Research Paper on Cognitive Behavioral Therapy As an Effective Treatment for Anxiety in a School Setting

Introduction

Children feel anxious frequently, and if the situation is left unaddressed, it may have an impact on their social and emotional wellbeing. Anxious children often find it challenging to manage their behaviors and emotions, which subsequently cause them to struggle to form formidable and sustainable social relationships with peers in school settings. As a result, it may affect their ability to engage with learning and overall wellbeing. According to (Kehle, 2008), 90% of children with anxiety disorders that does not manifest itself to diagnostic levels usually are left untreated. The reason being is that there are barriers such as social stigma or low socioeconomic background that could hinder children from accessing appropriate psychological interventions. The introduction of 12 plus examinations papers and puberty are some of the factors that are perceived to cause anxiety to 8-14-year-old. Therefore, due to the prevalence of children suffering from anxiety disorders, there have been recent urges for learning institutions to introduce social, emotions, and mental health needs (SEMH). It is a type of special education that is desired in children and young individuals (CYI) (Fisher & Newman, 2016). The paper aims to analyze ten pieces of Research which concentrate on the deliverance of school-based group Cognitive Behavioral Therapy (CBT) programs to children suffering from alleviated anxiety symptoms. Group CBT is a term used to depict intervention conducted to children in small teams who have all been diagnosed with mild to moderate anxiety disorders. In that regard, there is a need to ensure that learning institutions are providing appropriate group-based CBT programs to guide and support children who are suffering from increased levels of apprehension. Learning institutions are excellent cost-effective settings for children to access cognitive-based interventions that are monitored or led by trained professionals with knowledge on school systems such as Educational psychologists and psychological approaches.

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Why it is Important to do This Review

Anxiety disorders in children, specifically between the ages of 7-13 years have represented a significant source of morbidity and later linked to later adult psychopathology. Nonetheless, despite the increased prevalence and substantial morbidity, the manifestation of children suffering from anxiety disorder remains under-treated or under-recognized. In that regard, it represents a critical public health issue (Blakey & Deacon, 2013). The evidence base for helping children suffering from anxiety disorders is growing. The first trial of cognitive-based therapies has depicted positive Reviews, primarily when the strategies are conducted in school settings. It is recognized that children suffering from any given ailment, and continuously exposed to bullying have increased chances of anxiety disorders. Henceforth, the recognition of the significance of dealing with anxiety disorders in childhood has led to the introduction of school-based group Cognitive Behavioral Therapy (CBT) programs to help manage and control the disease before its manifests to adverse levels.

The Research on the Use of CBT Programs in Children

According to a study conducted by (Holas, Suszek, Szaniawska, & Kokoszka, 2015), in which the researchers undertook a broad meta-evaluation on the effects of age on the effectiveness of cognitive-behavioral therapy. The evaluation of 70 studies involving children between the ages of 4- 14 years indicated that although the use of CBT therapy was effective in all age groups to prevent the manifestation of anxiety disorder, their effect size was more significant in children between the ages of 10-13 years. The reason being is that the latter age group understands and copes with emotions better compared to the much younger children in the preoperational level. The outcome from this evaluation depicts that for CBT-therapy to be effective, it is desired to adapt and present materials at an appropriate development strategy. In such a manner, abstract elements could be translated into simpler age-appropriate media such as play or art. Therefore, although CBT-therapy is predominately for the older population, the therapeutic intervention can be modified to incorporate metaphors, simple language, and visual aids. Metaphors and simple expressions provide alternative strategies by which complex and new concepts can be presented to children in simple, understandable ways.

(Clevenger, Malhotra, Dang, Vanle & IsHak, 2017) classified unhelpful perceptions and negative behaviors as ' thought invaders' in which children between the ages of 7-13 years are encouraged to conquer, while (Rector, Bourdeau, Kitchen & Massiah, 2018) gave the example of a disturbing song that keeps popping into one's minds to illustrate intrusive thoughts. In that regard, school-based cognitive behavioral therapy can help children suffering from anxiety reframe their reaction to- and- the perception of negative experiences and emotions. The reason being is that cognitive-behavioral therapy does not necessarily eradicate negative emotions but instead provides strategies in which children can begin to understand that feelings will pass in a similar to the dark cloud on a sunny day.

