Anxiety and anxiety based disorders guidance 11-16 year olds

Anxiety is a word we use to describe feelings of worry, fear and panic. As well as these emotional feelings, people with anxiety might also experience physical (body) sensations such as a racing heart, breathing fast, sweaty hands, dry mouth and feeling shaky. Many people also have “what if” or negative thoughts when they are anxious.

Anxiety is a normal human response to feeling threatened or in danger, even if that threat or danger is a thought, image or memory. Anxiety can become a real problem if the thoughts, emotions (feelings) and physical sensations are very strong, happen even when there is no real danger or if it lasts for a long time.

Lots of people experience worry and anxiety although for some people it can impact on everyday life and get in the way of school/college, socialising and even home life.

All young people will worry and feel anxious from time to time.

In some cases children may develop an irrational fear of something specific. These are often referred to as phobias. Whilst we all experience irrational fears, with a phobia the sufferer feels extreme anxiety, even terror, at the thought of coming in contact with their feared thing or situation. The stronger the feeling of anxiety, the more likely we are to avoid the thing or situation.

Some children experience obsessive thoughts and compulsive rituals which can be distressing if they start to take over their normal lives. They tend to be more common in children when another family member has a similar problem, and they are more likely to experience these difficulties when they are under stress or during significant life changes.

This is a general guide to help you know how best to support your young person if they are experiencing anxiety. This is not an exhaustive list; young people may experience symptoms which may not be included in this guide.  If in doubt advice and guidance is available from the services listed below.

• Talk to your child about their anxiety or worries. Label the emotion that the child may be feeling to show them you are taking their concerns seriously. E.g. ‘ I can see that you are feeling worried about going to school’
• If your child is seeking frequent reassurance, it could be helpful to manage this by using distraction or relaxation or mindfulness.

• Worries and anxiety are common; everyone worries so it’s important the young person knows they are not alone. Some worries may seem very real and very scary. Remind them to tell someone how they are feeling no matter what their worries are, even if they are worried about doing so.
• Although anxiety feels horrible, the feelings will pass and the physical sensations cannot harm them. The young person should remind themself that they’ve been anxious before, that those feelings passed, that they coped and were ok. If they need to, use activities, such as watching TV, spending time with friends, reading, making things and listening to music, to help manage until they feel a bit better.
• Be aware that although their fear may be irrational, the child feelings of stress are real to them. Challenge any irrational thoughts they might have, but don’t minimise the intensity of their feelings.
• If appropriate, set small achievable targets to help increase confidence and reward any efforts your child makes to work towards these targets.
• Encourage them to face their FEARs with confidence following these four steps:
  Focus – rather than worry about the past, future or the unknown, focus on the present moment, the here and now
  Expose – the more you face your fears the easier it will become to manage
  Approach – the fear of experiencing anxiety is often worse than the situation you are avoiding. Face your fear and see for yourself that the situation probably isn’t as bad as you are predicting
  Rehearse – practice anxiety management techniques.

• Anna Freud Centre – 7 ways to support children and young people who are worried
• Anxiety UK – a charity providing support to anyone suffering from anxiety anxietyuk.org.uk
• Little Blue Book of Sunshine – includes tips for young people on dealing with anxiety and other common problems. Available on Google Play Books.
• MindShift anxiety management app. Available from Apple store or Google Play store
• The Anxious Child Booklet: A booklet for parents and carers wanting to know more about anxiety in children and young people. (Mental Health Foundation)

OCD Youth aims to increase awareness and access to support for anyone under 25 affected by OCD. OCD Youth is run by young people with OCD, for young people with OCD. The website is full of information and advice and they organise trips and outings, run online meet-ups, produce videos and media and much more.

OCD UK’s, a national OCD charity, website also provides a wealth of information about OCD, its sub-types, possible treatments and tips to help overcome it. They also offer a parent webinar as part of a Parents Education Project, funded by The National Lottery Community Fund for parents of children with Obsessive-Compulsive Disorder.

Young Minds gives free, relevant, practical information about a range of mental health issues in children and young people. It has information about feelings and symptoms, conditions and looking after yourself. youngminds.org.uk/young-person/mental-health-conditions/ocd/

Young Minds gives free, relevant, practical information about a range of mental health issues in children and young people youngminds.org.uk/young-person/mental-health-conditions/phobias/

These are worries and anxieties that most young people will have from time to time.

Examples might be:

• Being away from home/ parent
• Going to school (but settling)
• Worrying about going to bed/ the dark
• Worry about something bad happening to themselves, or to a loved one
• Doing new things
• Going to unfamiliar places
• Doing things independently
• Public speaking/ performing
• Tests and exams
• Change and uncertainty (e.g. family breakdown or conflict)
• In response to an upsetting event such as being bullied
• Being in social situations

If families or professionals are concerned that a young person is experiencing any of the issues above support is available, this includes:

Kooth

Kooth is a free online counselling and wellbeing support service, which is available to all young people aged 11-25 in Portsmouth.

Young people can access self-help resources, moderated peer support and professional support from counsellors.

There are no waiting lists or referrals, young people can visit Kooth.com and register anonymously.  The site is available 24/7 with counselling available 12pm – 10pm on weekdays and 6pm – 10pm on weekends, all year round.

Support in schools

All secondary schools have a named Mental Health Lead and within schools there is a range of pastoral support available.  Schools also work with other professionals in order to gain advice and guidance on how best to support children’s social and emotional needs. These services may include the Portsmouth Educational Psychology Team, the Multi Agency Behaviour Support Team and the Inclusion Outreach team.

