This paper explores a whole school approach to the prevention and intervention for anxiety disorders in children and adolescents. Anxiety disorders are the most prevalent psychopathology in childhood and adolescence. In addition to having serious consequences for academic, social and family life, anxiety has also been shown to be a precursor to depression, substance abuse and eating disorders. School counsellors are well placed to identify students with anxiety disorders, instigate prevention programs and treat or refer anxious students. Prevention and early intervention for anxiety disorders needs to be coordinated and integrated into the regular curriculum as well as into the life of the classroom and the school. Barriers to schools working well in this area are identified and discussed.
AndersonJ.C., WilliamsS., McGeeR., & SilvaP.A. (1987). DSM-III disorders in preadolescent children: Prevalence in a large sample from a general population. Archives of General Psychiatry, 44, 69–76.
3.
AsherS.R., & CoieJ.D. (1990). (Eds.). Peer rejection in childhood. New York: Cambridge University Press.
4.
BarrettP.M. (1998). Evaluation of cognitive-behavioral group treatments for childhood anxiety disorders. Journal of Clinical Child Psychology, 27, 459–468.
5.
BarrettP.M., DaddsM.R., & HollandD.E. (1994). The coping koala: Prevention manual. Unpublished manuscript, The University of Queensland, Queensland, Australia.
6.
BarrettP.M., DaddsM.R., & RapeeR.M. (1996). Family treatment of childhood anxiety: A controlled trial. Journal of Consulting and Clinical Psychology, 64, 333–342.
7.
BarrettP.M., RapeeR.M., DaddsM.R., & RyanS. (1996). Family enhancement of cognitive styles in anxious and aggressive children: The FEAR effect. Journal of Abnormal Child Psychology, 24, 187–204.
8.
BarrettP.M., DuffyA.L., DaddsM.R., & RapeeR.M. (2001). Cognitive-behavioural treatment of anxiety disorders in children: Long-term (6-year) follow-up. Journal of Consulting and Clinical Psychology, 69, 135–141.
9.
BarrettP., & TurnerC. (2001). Prevention of anxiety symptoms in primary school children: Preliminary results from a universal school-based trial. British Journal of Clinical Psychology, 40, 399–410.
10.
BeckJ.S., BeckA.T., & JollyJ. (2001). Manual for the Beck Youth Inventories of Emotional and Social Impairment. San Antonio, TX: Psychological Corporation.
11.
BeckhamJ.C., VranaS.R., MayJ.G., GustafsonD.J., & SmithG.R. (1990). Emotional processing and fear measurement synchrony as indicators of treatment outcome in fear of flying. Journal of Behavior Therapy and Experimental Psychiatry, 21, 153–162.
12.
BeidelD.C., FlinkC.M., & TurnerS.M. (1996). Stability of anxious symptomotology in children. Journal of Abnormal Child Psychology, 24, 257–269.
13.
BernsteinG.A. (1991). Comorbidity and severity of anxiety and depressive disorders in a clinic sample. Journal of the American Academy of Child and Adolescent Psychiatry, 30, 43–50.
14.
BernsteinG.A., BorchardtC.M., & PerwienA.R. (1996). Anxiety disorders in children and adolescents: A review of the past 10 years. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 1110–1119.
15.
BernsteinG.A., HektnerJ.M., BorchardtC.M., & McMillanM.H. (2001). Treatment of school refusal: One-year follow-up. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 206–213.
16.
BernsteinG.A., WarrrenS.L., MassieE.D., & ThurasP. (1999). Family dimensions in anxious-depressed school refusers. Journal of Anxiety Disorders, 13, 513–528.
17.
BlancoC., NissensonK., & LiebowitzM.R. (2001). Social anxiety disorder: Recent findings in the areas of epidemiology, etiology, and treatment. Current Psychiatry Reports, 3, 273–280.
18.
BradyE.U., & KendallP.C. (1992). Comorbidity of anxiety and depression in children and adolescents. Psychological Bulletin, 111, 244–255.
19.
BreierA., CharneyD.S., & HeningerG.R. (1984). Major depression in patients with agoraphobia and panic disorder. Archives of General Psychiatry, 41, 1129–1135.
20.
BrowneA. (1995). Willy the wimp. London: Walker.