Cognitive behavior therapy leads to a response of 67.7% compared to 54.5% when other therapeutic strategies are utilized (Clevenger, Malhotra, Dang, Vanle & IsHak, 2017). Cognitive-behavioral therapy is useful when combined with stress management and relaxation training in children suffering from anxiety disorders as they may be suffering from depression as well. (Rector, Bourdeau, Kitchen & Massiah, 2018) indicates that cognitive behavior therapy is vital in reducing symptoms associated with anxiety disorders mentioning that 70% of children who are under therapeutic report significant improvement in health.

Psychological Basis of Cognitive Behavioral Therapy

CBD treatment helps in exploring the thinking patterns that cause an inappropriate response in a person. It entails that anxiety is caused by a maladaptive action brought up by negative perception leading to dysfunctional behavior. The treatment strategy focuses on addressing thoughts and emotions that cause counter production reactions and examines the relationship between those behaviors and responses achieved. CBT therapy evaluates the awareness of inaccuracies in perception by exploring painful feelings, attitudes, and thoughts (Blakey & Deacon, 2013). Upon pattern identification, the patient is trained to develop new strategies to cope with negative feelings. Hence, the CBD strategy works on replacing maladaptive responses with effective coping strategies encouraging a goal-directed behavior that will patients deal with stressing situations outside therapy sessions. Practitioners prefer cognitive-behavioral therapy (CBD) in treating patients suffering from mental challenges, which include anxiety disorder due to its proved results and can be used in a group of patients suffering from similar dysfunction, thus a feeling of support in them.

The DSM-5 criteria are structured in various segments consisting of different mental health challenges in which anxiety disorders fit in them depending on manifestation levels such as eating disorders, mood disorders, and cognitive disorders. However, within the classifications, anxiety syndromes tend to overlap, leading to confusion. For this reason, there is a specific criterion that is used to diagnose one of these conditions (Fisher & Newman, 2016). For an accurate assessment, healthcare practitioners need to understand patients' symptoms by requesting them to complete self-report questionnaires. The standardized set of questions assists clinicians in making an accurate diagnosis of the type of anxiety disorder that manifested in a patient. The Penn State Worry Questionnaire, another diagnosis method, has been validated for its capability to differentiate types of anxiety disorder from mild to severe to help healthcare practitioners to prescribe the right medicine in accordance to the level of manifestation. In most situations, anxiety typically co-occurs with depression; hence, the patient health questionnaire-9 instrument is essential if there any suggestion of depression in an individual suffering from an anxiety disorder.

Group-Based Cognitive Behavioral Therapy at Schools

Past researches have explored the effectiveness of CBT-based interventions in a school setting. The studies have found out that CBT-based strategies delivered in groups are equally as effective as personally delivered CBT for children. However, similar studies have ascertained that classroom-based universal group CBT-based channels are the most desired in schools, although its effectiveness entirely depends on the facilitator.

A lot of group CBT-based anxiety prevention channels for children are well adapted to suit learning institutions while at the same time, maintaining critical characteristics and underlying therapeutic elements of cognitive-based therapy. The reason being is that group-based CBT programs to guide and support children assumes that behavioral challenges and emotional distress derive from persistent non-adaptive negative cognition such as perception concerning the environment that leads to specific automated thoughts in certain situations (Blakey & Deacon, 2013). Henceforth, the alteration of these negative perceptions and opinions could help enhance the changed behavior and emotional wellbeing of children suffering from anxiety disorders. The school-based group Cognitive Behavioral Therapy (CBT) programs are the desired technique because trained professionals deliver a balanced clinical setting with several sessions that last up to an hour (Galla et al., 2011). These trained professionals utilize therapeutic interventions to explore the relationship between behavior, emotions, and maladaptive cognition to promote positive change in children suffering from anxiety disorders.

Is CBT an Effective Form of Therapy for Children in a School Setting?

According to (Blakey & Deacon, 2013), cognitive and behavioral theories of human psychopathy are close proximal to cognitive behavioral therapy. Henceforth, by targeting several settings of potential vulnerabilities with developmental-guides objectives and flexible intervention strategies, school-based group Cognitive Behavioral Therapy (CBT) programs have been indicated to be effective strategies to deal with a broad range of psychological challenges experienced by children in a school setting.

Anxiety disorders are the most typical form of psychopathology in children and young adults. In children, the manifestation of anxiety disorders is generally exhibited as a rumination of their health, social issues, the wellbeing of loved ones, and opinions given by others. In that regard, (Fisher & Newman, 2016) ascertain that the implementation of social, emotions, and mental health needs (SEMH) to learners in learning institutions is a form of CBT-therapy that helps children suffering from anxiety disorders.