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A School Nurse-Delivered Intervention for Anxious Children: An Open Trial

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Abstract

Anxiety disorders are common in children and severely impair their functioning. Because a hallmark symptom of anxiety is somatic complaints, anxious youth often seek help from their school nurse. Thus, school nurses are in an ideal position to identify anxious children and intervene early. This study assessed the feasibility of a brief nurse-administered intervention (CALM—Child Anxiety Learning Modules) based on cognitive behavioral strategies to reduce anxiety symptoms and improve academic functioning. Nine elementary school nurses completed a one-day training and administered the CALM intervention to 11 children with elevated symptoms of anxiety (M age: 8.09; range 5–11; 54% male; 91% White). Feasibility of the intervention was assessed using several indicators (e.g., training satisfaction, intervention satisfaction/helpfulness). Pre-post intervention child outcomes were collected from evaluators, parents, children, and teachers. Results indicated that the majority of nurses were highly satisfied with the training and reported the intervention was feasible. Paired t tests on pre-post outcome measures revealed significant reductions in anxiety, somatic symptoms, and concentration problems. Nurses (70%), parents (81%), and children (50%) reported that the intervention was either somewhat or very helpful. Preliminary results identified barriers to implementation but also suggest that the intervention is feasible and helpful. A sufficiently powered randomized controlled trial is needed to assess the intervention’s efficacy.

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Acknowledgements

This research was funded by the Institute of Education Sciences, US Department of Education, Grant # R305A140694, to the third and last authors. The opinions expressed are those of the authors and do not represent views of the Institute or the U.S. Department of Education. We gratefully thank the CALM development group members for their expert guidance and feedback throughout the course of the study: Donna Mazyck, Nichole Bobo, Dr. Mark Weist, Dr. Catherine Bradshaw, and Stephanie Knutson. The authors would like to thank all the nurses, teachers, children, and parents who participated in the study.

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Authors and Affiliations

  1. Department of Psychiatry, University of Connecticut Health Center, 65 Kane Street, West Hartford, CT, 06119, USA

    Michela A. Muggeo & Golda S. Ginsburg

  2. Department of Psychological Sciences, University of Connecticut, Storrs, CT, 06269-1020, USA

    Catherine E. Stewart

  3. The Johns Hopkins University School of Medicine, and Anxiety Treatment Center of Maryland, 5022 Dorsey Hall Drive, Suite 201, Ellicott City, MD, 21042, USA

    Kelly L. Drake

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  1. Michela A. Muggeo
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Correspondence to Golda S. Ginsburg.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the Institutional and/or National Research Committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. Informed consent: Informed consent was obtained from all individual participants included in the study.

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Muggeo, M.A., Stewart, C.E., Drake, K.L. et al. A School Nurse-Delivered Intervention for Anxious Children: An Open Trial. School Mental Health 9, 157–171 (2017). https://doi.org/10.1007/s12310-017-9211-x

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