21.
BulikC.M., TozziF., AndersonC., MazzeoS.E.AggenS., & SullivanP.F. (2003). The relation between eating disorders and components of perfectionism. American Journal of Psychiatry, 160, 366–369.
22.
BurkeJ.D., BurkeK.C., & RaeD.S. (1994). Increased rates of drug abuse and dependence after onset of mood or anxiety disorders in adolescence. Hospital and Community Psychiatry, 45, 451–455.
23.
CampbellM.A. (2003). Worrybusters: Counselling strategies for anxious children. Unpublished manuscript.
24.
CampbellM.A. (2003). Cilla the worried gorilla: A story for children with separation anxiety disorder. Manuscript submitted for publication.
25.
CampbellM.A., & RapeeR.M. (1996). Current issues in the assessment of anxiety in children and adolescents: A developmental perspective. Behaviour Change, 13, 185–193.
26.
CaspiA., HenryB., McGeeR.O., MoffitT.E., & SilvaP.A. (1995). Temperamental origins of child and adolescent behavior problems: From age three to age fifteen. Child Development, 66, 55–68.
27.
CobhamV.E. (1999). Family treatment of childhood anxiety. The Australian Educational and Developmental Psychologist, 16, 25–45.
28.
CobhamV.E., DaddsM.R., & SpenceS.H. (1999). Anxious children and their parents: What do they expect?Journal of Clinical Child Psychology, 28, 220–231.
29.
ColeD.A., PeekeI.G., MartinJ.M., TruglioR., & SenczynskiA.D. (1998). A longitudinal look at the relation between depression and anxiety in children and adolescents. Journal of Consulting and Clinical Psychology, 66, 451–460.
30.
ComptonS.N., BurnsB.J., EggerH.L., & RobertsonE. (2002). Review of the evidence base for treatment of childhood psychopathology: Internalizing disorders. Journal of Consulting and Clinical Psychology, 70, 1240–1266.
31.
CostelloE.J., & AngoldA. (1995). Epidemiology. In MarchJ.S. (Ed.), Anxiety disorders in children and adolescents (pp. 109–124). New York: Guilford Press.
CrawfordA.M., & ManassisK. (2001). Familial predictors of treatment outcome in childhood anxiety disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 1182–1189.
34.
DaddsM.R., BarrettP.M., & CobhamV.E. (1997). Anxiety disorders. In OllendickT.H. (Ed.), Comprehensive clinical psychology. Vol 4: Children and adolescents clinical formulation and treatment (pp. 112–136). Oxford: Elsevier Science.
35.
DaddsM.R., HollandD.E., LaurensK.R., MullinsM., BarrettP.M., & SpenceS.H. (1999). Early intervention and prevention of anxiety disorders in children: Results at 2-year follow-up. Journal of Consulting and Clinical Psychology, 67, 145–150.
36.
DaddsM.R., SpenceS.H., HollandD.E., BarrettP.M., & LaurensK.R. (1997). Prevention and early intervention for anxiety disorders: A controlled trial. Journal of Consulting and Clinical Psychology, 65, 627–635.
37.
Deas-NesmithD., BradyK.T., & CampbellS. (1998). Comorbid substance use and anxiety disorders in adolescents. Journal of Psychopathology and Behavioral Assessment, 20, 139–148.
38.
DeJongP.J., AndreaH., & MurisP. (1997). Spider phobia in children: Disgust and fear before and after treatment. Behaviour Research and Therapy, 35, 559–562.
39.
DeykinE.Y., BukaS.L., & ZeenaT.H. (1992). Depressive illness among chemically dependent adolescents. American Journal of Psychiatry, 149, 1341–1347.
40.
DobsonK.S. (1985). The relationship between anxiety and depression. Clinical Psychology Review, 5, 307–324.
41.
DuffA. (1999). Duffy's once were worriers. Auckland: Random House.
42.
EisenA.R., & SilvermanW.K. (1998). Prescriptive treatment for generalised anxiety disorder in children. Behavior Therapy, 29, 105–121.
43.
EliasM.J., & WeissbergR.P. (2000). Primary prevention: Educational approaches to enhance social and emotional learning. Journal of School Health, 70, 186–190.
44.
