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Constantly anxious student

Discussion in 'Workplace dilemmas' started by Bonnie23, Oct 13, 2018.

  1. Bonnie23

    Bonnie23 Occasional commenter


    Short story: Year 11 girl, extreme anxiety, nothing is helping, on a long list for help, having daily break downs.

    Long story: I'm a year 11 tutor and have a girl in my tutor who is constantly anxious to the point where she is in tears every day. For this post I'm going to call her Louise.

    Louise is a top student, targets of 9's for all of her subject and works extremely hard to meet those targets and is in the top sets for everything. She is a prefect, council member and does other extra cirruculars. During year 10 Louise started to become very anxious; she worried about all of her subjects, feeling she wasn't doing well enough. She does more than enough. She will work on her homework until 1am sometimes - she doesn't get enough sleep. I do feel angry with her parents for this because they know she needs to stop working.

    We've had meetings with her and her parents one before and after summer. She has had a Camh's analysis and she is on the waiting list for help (approximately 6 months). Her parents have also paid for her to see a private counsellor to help her - nothing is working.

    The school have given her a 'time out' card so Louise can go to a quiet area of the school to work or just to take five minutes to calm down. Myself and Louise have a check in every day. She is getting personal one to one from our head of year. We have given her a positivity card to help her track things that have gone well.

    However every morning she will be in tears, then at break and at lunch and in between lessons as well as frequent panic attacks and she now thinks she's blacking out from stress with some areas of memory loss. When we ask what is wrong she will just reply 'I don't know'. I'm also getting daily e-mails from parents. Last week she broke down in tears because she thought she'd forgotten a textbook - which was in her bag the whole time (and easy to find).

    I'm looking for advice. I don't know what else to do with Louise. I'm not trained in mental health and I sometimes worry that anything I do/say could backfire on me. Her parents think the school will have the answers to solve this problem but it is so much bigger than that. I'm now getting frustrated with the whole situation because I feel useless in being able to help her.

    Socially she doesn't want to be a burden and she has stopped making an effort with her friends because she feels like she's getting in the way. Her anxiety makes it worse and she doesn't put herself forward in conversations etc in fear of anything backfiring.

    Any advice would be amazing. It's so hard to see her upset all the time.
  2. lrw22

    lrw22 Established commenter

    Can she have a break from some extra curricular stuff? Could she be introduced to some more relaxing extra curricular activities like mindfulness or yoga that she could have an opportunity to pass on to younger students and, from her parent's pov, would still contribute to her cv?
    Bonnie23 and grumpydogwoman like this.
  3. frustum

    frustum Star commenter

    The problem is that there probably aren't any mental health experts here either.

    I can't help wondering whether she needs a complete break from academic work - and a chance to see that she can still keep up without doing homework. Or a ban on taking anything home - an hour in the library after school and then NO work at home. Better to have a few 8s than all 9s and in too much of a state to cope with A-levels. Of course it's hard to convince someone that GCSE grades are not quite the big deal everyone makes out, especially when teachers are spending their time trying to persuade the less diligent members of year 11 that they are of the utmost importance. (I knew someone who had some mental health difficulties in year 11, and got no A*s, but still went to Cambridge.) But I'd be hesitant to suggest actually implementing anything without advice from a relevant professional.

    I'm guessing there's no possibility of the doctor asking for some acceleration through CAMHS on the grounds of her being year 11? (Probably not - I know one youngster who didn't even go on the waiting list because there was no chance of him reaching the top before he was 18, at which point he would have to start over again on the adults list.) By the sounds of things, she's getting worse not better, so maybe the doctor can get some acceleration on those grounds.

    Have they given up on the private counsellor, or might that have some success? Is it worth asking if the private counsellor could meet with school staff to let you know what you can best do to support?
  4. rustyfeathers

    rustyfeathers Occasional commenter

    Do you have access to an ed psych? Can the private counsellor be switched? Has she tried different approaches beyond talk therapy and mindfulness? CBT? DBT? Has medication at least been discussed?

