An exploratory analysis of the impact of the teacher anxiety program for elementary students on school-related outcomes

Abstract

Student anxiety impairs school functioning. Anxiety reduction interventions are effective, but most youth do not receive these services. Task shifting intervention delivery to teachers can improve access to these interventions. This exploratory analysis used data from a randomized clinical trial and examined the impact of a teacher-delivered school-home intervention (TAPES) compared to a didactic teacher training on student anxiety (Teacher Anxiety Training (TAT)) on school related outcomes. It was hypothesized that students in TAPES, compared to TAT, would show greater improvements. Teachers (N = 54) identified potentially eligible students in their classrooms who were assessed by study staff using a diagnostic interview to confirm impairing levels of anxiety at school and at home. Fifty-four students (mean age 8.0 years; 46% females; 78% white; 81% with an anxiety disorder) participated. Outcomes were assessed, by multiple informants, at approximately eight weeks (postintervention) and six months after a student was enrolled. Results indicated no statistically significant between group differences, but within group changes showed that students receiving TAPES demonstrated significant improvements in math and English grades and in parent-reports of school-related impairment. Students in both groups showed significant improvements in teacher-rated classroom behavior. Implications of these exploratory findings for providing, improving, and evaluating teacher interventions for anxiety are discussed.

Trial registration

ClinicalTrials.gov, NCT03899948

Keywords

Anxiety teachers students school-based interventions school functioning

Get full access to this article

View all access options for this article.

References

Albano

A. M.

Silverman

W. K.

(2022). ADIS-C: Anxiety disorders interview schedule for DSM-V. Oxford University Press .

Baker

H. J.

Lawrence

P. J.

Karalus

Creswell

Waite

(2021). The effectiveness of psychological therapies for anxiety disorders in adolescents: A meta-analysis. Clinical Child and Family Psychology Review, 24(4), 765–782. https://doi.org/10.1007/s10567-021-00364-2

Bas

(2021). Relation between student mental health and academic achievement revisited: A meta-analysis In Health and academic achievement-new findings (pp. 1–15). IntechOpen.

Belmont

Skinner

Wellborn

Connell

(1988). Teacher as social context: A measure of student perceptions of teacher provision of involvement, structure, and autonomy support. Technical Report 102. https://doi.org/10.1037/t10488-000

Brown

C. H.

Knight

(2023). Staffing schools to support the classroom: Examining student-to-school-counselor ratios and academic student outcomes in Texas. Professional School Counseling, 27(1). https://doi.org/10.1177/2156759X231165497

Center on Multi-Tiered Systems of Supports . (2025). https://mtss4success.org/

Cohen

(1988). Statistical power analysis for the behavioral sciences (2nd ed.). Taylor & Francis Group. https://doi.org/10.4324/9780203771587

de Lijster

J. M.

Dieleman

G. C.

Utens

E. M. W. J.

Dierckx

Wierenga

Verhulst

F. C.

Legerstee

J. S.

(2018). Social and academic functioning in adolescents with anxiety disorders: A systematic review. Journal of Affective Disorders, 230, 108–117. https://doi.org/10.1016/j.jad.2018.01.008

Dickson

S. J.

Oar

E. L.

Johnco

C. J.

Lavell

C. H.

Seaton

A. H.

McLellan

L. F.

Wuthrich

V. M.

Rapee

R. M.

(2024). A systematic review and meta-analysis of impairment and quality of life in children and adolescents with anxiety disorders. Clinical Child and Family Psychology Review, 27(2), 342–356. https://doi.org/10.1007/s10567-024-00484-5

10.

Donohue

Parzych

J. L.

Chiu

M. M.

Goldberg

Nguyen

(2022). The impacts of school counselor ratios on student outcomes: A multistate study. Professional School Counseling, 26(1), Article 105969. https://doi.org/10.1177/2156759X221137283

11.

Franklin

Kim

J. S.

Beretvas

T. S.

Zhang

Guz

Park

Montgomery

Chung

Maynard

(2017). The effectiveness of psychosocial interventions delivered by teachers in schools: A systematic review and meta-analysis. Clinical Child and Family Psychology Review, 20, 333–350. https://doi.org/10.1007/s10567-017-0235-4

12.