FergusonD.M., & WoodwardL.J. (2002). Mental health, educational, and social role outcomes of adolescents with depression. Archives of General Psychiatry, 59, 225–231.
45.
GieseckeD., & CartledgeG. (1993). Low-achieving students as successful cross-age tutors. Preventing School Failure, 37, 34–44.
46.
GillhamJ.E., ReivichK.J., JaycoxL.H., & SeligmanM.E. (1995). Prevention of depressive symptoms in schoolchildren: Two-year follow-up. Psychological Science, 6, 343–351.
47.
GinsburgG.S., SilvermanW.K., & KurtinesW.K. (1995). Family involvement in treating children with phobic and anxiety disorders: A look ahead. Clinical Psychology Review, 15, 457–473.
48.
GodartN.T., FlamentM.F., LecrubierY., & JeammetP. (2000). Anxiety disorders in anorexia nervosa and bulimia nervosa: Comorbidity and chronology of appearance. European Psychiatry, 15, 38–45.
49.
HagedomJ., & OmarH. (2002). Retrospective analysis of youth evaluated for suicide attempt or suicidal ideation in an emergency room setting. International Journal of Adolescent Medicine and Health, 14, 55–60.
50.
HannanA.P., RapeeR.M., & HudsonJ.L. (2000). The prevention of depression in children: A pilot study. Behaviour Change, 17, 78–83.
51.
HibbertA., FogelmanK., & ManorO. (1990). Occupational outcomes of truancy. British Journal of Educational Psychology, 60, 171–179.
52.
HightowerA.D., & BradenJ. (1991). Prevention. In KratochwillT.R. & MorrisR.J. (Eds.), The practice of child therapy (pp. 410–440). New York: Pergamon Press.
53.
HillS., & HillT. (1990). The collaborative classroom: A guide to cooperative learning. South Yarra: Curtain Press.
54.
IalongoN., EdlesohnG., Werthamer-LarssonI., CrockettI., & KellamS. (1994). The significance of self-reported anxious symptoms in first grade children. Journal of Abnormal Child Psychology, 22, 441–455.
55.
IalongoN., EdlesohnG., Werthamer-LarssonI., CrockettI., & KellamS. (1995). The significance of self-reported anxious symptoms in first grade children: Prediction to anxious symptoms and adaptive functioning in fifth grade. Journal of Child Psychology and Psychiatry, 36, 427–437.
56.
JerremalmA., JanssonL., & OstL.G. (1986). Cognitive and physiological reactivity and the effects of different behavioral methods in the treatment of social phobia. Behavior Research and Therapy, 24, 171–180.
57.
JohnsonJ.G., CohenP., KotlerL., KasenS., & BrookJ.S. (2002). Psychiatric disorders associated with risk for the development of eating disorders during adolescence and early adulthood. Journal of Consulting and Clinical Psychology, 70, 119–1128.
58.
KashaniJ.H., & OrvaschelH. (1990). A community study of anxiety in children and adolescents. American Journal of Psychology, 147, 313–318.
KendallP.C. (1994). Treating anxiety disorders in youth: Results of a randomized clinical trial. Journal of Consulting and Clinical Psychology, 65, 627–635.
61.
KendallP.C., BradyE.U., & VerduinT.I. (2001). Comorbidity in childhood anxiety disorders and treatment outcome. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 787–794.
62.
KendallP.C., Flannery-SchroederE., Panichelli-MindelS.M., Southam-GerowM., HeninA., & WarmanM. (1997). Therapy for youths with anxiety disorders: A second randomized clinical trial. Journal of Consulting and Clinical Psychology, 65, 366–380.
63.
KendallP.C., KaneM., HowardB., & SiquelandL. (1990). Cognitive- behavioral treatment of anxious children: Treatment manual. (Available from the Department of Psychology, Temple University, Philadelphia PA 19122, United States).
64.
KendallP.C., & Southam-GerowM.A. (1996). Long-term follow-up of a cognitive-behavioral therapy for anxiety-disordered youth. Journal of Consulting and Clinical Psychology, 64, 724–730.
65.
KingN.J., Clowes-HollinsV., & OllendickT.H. (1997). The etiology of childhood dog phobia. Behaviour Research and Therapy, 35, 77–78.
66.