    Are her parents contributing to the pressure? You say they know she needs to stop working - is she "sneaking" work (or working whilst they're asleep, etc) or are they enabling her?

    Is her anxiety around failure, or more general/vague? If the former, having firm back-up plans and knowing they are viable options can help. GCSEs can feel like the be all and end all; IME, students having *options* for post-16 can be a life-raft. E.g. we had a very anxious girl - high performer, hard worker - and we made it plain to her that if she did "fail everything" we'd know that it was a fluke, and she could continue with us, either to resit GCSEs or to do A Levels. We did of course impress that the chances of failure were small - but that we'd have her back should the worst happen. Contingency plans can very much help where reassurance of "you'll be fine" is often hard to believe. Remind her that an 8 is an A*. A 7 is an A and that's a damn good grade. Remind her that *references* count too, and she's ALREADY got those in the bag - she's allowed a break from extra responsibilities for a bit.

    Excuse her from GCSE themed assemblies where she may not realise the "you have to work harder" message is aimed at her. Give her timed tasks for homework, and she must stop after that. You can pitch it not only as well-being but helping with getting a handle on exam timings - and may benefit the whole class.

    Set her "homework" of "have a night off", "chat with friends", "read a good book" etc.
  5. grumpydogwoman

    grumpydogwoman Star commenter

    I'm going to suggest something you won't want to hear.

    This is taking its toll on you. I think the responsibility (or what appears to you to be the responsibility) for this girl has to be shared. You say nothing is working. If you carry on this way you will grow ever more disillusioned. It's not as if her dependence on you solves anything.

    I think she has to report to different people through the week. Sometimes you. Sometimes SLT. Sometimes technicians or TAs. Do you have a Post-16 provision and someone who is happy to be a buddy? Other kids in YR11.

    Two reasons.
    1 You can't continue like this. It's not good for you.
    2 It's not good for her. She needs breadth and diversity of people and opinions and strategies and age-groups. Her life is narrow enough.

    I wouldn't be trying to save this girl almost single-handed. You certainly shouldn't.
    saluki, BioEm, daisy1603 and 8 others like this.
  6. carterkit

    carterkit Occasional commenter

    Poor girl. You may have to accept that you are very limited in what you can do to help her. Such a high level of anxiety needs to be tackled by a mental health professional able to look at all aspects of her life, not just school. I've attached some strategy sheets - one for anxiety with perfectionism and one for anxiety and social withdrawal and I hope they might help but they are obviously generic. There may be more resources on the named website you can use.

    Speak to your Ed Psych if you are lucky enough to have access to one and ask your Senco to keep putting pressure on Camhs.

    Attached Files:

    pepper5, Bonnie23 and grumpydogwoman like this.
  7. HelenREMfan

    HelenREMfan Star commenter

    I have to say.... don't pin your hopes on Camhs being any help/use. As you have seen it can take forever to be seen..... and the personnel in my experience change all the time. One of my students summed it up when she complained that she saw someone new nearly every time and had to go over everything all over again! I always felt that if they got involved there was rarely a good outcome for the pupil and all too often things went worse. Now I know there is chicken and egg..... but I did learn to become very wary of these 'professionals'
    I agree very much with the trying to reinforce the "not the end of the world" to slip on the odd exam. I used to and still do quote cases I know of where not a single GCSE was taken and the young person still went off to Uni to do a course they wanted to do....sometimes things just take longer..... more than one way to swing a cat etc.
    I also totally agree with the avoidance of assemblies where the cohort are being encouraged to work harder etc..... these anxious kids do not see that they are not the target of the pep talk and that the opposite is true. That is excellent advice. In fact assembly time could be a good chance to have a catch up on how she is feeling and whether she is putting into action some of the strategies suggested. Yoga too I am am strong advocate of...... we brought in after school sessions when we had a Yoga person to lead it. I would love it on the PE curriculum if at all possible esp in KS4.
  8. Bedlam3

