Anxious People…. Anxious Places. How the school counsellor can help

 
 
Rather than visit the OED for a definition of anxiety, might I suggest that you visit a school. There’s noise, tension, stress, rushing, sensory overload and often overwhelming expectations of misfortune and failure for all who dare enter. However, schools are also testing grounds for a wide range of tools, techniques and strategies to help with anxiety, often supported or delivered by school counsellors. 

A recent survey by the National Education Union1 (April, 24) highlighted that 78% of teachers in England and Wales were struggling with workload stress. One teacher commented

“I feel on the verge of going off sick with stress. I feel that my work life balance is terrible, and I spend all my family time worrying about when I am going to fit my work in.”  

Anxiety is often contagious. If this is how teachers feel, then young people can surely be excused for feeling equally anxious. Young Minds2 lists many reasons why young people feel anxious at school. These include school work (concentration problems, exam stress, neurodivergence); relationship problems with peers and teachers; managing school with mental health conditions and family problems; behavioural issues which lead to exclusion or damage to reputation, and problems with specific activities like eating lunch, going to the toilet or PE. Problems with social media have also been found to exacerbate anxiety and although most schools exclude social media from the school day, this does not stop these problems emerging in the dynamic school community. During autumn 2024, local authorities in England reported the total number of children missing education was an estimated 149,900. 3 This is an increase from an estimated 117,100 in the year before. Many of these young people are suffering from EBSA – Emotional  Based School Avoidance – an anxious disorder that often occurs when school becomes too stressful a place to attend.

Nevertheless, schools are at the forefront of trying to develop resources to help with anxiety. They are often considered mental health hubs for helping vulnerable families and children access support. As well as offering advice and support, if anxiety in the school system is lessened, then pupils will find schools less anxious places. For this reason, the most important intervention for anxiety relates to whole school approaches to mental health. Since as early as 2004, when the Mental Health Foundation created one of the first comprehensive whole school approaches to mental health called Bright Futures, schools have continued to develop experience in this area. These approaches usually involve an audit, evaluation and action plan of key areas in the school system. One of the more current programmes is that offered by the Anna Freud Centre 4 and identifies eight areas to be addressed   - Leadership and Management; Ethos and Environment; Curriculum, Teaching and Learning; Student Voice, Staff Development, Health and Well being, Identifying Need and Monitoring Impact. 

Other whole school approaches tackle training of staff for specific problems such as recognising and responding to children who present with trauma behaviours (Trauma Informed Schools UK).5 Some Educational Psychology Services also offer specific programmes for EBSA (Somerset EPS).6 The National Education Union also offers regular training on areas like neurodivergence. In addition, there is a never-ending plethora of helpful information in an increasing variety of forms. Child and Adolescent Mental Health Services7 offer almost 100 videos and many apps on how to help young people, many of which are useful in understanding and coping with anxiety. 

So, how come anxiety, and specifically anxiety in schools, continues to be an ongoing problem?

There are now so many resources available for anxiety that selecting the right one for the right person, and the right school, has become a task in itself. One size, sadly, does not fit all.  This year, the Department for Education8 published the results of one of the largest research programmes into school-based mental health interventions and the results were inconclusive. Issues around the organisation of the lessons, including lack of time, repetitive content, and behaviour management, were cited as barriers to engagement. School counsellors may have a key role to play in overcoming these problems.

There are few professionals who know how to deal with anxiety better than the school counsellor. Standing slightly apart from the mainstream education platform, they are in a unique position to understand the dynamics of anxiety, how it manifests consciously and unconsciously in the school setting. Counsellors can help to create individual programmes for the schools that they work in and these are likely to be more effective than packaged off the shelf programmes. Similarly for individuals experiencing anxiety, school counsellors adapt, create and support a wide range of techniques. Their work on anxiety is all underpinned by extensive training, allocated time, variety of content and relational connections which help to overcome behavioural difficulties.