KovacsM., AkiskalH., GatsonisC., & ParroneP. (1994). Childhood-onset dysthymic disorder: Clinical features and prospective naturalistic outcome. Archives of General Psychiatry, 55, 56–64.
67.
KovacsM., & DevlinB. (1998). Internalizing disorders in childhood. Journal of Child Psychology and Psychiatry, 39, 17–63.
68.
LabellarteM.J., GinsburgG.S., & WalkupJ.T., (1999). The treatment of anxiety disorders in children and adolescents. Biological Psychiatry, 46, 1567–1578.
69.
LaFreniereP.J., & CapuanoF. (1997). Preventive intervention as means of clarifying direction of effects in socialization: Anxious-withdrawn preschoolers case. Developmental and Psychopathology, 9, 551–564.
70.
LastC.G., HansenC., & FrancoN. (1997). Anxious children in adulthood: A prospective study of adjustment. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 645–652.
71.
LastC.G., HersenM., KazdinA., OrvaschelH., & PerrinS. (1994). Anxiety disorders in children and their families. Archives of General Psychiatry, 18, 769–773.
72.
LastC.G., StraussC.G., & FrancisG. (1987). Comorbidity among childhood anxiety disorders. The Journal of Nervous and Mental Disease, 175, 726–730.
73.
LewinsohnP.M., ZinburgR., SeeleyJ.R., LewinsohnM., & SackW.H. (1997). Lifetime comorbidity among anxiety disorders and between anxiety disorders and other mental disorders in adolescents. Journal of Anxiety Disorders, 11, 377–394.
74.
Lowry-WebsterH.M., BarrettP.M., & DaddsM.R. (2001). A universal prevention trial of anxiety and depressive symptomatology in childhood: Preliminary data from an Australian study. Behaviour Change, 18, 36–50.
75.
ManassisK., & BradleyS.J. (1994). The development of childhood anxiety disorders: Toward an integrated model. Journal of Applied Developmental Psychology, 15, 345–366.
76.
ManassiK., BradleyS., GoldbergS., HoodJ., & SwinsonR.P. (1995). Behavioral inhibition, attachment and anxiety in children of mothers with anxiety disorders. Canadian Journal of Psychiatry, 40, 87–92.
77.
ManassisK., & HoodJ. (1998). Individual familial predictors of impairment in childhood anxiety disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 37, 428–434.
78.
ManassisK., MendlowitzS.L., ScapillatoD., AveryD., FiksenbaumL., FreireM., et al. (2002). Group and individual cognitive-behavioral therapy for childhood anxiety disorders: A randomized trial. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 1423–1430.
79.
ManassisK., & MennaR. (1999). Depression in anxious children: Possible factors in comorbidity. Depression and Anxiety, 10, 18–24.
80.
ManassisK., & MongaS. (2001). A therapeutic approach to children and adolescents with anxiety disorders and associated comorbid conditions. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 115–117.
81.
MattisonR.E. (1988). Suicide and other consequences of childhood and adolescent anxiety disorders. Journal of Clinical Psychiatry, 49(10), 9–11.
MendlowitzS.L., ManassisK., BradleyS., ScapillatoD., MiezitisS., & ShawB.F. (1999). Cognitive-behavioural group treatments in childhood anxiety disorders: The role of parental involvement. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 1223–1229.
84.
MesserS.C., & BeidelD.C. (1994). Psychosocial correlates of childhood anxiety disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 33, 975–983.
85.
The National Health Plan Steering Committee. (2003). Consultation paper on the National health plan, 2003–2008. Canberra, Australia: Author.
86.
ParkR. (1989). Things in corners. Ringwood Vic: Penguin.
87.
PineD.S., CohenP., GurleyD., BrookJ., & MaY. (1998). The risk for early-adulthood anxiety and depressive disorders in adolescents with anxiety and depressive disorders. Archives of General Psychiatry, 55, 56–64.
88.
PollackM.H., OttoM.W., SabatinoS., & MajcherD. (1996). Relationship of childhood anxiety to adult panic disorder: Correlates and influence on course. American Journal of Psychiatry, 153, 376–381.
89.
RapeeR.M. (1997). Potential role of childrearing practices in the development of anxiety and depression. Clinical Psychology Review, 17, 47–67.