    Bedlam3 Star commenter

    What a difficult time for her. Could she perhaps drop one or two subjects and sit less GCSEs? Then during the times she would spend in those lessons she could maybe do some meditation or relaxation sessions.
    Mermaid7 and Bonnie23 like this.
  9. katykook

    katykook Occasional commenter

    She needs medication. If she had asthma she'd have inhalers. Mental health problems can have a physical cause i.e. a chemical imbalance.
    Bonnie23 likes this.
  10. Bonnie23

    Bonnie23 Occasional commenter

    I think prefect duty is going to stop in the near future due to the high pressure on year 11 as it is - hopefully this will help. We don't have any extra curriculars for this but I will talk to our PE department/HoYs to see if something could be added.

    This is a great idea. We run a homework club from 3.30-5pm. I think part of the problem is that she goes over and above in worries that she's not doing enough.

    I will put this forward too. We had to spend a lot of time convincing her parents to keep contacting CAMHS to push her assessment through faster. This could be a point to help her.

    Louise mentioned that her private counsellor wasn't helping. I believe they are going to switch to another counsellor. I wasn't sure if medication was possible at her age. I believe this would be a strong help for her.

    I think that they try to convince her to stop but she won't and her parents aren't being firm enough with her. She does her work in her bedroom. I will suggest that she does it in a more public space and no work can be done in her room.

    I think it's both. She was frantic the other day when she thought she hadn't done enough on a piece of homework and she was going to get a detention. The detention hadn't even been issued before she had a breakdown. She didn't get a detention in the end and I don't think she's ever had one previously.

    This is a great idea. I would like her to use that time to practice mindfulness and take a time out. She definitely takes messages like that on board far too much for someone who already works too much.

    I love the idea of a Sixth Former being a talk to person. I will put this forward as an idea for her.

    Thank you!! These are great. I will definitely be using them.

    I completely agree with this. If she were a physical manifestation of her illnesses I think she'd have multiple broken bones and infections. She needs to see it the same way.
    strawbs and agathamorse like this.
  11. mothorchid

    mothorchid Star commenter

    I am not an expert in this, but having many years of counselling (and training) behind me, I will add my thoughts in no particular order, for what they are worth.
    • this is taking a toll on you. You are not a Doctor or anything else and you have a number of other responsibilities. You need to step back a little.
    • what is she gaining by this behaviour? She is having a huge amount of input to no avail. Is there a chance that the behaviour is "designed" to gain attention? It is often more helpful to think "What is the student gaining?" than to think "Why is the student behaving like this?"
    • If she is trying to gain attention like this, why? It might be worth considering what she isn't saying. I had a very similar student once, who was almost certainly being abused by a family member, but was unable to speak about the issue, as her parents were at least partially aware but refused to acknowledge the situation, and would go on holiday with the family member quite happily, despite various discussions we had. "Nice middle class family" who told us "such things" didn't happen in "families like ours"...
    • It might also be worth being aware of the chances of self harm or eating disorders (or the like) which could be linked to this sort of beahviour.
    I suspect we all have a student from time to time who gets under our skin. That's normal and shows our compassion and commitment. But do remember that she is being looked out for by a number of people higher up the ladder and (maybe) better trained and better paid to do it.
    You need to take care of yourself too.
    Finally, it may simply be worth her taking a few weeks/months off and doing GCSEs next year, or over two years. It won't kill her and in the big scheme of things it won't matter.
  12. grumpydogwoman

    grumpydogwoman Star commenter

    What @mothorchid said.

    I volunteer (mentoring/confidence-building for girls) as support to a social worker at a local school.

    One of our girls started developing an attachment to the worker. Let's call the worker Sarah.