Ginsburg

G. S.

Drake

K. L.

Muggeo

M. A.

Stewart

C. E.

Pkulski

P. J.

Zheng

Harel

(2021). A pilot RCT of a school nurse delivered intervention to reduce student anxiety. Journal of Clinical Child & Adolescent Psychology, 50(2), 177–186. https://doi.org/10.1080/15374416.2019.1630833

13.

Ginsburg

G. S.

Pella

J. E.

Chan

(2024). A pilot RCT of a teacher delivered school-home intervention to reduce student anxiety. School Mental Health, 16(2), 314–330. https://doi.org/10.1007/s12310-024-09638-w

14.

Ginsburg

G. S.

Pella

J. E.

DeVito

Chan

(2023a). Child avoidance of anxiety provoking situations in the classroom and teacher accommodation. Journal of Psychologists and Counsellors in Schools, 33, 51–61. https://doi.org/10.1017/jgc.2021.30

15.

Ginsburg

G. S.

Pella

J. E.

DeVito

Chan

(2023b). A comparison of two teacher trainings on student anxiety. School Psychology International, 45(1), 36–52. https://doi.org/10.1177/01430343231180299

16.

Ginsburg

G. S.

Pella

J. E.

Piselli

Chan

(2019). Teacher anxiety program for elementary students (TAPES): Intervention development and proposed randomized controlled trial. Trials, 20(1). https://doi.org/10.1186/s13063-019-3863-9

17.

Higa-McMillan

C. K.

Francis

S. E.

Rith-Najarian

Chorpita

B. F.

(2016). Evidence base update: 50 years of research on treatment for child and adolescent anxiety. Journal of Clinical Child and Adolescent Psychology, 45, 91–113. https://doi.org/10.1080/15374416.2015.1046177

18.

Kearney

C. A.

Albano

A. M.

(2004). The functional profiles of school refusal behavior. Behavior Modification, 28(1), 147–161. https://doi.org/10.1177/0145445503259263

19.

Keogh

Bond

F. W.

Flaxman

P. E.

(2006). Improving academic performance and mental health through a stress management intervention: Outcomes and mediators of change. Behaviour Research and Therapy, 44(3), 339–357. https://doi.org/10.1016/j.brat.2005.03.002

20.

Koth

Bradshaw

Leaf

(2009). Teacher observation of classroom adaptation checklist: Development and factor structure. Measurement and Evaluation in Counseling and Development, 42(1), 15–30. https://doi.org/10.1177/0748175609333560

21.

Langley

A. K.

Bergman

R. L.

McCracken

Piacentini

J. C.

(2004). Impairment in childhood anxiety disorders: Preliminary examination of the child anxiety impact scale-parent version. Journal of Child and Adolescent Psychopharmacology, 14(1), 105–114. https://doi.org/10.1089/104454604773840544

22.

Langley

A. K.

Falk

Peris

Wiley

J. F.

Kendall

P. C.

Ginsburg

Birmaher

March

Albano

A. M.

Piacentini

(2014). The child anxiety impact scale: Examining parent- and child-reported impairment in child anxiety disorders. Journal of Clinical Child and Adolescent Psychology, 43(4), 579–591. https://doi.org/10.1080/15374416.2013.817311

23.

Lawson

Orapallo

Ginsburg

Brewton

Baker

Azad

(2025). Teacher-delivered mental health interventions: Promises, challenges, and recommendations for future directions. Administration and Policy in Mental Health and Mental Health Services Research. https://doi.org/10.1007/s10488-025-01467-6

24.

Lichtenfeld

Pekrun

Marsh

H. W.

Nett

U. E.

Reiss

(2023). Achievement emotions and elementary school children’s academic performance: Longitudinal models of developmental ordering. Journal of Educational Psychology, 115(4), 552–570. https://doi.org/10.1037/edu0000748

25.

Mazzone

Ducci

Scoto

M. C.

Passaniti

D’Arrigo

V. G.

Vitiello

(2007). The role of anxiety symptoms in school performance in a community sample of children and adolescents. BMC Public Health, 7(1), Article 347. https://doi.org/10.1186/1471-2458-7-347

26.

Mychailyszyn

M. P.

Mendez

J. L.

Kendall

P. C.

(2010). School functioning in youth with and without anxiety disorders: Comparisons by diagnosis and comorbidity. School Psychology Review, 39(1), 106–121. https://doi.org/10.1080/02796015.2010.12087793

27.

