How School Accommodations for Mental Health May Actually Worsen Anxiety

by | Aug 21, 2023 | Anxiety, Counseling, Highly Sensitive People (HSP), Perfectionism, Self-Esteem, Stress, Teen therapy

How School Accommodations for Mental Health May Actually Worsen Anxiety

Written by: Ira Finkel, LCSW

So, your child has an upcoming presentation that they are anxious about. They, and you, may be wondering if this anxiety is going to have a negative impact on their presentation and grade. Or maybe your child is afraid to mess up, for they may be ridiculed. 

This is more common than you may realize. Oftentimes, as parents, we turn to the school to help ease our child’s anxiety about giving a presentation or other school-related anxieties. As a Certified School Social Work Specialist, I can tell you exactly how the school can handle this. But you probably don’t need me to tell you what to do. The school would handle this by making an accommodation to help your child. This is especially true if your child has an Individualized Education Plan (IEP) or a 504 plan. That would be a great idea.

But that’s just the problem, it is an idea.

Let’s put this into practice. Your child will likely be allowed to give presentations to just their teacher or small groups. Or, they may be given an alternate assignment to do instead of public speaking. “Wonderful,” you may think. From the school’s perspective, this works fine and helps your child be more successful in school. Now, they can worry less because they get to avoid anxiety and focus on just their grades. What more could you ask for?

Well, does this REALLY help their anxiety? No. Instead, they get to avoid their anxiety. The reality is that this not only doesn’t help their anxiety, it actually makes it worse

The brain is a powerful thing. It helps keep us safe by telling us when something is dangerous and needs to be avoided. And the more we avoid the danger, the more our brain tells us to avoid it. Unfortunately, our brain doesn’t always get things right. If we think about it logically, giving a presentation poses no danger to us. But our Amygdala does not know that. We need to TEACH our Amygdala otherwise.

Each time we confront something that the Amygdala sees as a threat without running away, the Amygdala starts to decrease the “danger” signal it sends. Much like going into the pool, we can get used to the perceived danger. When we first enter the pool, our nerves may tell us it is cold. After some time, we no longer perceive the cold. It may surprise you to know that the temperature has not changed. Rather, your brain is becoming accustomed to the signals from your nerves and starts to ignore them. The same thing happens with your anxiety. The more time you spend in or near a situation that is anxiety provoking, your brain becomes used to it and starts to not respond to the fear signals.

Let’s delve into a real situation that occurs in schools that I have worked in. A student has an IEP due to a diagnosis of Selective Mutism. In order to help the student achieve their academics, the special education team includes the following accommodations: small group instruction, the use of written responses to questions, and permission to give presentations to teachers only. These are just common accommodations. The problem is, these accommodations help the student avoid anxiety, therefore reinforcing it. Now, it will only get harder as time goes on for the student to speak in class. Rather, with help from an outside therapist, the student and parents can create a fear hierarchy for the student and help gradually overcome the anxiety.

A great way that I like to explain anxiety to kids is by talking about how our Amygdala is like a fast-processing computer. It takes a quick snapshot of what is happening and processes the information faster than the rest of the brain. This was great during times of cavemen when we were faced with sabertooth tigers. Our bodies have evolved a lot since those days. Except for our Amygdala. 

Let’s call our Amygdala Amy. Amy is really fast but doesn’t do a good job of listening to the rest of our brain. Once Amy decides something, there is nothing you can do to change Amy’s decision. Amy has hijacked your brain. The only thing we can do moving forward is show Amy that there is no danger. That is the only way she will remember. 

How does this look in practice? Your child has to give a talk in class. Amy determines this is a threat and sends the message to the rest of the body. Logically, the rest of the brain knows there is no danger but Amy cannot be overridden. Despite this “danger” your child needs to ignore it in order to show Amy that it is not a dangerous situation. By ignoring Amy and talking in class anyways, your child has now imprinted a memory on Amy, that Amy was wrong. 

Now, the next time Amy is presented with the same scenario, Amy will have a memory that it was not a danger last time. Amy may still send the signal that there is danger, but it won’t be as strong. Each time this happens, the signal will get weaker and weaker. On the flip side, if your child listens to Amy, they prove Amy right and the signal will get stronger.

In summary, while your child’s school is doing the correct thing from a school perspective by adding an accommodation to help your child succeed in the school setting, they are unknowingly making your child’s anxiety worse. This is a common, yet understandable mistake that the school-based social worker or psychologist may not be aware of. If your child already has an outside therapist, make sure that they are in touch with your child’s educational team so the school can help your child overcome anxiety, rather than enhance it. 

Ira Finkel is a Licensed Clinical Social Worker and is endorsed by the National Association of Social Workers as a Certified School Social Work Specialist. He specializes in the treatment of and is a Certified Clinical Anxiety Treatment Professional. He previously worked as a school social worker for Chicago Public Schools before founding Anxiety Professionals of Illinois. He can be contacted by email at irafinkel@anxietyprofessionalsofillinois.com or by phone at (773)-219-1718. You can also reach him by completing an inquiry form at anxietyprofessionalsofillinois.com.

To discuss how therapy could help you during this season of your life, please contact me or schedule your free 15 minute consultation.

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