    Always wanting to speak to Sarah afterwards etc etc. Turned out she'd formed a very strong attachment to her form tutor. The school has a dedicated full-time counsellor but the girl wanted first her tutor and then Sarah. The tutor had got overwhelmed by this and school saw a pattern emerging.

    I don't think there's any "resolution" as the girl had multiple problems but the staff had to be protected from her demands on their time. It all became too much. Staff thought they were coping and doing the right thing. Actually they didn't get anywhere with her and ended up feeling useless. You have to watch out for that.

    For my money you can do bits and bobs but CAMHS is the way and, if the parents can pay, private therapy seems a good idea.

    Trouble is that you're always there. That can be a minus as well as a plus.

    As for her parents? Someone needs to disabuse them of the notion that school has all the answers. Absolutely NOT.
    carterkit, Bonnie23 and mothorchid like this.
  13. FrankWolley

    FrankWolley Star commenter

    To be honest, I was a Form Tutor (at different times, in different schools) in all the Key Stages. And I really saw my job as recording attendance, chasing up absence notes, passing on information and, when a Sixth Form Tutor, giving advice on University applications. I'd also deliver praise or a b.ollocking when required.

    But 'counselling' ...Nope. I'm a fully paid up member of the 'curtains' view* on that, so probably best to pass people on to others better qualified. I'd suggest the OP does likewise. ;)

    * Having a problem? 'Pull yourself together...':D
    Bonnie23 likes this.
  14. CWadd

    CWadd Star commenter

    You need to take a step back.

    She needs professional help which you and the school cannot give her. I agree with others that CAMHS are the best option. Medication might be needed. Private counselling will only work if she engages with the therapist. But she won't, because she is getting that engagement from you and the HoY.

    You need to protect yourself. I've seen situations like this which escalate to students and teachers emailing and communicating outside work. The parents need to stop emailing you - get the HT involved to put a stop to that. They need to step up here, and stop relying on you and the school to sort this.
  15. dodie102

    dodie102 Occasional commenter

    Completely agree with the advice others have given re looking after yourself here as well as the student. I too have a tutor group with a fair number of complex characters. I am here to be a listening ear when needed, to record their attendance and facilitate communication but there is no way I can be responsible for counselling.

    You need to pass the baton to your HOY/SEND/SLT team. This is their responsibility. I would also say the same with the constant emails from her parents. They are obviously concerned but you cannot be expected to respond to all of these! By all means take time for the girl but just remember your other students, tutor group and teaching classes, need you too.

    In my many years teaching I have seen a real rise in these conditions and for you to 'cope', however well meaning, will do yourself, your student and your colleagues a disservice as the strain will be enormous.

    Very tricky situation and I wish you all the best OP.
    Bonnie23 and grumpydogwoman like this.
  16. BioEm

    BioEm Occasional commenter

    I'd like to second this.

    I had a student who sounded very similar to the OP's and she ended up leaving my lesson to self-harm on the college grounds. She continued to do that in other colleagues lessons too and it really took a toll on everyone who taught her.

    There was a band of 3/4 of us who had to push really very hard to get anything sorted for the student and emotionally it was very difficult for everyone involved. Her tutor because her solace and she refused to engage with anyone else, so her intervention actually did more harm than good for a short time. Our SLT saw we were trying to deal with it and effectively washed their hands of her until one of them found her self-harming in a corridor. It was a nightmare. Luckily we got an action plan put in place and she is in a far, far better place (so my colleagues tell me, I have since left) but it was very stressful and emotionally draining because we all cared so very much and were so very worried for her almost all of the time.

    As teachers we often try and solve things that we can't and students like this fall under that category. Louise needs professional help and guidance. Speak to your line manager and get support from there, then see what the guidance/child protection staff in your place can do to help and advise. As @CWadd rightly points out this is way above your paygrade and you need assistance in helping this girl.
    Bonnie23 and grumpydogwoman like this.

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