If a young person discloses to the school counsellor that they are having overwhelming anxiety in school, the counsellor will start by exploring the nature of these difficulties. If the problems are obviously school related, she may suggest an anxiety wristband or card, to help communicate with staff and get immediate help with specific times or areas of difficulty in class and beyond. A support group may be set up from a group of peer supporters that the counsellor has trained. If the young person cannot transition into school, then the counsellor will help with grading anxiety around entering the school and reduced timetables, as well as finding supportive companions for the transition. The counsellor will also talk to staff and advise on the best way to help.

The school counsellor will also have a sound overview of the following more popular  ways to help individuals with anxiety and will assess and adapt them accordingly: 

Breathing exercises can range from simple deep breaths to square breathing, butterfly breathing and using polyvagal zones. For some very anxious pupils, the mindful drinking of water may be a place to start. For younger students, blowing bubbles with different breaths, or breathing in and out with the movement of a yoyo, may be a fun way to help them to understand the importance of breath work.

Bodywork can range from helping pupils learn to do a simple body scan or yoga position to choosing the right regulatory and soothing fiddle toys, of which there is a vast and growing range. Tapping9 and reflexology10 identifies key acupuncture points which children can regulate, sometimes discretely in class. Psychoeducation of how the brain creates anxiety is also useful and fascinating for young people. Watching videos about their window of tolerance11 and then creating exercises around this can be a good focus for therapy.

Guided visualisation can help young people to relax but also to imagine a protective shell or covering to keep them safe in anxious situations, e.g. a screen door or portal or bubble that separates them from anxious places and people. The best and most effective visualisations come from young people’s own interests which the school counsellor is more likely to be aware of. 
Creativity allows young people to use artwork to externalise their anxiety. Sculpting anxiety from clay, giving this model a name, colour, shape and even sound, then transforming this metaphorical object into something else can be fun and effective. Creating rhymes and raps, stories and cartoons all help to lessen the power of anxiety. Engaging with computer games and new online websites can offer sources of support and resilience to young people while ensuring safe access. School counsellors have ever been open to doing different things and doing things differently. Young people are rarely disengaged from their interventions.

Counting is another tried and tested technique. Using the 5,4,3,2,1, approach ( 5 things you see, 4 that you hear, 3 that you touch, 2 that you taste, 1 that you smell) can be altered to colours, animals, foods, or even simple counting of the tiles on the classroom floor or the legs of tables and chairs. Counting the length of time it takes for a small spinning top or wind up toy to stop also helps distract the mind and calm the nervous system. Counting, like many of the other approaches, however, needs practice, and counselling provides a safe place for this rehearsal to take place.

Cognitive Behavioural Therapy remains the bedrock of many anxiety interventions. If the anxious person can change their thinking patterns about school, they will change the way they feel and then behave. CAHMS videos and apps favour this approach. Customizing some of the best CBT tools to the young person however is likely to be more effective, and knowing that there is someone who will continue to support change enhances this approach. School Counsellor facebooks (national and international) offer a wide variety of adapted CBT tools into games and customised worksheets. 12,13 

The CBT approach is also highly influential in the new online approaches to anxiety. The increased availability of online programmes enhanced by artificial intelligence is likely to become ever more common in schools. One way these programmes work is to use schools as a screening portal for referral and then offer parents and young people integrated online and therapist programmes to help with anxiety. The University of Oxford recently positively evaluated Online Support and Intervention (OSI) highlighting that this programme reduced the need for therapist input.14

School counsellors however may be heartened to learn that research continues to suggest that there are problems related to ethics, bias and the necessity of preserving a human touch in delivering therapy that AI still cannot offer (Das and Gavade, 2024). Even so, the new wave of AI-enabled interventions with its various digital tools, such as AI-enabled virtual reality (VR) environments, chatbots and machine learning (ML) algorithms designed to customize treatment plans to individual need are likely to become more popular with young people and may be an enhancement to the counsellor’s toolbox.