Nail

J. E.

Christofferson

Ginsburg

G. S.

Drake

Kendall

P. C.

McCracken

J. T.

Birmaher

Walkup

J. T.

Compton

S. N.

Keeton

Sakolsky

(2015). Academic impairment and impact of treatments among youth with anxiety disorders. Child & Youth Care Forum, 44(3), 327–342. htthttps://doi.org/10.1007/s10566-014-9290-x

28.

O’Connor

E. E.

Dearing

Collins

B. A.

(2011). Teacher-child relationship and behavior problem trajectories in elementary school. American Educational Research Journal, 48(1), 120–162. https://doi.org/10.3102/0002831210365008

29.

Park

Guz

Zhang

Beretvas

S. N.

Franklin

Kim

J. S.

(2020). Characteristics of effective school-based, teacher-delivered mental health services for children. Research on Social Work Practice, 30(4), 422–432. https://doi.org/10.1177/1049731519879982

30.

Pegg

Hill

Argiros

Olatunji

B. O.

Kujawa

(2022). Cognitive behavioral therapy for anxiety disorders in youth: Efficacy, moderators, and new advances in predicting outcomes. Current Psychiatry Reports, 24(12), 853–859. https://doi.org/10.1007/s11920-022-01384-7

31.

Piselli

Pella

J. E.

Chan

Ginsburg

G. S.

(2022). The teacher anxiety program for elementary students: Open trial results. Education and Treatment of Children, 4(1), 33–50. https://doi.org/10.1007/s43494-021-00055-1

32.

Ranta

Kaltiala-Heino

Rantanen

Marttunen

(2009). Social phobia in Finnish general adolescent population: Prevalence, comorbidity, individual and family correlates, and service use. Depression and Anxiety, 26(6), 528–536. https://doi.org/10.1002/da.20422

33.

Settanni

Longobardi

Sclavo

Fraire

Prino

L. E.

(2015). Development and psychometric analysis of the student-teacher relationship scale - short form. Frontiers in Psychology, 6, Article 898. https://doi.org/10.3389/fpsyg.2015.00898

34.

Shelemy

Harvey

(2020). Meta-analysis and systematic review of teacher-delivered mental health interventions for internalizing disorders in adolescents. Mental Health & Prevention, 19(1), Article 200182. https://doi.org/10.1016/j.mhp.2020.200182

35.

Sheridan

S. M.

Clarke

B. L.

Burt

J. D.

(2008). Conjoint behavioral consultation: What do we know and what do we need to know? In Handbook of research in school consultation (pp. 171–202).

36.

Suveg

Hudson

J. L.

Brewer

Flannery-Schroeder

Gosch

Kendall

P. C.

(2009). Cognitive-behavioral therapy for anxiety-disordered youth: Secondary outcomes from a randomized clinical trial evaluating child and family modalities. Journal of Anxiety Disorders, 23(3), 341–349. https://doi.org/10.1016/j.janxdis.2009.01.003

37.

Weems

C. F.

Taylor

L. K.

Costa

N. M.

Marks

A. B.

Romano

D. M.

Verrett

S. L.

Brown

D. M.

(2009). Effect of a school-based test anxiety intervention in ethnic minority youth exposed to Hurricane Katrina. Journal of Applied Developmental Psychology, 30(3), 218–226. https://doi.org/10.1016/j.appdev.2008.11.005

38.

Witteborg

K. M.

Lowe

P. A.

Lee

S. W.

(2009). Examination of the relationship among different dimensions of trait anxiety, demographic variables, and self-reported school adjustment in elementary and secondary school students. Journal of Applied School Psychology, 25(1), 28–46. https://doi.org/10.1080/15377900802484141

39.

Pennell

M. L.

Andridge

R. R.

Paskett

E. D.

(2018). Comparison of intent-to-treat analysis strategies for pre-post studies with loss to follow-up. Contemporary Clinical Trials Commun., 11, 20–29. https://doi.org/10.1016/j.conctc.2018.05.008

40.

Zhang

Wang

Neitzel

(2023). School-based mental health interventions targeting depression or anxiety: A meta-analysis of rigorous randomized controlled trials for school-aged children and adolescents. Journal of Youth and Adolescence, 52, 195–217. https://doi.org/10.1007/s10964-022-01684-4