Within many schools, pastoral support may be provided by Emotional Literacy Support Assistants (ELSAs)

ELSAs are teaching assistants or learning mentors in schools who have been trained by Educational Psychologists to work with children who are showing a wide range of emotional or social needs for example; anxiety, low self-esteem, problems with anger etc. Through individual (and small group) support programmes ELSAs help children to develop their social and emotional skills.

Support will also  include Mental Health Support Teams (MHST’s) who are available in all secondary schools.

MHST’s support children and young people with mild to moderate mental health problems. They use cognitive behaviour therapy informed interventions to make changes in the way young people think and behave, improving their outlook on life.  They can help young people who avoid situations, or worry frequently due to their anxiety. The type of issues MHST’s can support with is worry, panic symptoms, anxiety-based school avoidance, exam stress and stress management.

The school should make contact with MHST for consultation and support for MHST referral where appropriate.

The CAMHS Single Point of Access is also available for consultation and advice.

Available: Monday to Friday: 9am – 5pm. Please contact: 0300 123 6632.

The degree to which a young person worries appears out of context or disproportionate to the reason why they might be worrying.

Episodes of anxiety might be more frequent or prolonged and cause the young person distress, or might have some mild impact on their ability to cope with everyday life such as going to, or coping at school, seeing friends or taking part in leisure activities.

Examples might be:

• Fears that something bad might happen to themselves, or someone else
• Worry about not coping
• Worry about performance in exams or the future
• Worries related to being habitually bullied, or experiencing regular conflict or distress, either at home or school
• Worries about what others might think, say, or do
• Worries about negative judgements by others, or social rejection/exclusion
• Specific Phobia e.g. fear of dogs that impacts on day to day life
• Repetitive behaviours e.g. excessive hand washing, counting, checking windows and doors. That are beginning to impact on day to day life.

If families or professionals are concerned that a young person is experiencing any of the issues above support is available, this includes:

Kooth

Kooth is a free online counselling and wellbeing support service, which is available to all young people aged 11-25 in Portsmouth.

Young people can access self-help resources, moderated peer support and professional support from counsellors.

There are no waiting lists or referrals, young people can visit Kooth.com and register anonymously.  The site is available 24/7 with counselling available 12pm – 10pm on weekdays and 6pm – 10pm on weekends, all year round.

Hampshire Youth Access counselling (HYA) service

Hampshire Youth Access offer counselling, mental health and emotional wellbeing support to people aged 5-17 (or up to age 24 for care leavers or those with SEND). Sessions will be delivered by No Limits in schools, in the community or, for older children, sessions may be online via Zoom.

Young people aged 11 and over can refer themselves to HYA or be referred by a parent, carer or professional.

To refer a young person: call 023 8214 7755, email enquiries@hampshireyouthaccess.org.uk or refer online at Hampshire Youth Access.

Support in schools

All secondary schools have a named Mental Health Lead and within schools there is a range of pastoral support available.  Schools also work with other professionals in order to gain advice and guidance on how best to support children’s social and emotional needs. These services may include the Portsmouth Educational Psychology Team, the Multi Agency Behaviour Support Team and the Inclusion Outreach team.

Within many schools, pastoral support may be provided by  Emotional Literacy Support Assistants (ELSAs)

ELSAs are teaching assistants or learning mentors in schools who have been trained by Educational Psychologists to work with children who are showing a wide range of emotional or social needs for example; anxiety, low self-esteem, problems with anger etc. Through individual (and small group) support programmes ELSAs help children to develop their social and emotional skills.

Support will also  include Mental Health Support Teams (MHST’s) who are available in all secondary schools.

MHST’s support children and young people with mild to moderate mental health problems. They use cognitive behaviour therapy informed interventions to make changes in the way young people think and behave, improving their outlook on life.  They can help young people who avoid situations, or worry frequently due to their anxiety. The type of issues MHST’s can support with is generalised anxiety, separation anxiety, social anxiety and panic disorder

The school should make contact with MHST for consultation and support for MHST referral where appropriate.

For professionals such as GP’s they should encourage young people to register with Kooth and to link in with the school-based support described above.  The CAMHS Single Point of Access is available for consultation and advice.

Available: Monday to Friday: 9am – 5pm.

Please contact: 0300 123 6632.

These anxieties are severe and enduring which may need specialist support.

These cause significant distress to a young person and significantly disrupt daily coping such as school/ college, socialising, and even self-care activities (e.g. sleep, bathing, eating).

Despite trying advice and support in the previous help sections the young person still experiences anxiety symptoms.

• Strong unwavering beliefs that something bad might happen, or that there is danger
• Repeated, intense and overwhelming “what if” thoughts that are catastrophic in nature
• Repetitive behaviours e.g. excessive hand washing, counting, checking windows and doors. That are significantly impacting on day to day life.
• Specific Phobia where the impact on functioning is significant and/ or there are associated risks with the avoidant behaviours.

There are risks identified with regards to self-harming behaviour and/or suicidal thinking.

If families or professionals are concerned that a young person is experiencing any of the issues above support is available, this includes

Child and Adolescent Mental Health Service (CAMHS).

If families or professionals are concerned that a young person is experiencing severe and enduring mental health issues that are impacting daily life then they can contact CAMHS Single Point of Access for consultation and advice.

Following on from this consultation if indicated CAMHS will require a written referral from a professional (this can include any professional that knows the child or young person).  Once a referral is received into the CAMHS single point of access team they will aim to contact the family by phone to further triage the concerns. The outcome of this triage may be that the child / young person is offered an initial appointment for further assessment, the outcome may also be signposting to other services mentioned earlier in this guidance.

CAMHS provide evidenced based treatment for mental health disorders. This can include medication and talking therapies on a 1-2-1, group or family basis. They offer face-to-face, web based, and telephone support on a needs-led basis.

Available Monday to Friday, 9am-5pm

Please contact: 0300 123 6632.