However, it’s important to remember that school counselling is more than dealing with anxiety and most school counsellors use more than CBT approaches. This is why the role has been so long standing in the geography of mental health professionals for young people.  One of the reasons that the rising tide of anxiety relieving strategies do not work, is that anxiety may be the tip of an iceberg from deeper rooted issues both in the individual, the school and the wider society. Issues below the iceberg may not respond to recommended strategies, tools and techniques.  
We also live in an anxiety provoking world. Anxiety will always be with us.  Aristotle believed that anxiety is a natural human drive that motivates us to learn and question the unknown. Very few people in schools can facilitate learning from what is  fearful and unknown, from the difficult questions that often seem to have no answer. The school counsellor, however, is one of them.

1. References and Resources 
   NEU (2024) State of Education: Workload and wellbeing, available form https://neu.org.uk/latest/press-releases/state-education-workload-and-wellbeing
   
2. https://www.youngminds.org.uk/ 
3. https://epi.org.uk/publications-and-research/children-missing-from-education/ 
4. https://www.mentallyhealthyschools.org.uk/whole-school-or-college-resources/whole-school-approach-audit-tool/ 
5. https://www.traumainformedschools.co.uk/training/diploma-in-trauma-and-mental-health 
6. Emotionally Based School Avoidance Information and Guidance for Schools and Educational Settings, available from https://www.supportservicesforeducation.co.uk- 
7. https://www.camhs-resources.co.uk/copy-of-videos; https://www.camhs-resources.co.uk/apps-1 
8. DFE (2025) Research and Analysis: Education for well being programmes, available from https://www.gov.uk/government/publications/education-for-wellbeing-programme-findings 
9. Tapping for kids with Alison, available from https://www.youtube.com/watch?v=R0NUNNhosPU 
10. Reflexology for children, available from https://www.youtube.com/watch?v=MqaPK3YIJNU 
11. Window of Tolerance Reimagined, available from https://www.youtube.com/watch?v=ZVEDueyZ2C4 
12. Cognitive Behaviour for School Counseling, available from https://www.youtube.com/watch?v=y3vQbwMTh28 
    
13. https://thinkcbt.com/think-cbt-worksheets 
    
14. https://www.arc-oxtv.nihr.ac.uk/research/OSI-GROWS 

• Schools can be highly anxious places – Noise, tension, stress, and overwhelming expectations can create an environment where anxiety spreads among both students and teachers. 
  
• Anxiety in school is a growing issue – Emotional Based School Avoidance (EBSA) is on the rise, with nearly 150,000 children missing education in England due to school-related stress. 
  
• Whole school approaches matter – Schools that prioritise mental health through structured programmes, staff training, and student support create environments where anxiety is more effectively managed. 
  
• School counsellors play a vital role – Positioned outside the mainstream education system, they understand school-related anxiety and can create tailored interventions that work better than off-the-shelf programmes. 
  
• Anxiety strategies need to be personalised – There is no one-size-fits-all solution, but techniques such as breathing exercises, bodywork, guided visualisation, creative approaches, and CBT can be adapted to meet individual needs. 
  
• AI and digital tools are emerging – Online interventions are becoming more common, but they lack the human connection, ethical considerations, and depth of understanding that school counsellors provide. 
  
• Anxiety is often the tip of the iceberg – Surface-level strategies may not be enough if deeper issues within the individual, school, or wider society are left unaddressed. School counsellors help navigate these complexities.

Anxiety in schools is a complex issue, and while there are many strategies available, their success depends on how well they are adapted to the needs of each student and school community. School counsellors play a crucial role in this process, offering personalised support that goes beyond quick fixes to address the deeper challenges young people face. 

• Anxiety in schools affects both students and teachers, creating an environment where stress can feel unavoidable. 
• Whole school approaches to mental health, like those from the Anna Freud Centre, can make schools less anxiety-provoking places. 
• School counsellors provide tailored support, helping young people navigate anxiety with personalised strategies rather than one-size-fits-all solutions. 
• While AI and digital tools are emerging in mental health support, the human connection and adaptability of school counsellors remain irreplaceable. 

Written by Dr Marilyn McGowan,
Development Manager and a tutor on the Advanced Diploma in Integrative Counselling 

Written March 2025

 

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