An NPR report from August 31st, 2016, talks about the roles of different school personnel in helping students with anxiety and OCD.
The school counselor ideally has a role of serving as a bridge between teachers, students, parents, and therapists. However, the report also recognizes the reality that most school counselors serve, on average, nearly 500 students. Since up to 20% of students have an anxiety disorder or OCD, this means each school counselor might be responsible for 100 students with anxiety or OCD. That is a heavy caseload!
If you are a therapist working with a school counselor, remember this is a great chance to collaborate and educate the counselor. I recently spoke at the request of ADAA to a group of 125 elementary school counselors and learned that about while half had some training in CBT, only one had been to the ADAA website, and only one knew about ERP. This is a group that is eager to learn.
Here are the principals of CBT that were shared with the group:
- CBT involves collaboration and active participation
- Therapist and client are a team!
- The relationship is based on empathy about the client’s suffering
- Client / family decides what to work on
- Client identifies their own cognitive distortions
- Client / family decides on homework
They were particularly interested to notice that the client and family decided on homework because some of them believed incorrectly that CBT is a cold, mechanical process. They were glad to learn that treatment could be tailored to any problem a child and family would bring in.
The Stat That Shocked School Counselors
These counselors were shocked to learn that even today, only about 20% of children get the treatment they need, and it takes, on average, 14 years for a child with OCD to get a diagnosis and treatment. They were interested to learn that avoidance and accommodation will not help a child get well and that exposure and response prevention work to change the brain so it works like the brain of a person who does not have anxiety and OCD.
A Helpful Tip Shared About Exposure Therapy
I modeled an exposure of loud noise to the counselors, and though the balloon didn’t pop as loudly in the large auditorium as it does in my office, they laughed and seemed relieved to know that exposure doesn’t always go perfectly!
I left grateful for the chance to talk to this important group of educators. School counselors serve as an important bridge to diagnosis and treatment, and I thank them for the help they are able to give the students in their school.