90.
RegisterA.C., BeckhamJ.C., MayJ.G., & GustafsonD.J. (1991). Stress innoculation bibliotherapy in the treatment of test anxiety. Journal of Consulting Psychology, 38, 115–119.
91.
RaoU., RyanN.D., DahlR.E., BirmaherB., RaoR., WilliamsonD.E., et al., (1999). Factors associated with the development of substance use disorder in depressed adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 1109–1117.
92.
RhodeP., LewinsohnP.M., & SelbyJ.R. (1996). Psychiatric comorbidity with problematic alcohol use in high school students. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 101–109.
93.
RussoM.F., & BeidelD.C. (1994). Comorbidity of childhood anxiety and externalising disorders: Prevalence, associated characteristics and validation issues. Clinical Psychology Review, 14, 199–221.
94.
SawyerM.G., ArneyF.M., BaghurstP.A., ClarkJ.J., GraetzB.W., KoskyR.J., et al. (2000). Mental health of young people in Australia: Child and adolescent component of the national survey of mental health and well-being. Canberra: Commonwealth Department of Health and Aged Care.
95.
SchnieringC.A., HudsonJ.L., & RapeeR.M. (2000). Issues in the diagnosis and assessment of anxiety disorders in children and adolescents. Clinical Psychology Review, 20, 453–478.
96.
SchwalbergM.D., BarlowD.H., AlgerS.A., & HowardL.J. (1992). Comparison of bulimic, obese, binge eaters, social phobics and individuals with panic disorder on comorbidity across DSM-III-R anxiety disorders. Journal of Abnormal Psychology, 101, 675–681.
97.
ShochetI., & OsgarbyS. (1999). The resourceful adolescent project: Building psychological resilience in adolescents and their parents. The Australian Educational and Developmental Psychologist, 16, 46–65.
98.
SilvermanW.K. (2001). Workshop on anxiety treatment of youth. Brisbane, Australia: Griffith University.
99.
SmithP.K., & SharpS. (Eds.). (1994). School bullying: Insights and perspectives. London: Routledge.
100.
SpenceS.H. (1994). Preventative strategies. In OllendickT.H., KingN.J. & YuleW. (Eds.), Handbook of phobic disorders in children and adolescents (pp. 435–473). New York: Plenum.
101.
StraussC.C., FrameC.L., & ForehandR.L. (1987). Psychosocial impairment associated with anxiety in children. Journal of Clinical Child Psychology, 16, 235–239.
102.
TorenP., WolmerM.A., RosentalB., EldarS., KorenS., LaskM., et al. (2000). Case series: Brief parent-child group therapy for childhood anxiety disorders using a manualbased cognitive-behavioral technique. Journal of the American Academy of Child and Adolescent Psychiatry, 39, 1309–1312.
VerhulstF.C., van der EndeJ., FerdinandR.F., & KasiusM.C. (1997). The prevalence of DSM-III-R diagnoses in national sample of Dutch adolescents. Archives of General Psychiatry, 54, 329–336.
105.
WaddellM. (1999). Can't you sleep little bear?London: Walker.
106.
WadeT.D., DavidsonS., & O'DeaJ.A. (2002). Enjoyment and perceived value of two school-based interventions designed to reduce risk factors for eating disorders in adolescents. Australian e-Journal for the Advancement of Mental Health, 1(2), 1–8.
107.
WhaleyS., PintoA., & SigmanM. (1999). Characterizing interactions between anxious mothers and their children. Journal of Consulting and Clinical Psychology, 67, 826–836.
108.
WinettR.A. (1998). Prevention: A proactive developmental-ecological perspective. In OllendickT.H. & HersenM. (Eds.,), Handbook of child psychopathology (3rd ed., pp. 637–671). New York: Plenum Press.
109.
WonderlichS.A., & MitchellJ.E. (1997). Eating disorders and comorbidity: Empirical, conceptual, and clinical implications. Psychopharmacological Bulletin, 33, 381–390.
110.
ZubrickS.R., SilburnS.R., TeohH.J., CarltonJ., ShepherdC., & LawrenceD. (1997). Western Australian child health survey: Education, health and competency catalogue 4305.5, Perth, WA: Australian Bureau of Statistics.
