your Needs Matter: Learn to Speak Up!
11. Facing Your Fears: Creating a Fear Ladder
12. Climbing the Ladder: Exposure Practice in School
III. Supplementary Strategies
13. Getting Parents Involved: How Can They Help?
14. School Social Events and Peer Facilitators
15. Classroom Strategies for Teachers
IV. Other Practical and Clinical Considerations
16. The Nuts and Bolts of Helping Anxious Students at School: Putting It All Together
17. Applying Intervention Skills to Other Anxiety Concerns
18. Keep It Up!: Ways to Maintain Student Progress