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By Denise Egan Stack, LMHC, OCD Foundation

Anxiety in school is a widespread problem at every grade level.

Research shows that up to 25% of students struggle with clinical anxiety which can significantly impact a student’s ability to learn and perform up to their capacity.

Anxious students may have:

  • high absenteeism rates
  • difficulty processing and retrieving information
  • sleep deprivation
  • distributive behaviors in class
  • fractured relationships with peers and teachers
  • irregular homework completion and classroom participation
  • complaints of physical ailments

Because anxiety levels fluctuate throughout the day and from day to day, difficulties are often unpredictable and inconsistent. In other words, sometimes a student struggles in a particular situation and sometimes they don’t. This confuses and frustrates teachers, parents, and students. Another complicating factor is that school-based anxiety looks like many different things, including ADHD, anger, shyness, disorganization, and/or apathy. As a result, anxiety in school often goes unrecognized and, thus, unmanaged.

Based on 1,000 responses to a recent International OCD Foundation (IOCDF) survey, school personnel are looking for help on how to manage this often-debilitating problem. To meet that need, the IOCDF is developing an innovative program called Anxiety in the Classroom. The website provides useful information, resources, and materials about anxiety and OCD as they relate to the classroom, including tips on developing an effective accommodation plan for the anxious student.

There are many moving parts to a comprehensive plan aimed at helping a student manage their school anxiety, but in my experience, one of the most fundamental is effective communication between school and home. Sharing information and collaborative problem solving throughout the entire process is essential. Otherwise, misunderstandings and inconsistencies are bound to occur.

Recently, I treated a high school student who struggled with social anxiety and perfectionism. When we started working together, she was overwhelmed with missed assignments and felt stuck in her attempts to get help. As a result, she frequently missed school because she “didn’t feel well,” which only exacerbated the problem. When she was in class, she doodled to cope and refused to participate. Most of her teachers avoided her and her parents thought she simply had a bad attitude.

When the full extent of the problem became clear, I called a meeting with my student, her school counselor, her parents, and several of her teachers. My first task was to get all parties to agree that my student’s challenges in school was a mental health problem and not an attitude or behavioral problem. Her parents believed that she simply needed to “just do the work” and the school believed that any accommodations would be an unhelpful crutch.

I set about getting consensus by educating everyone about anxiety: how prevalent it is in classrooms, how it manifests in school, and how it effectively shuts down the brain. I also took great care to demonstrate how my student’s behaviors fit this pattern, using many concrete examples. My student elaborated on all the above, which was very helpful because it was the first time that most of her teachers heard her talk about her experience with anxiety. Finally, I assured everyone that the accommodations on the 504 plan would be short lived because the expectation was that my student would be learning how to manage these situations more independently over time.

Once we established that anxiety was the problem and I had “buy in” from all parties, we started the process of developing a 504 plan, created an interim program that allowed her to start to make up her work, and kept in regular contact as the plan was being put into effect. We had established a comprehensive and proactive plan to deal with familiar patterns and problems instead of waiting until a crisis occurred to intervene. This reduced everyone’s anxiety!

Large assignments and long photography projects were particularly difficult for my student. She would get overwhelmed with possibilities and confused about where to start and what to do. Complicating matters even more, she was very reluctant to approach her teachers for help because she didn’t want to be a bother and felt she should be able to do it on her own.



Because my student was struggling with decision making, organization, and procrastination and not the academic material, the plan we developed centered on improving student/teacher communication. It included specific times to meet and goals for each meeting. For example, the student and teacher would meet when a large assignment was given in order to create an outline and set deadlines for the smaller parts of the assignment. In session with my student, I monitored her progress meeting these smaller deadlines and communicated with her school counselor as needed.



Having established good communication amongst all parties made it easy to adjust the plan as necessary. For example, when my student returned to school after having been sick for several days, she was overwhelmed with missed work and vulnerable to engaging in old, ineffective patterns of behavior (avoidance). Within a day, I emailed her school counselor who then coordinated with her teachers to develop a manageable plan for missed work, including specific deadlines and scheduled check-ins.

Plans like these helps anxious students break through their avoidance patterns and acquire experience managing difficult triggers in a more effective way. As they build more successful habits and coping strategies, accommodations are faded out. At this point, my student is much less anxious when asking her teachers for assistance or clarification, therefore her school counselor and I are rarely involved in helping her manage these interactions.



I am pleased to report that my student, who at one point was so burnt out on academics that she couldn’t fathom another four years in school, is now a senior, recently received a glowing first term report card, and is excitedly applying to college.

For more information and resources to help with anxiety and OCD in school, visit Anxiety in the Classroom.

Provide Feedback for Parent Resources!

The IOCDF is looking for feedback from parents to help build additional resources for the Anxiety in the Classroom website. To provide feedback, please take this short survey.

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