Child & Youth Mental Health Algorithm - GPSC

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School & Teacher ToolsTips for TeachersOf Anxious StudentsTips for TeachersOf Depressed StudentsLetter RequestingPsychoeducational TestingTips for GP’s Dealing withStudents at SchoolSample Request for SchoolSupport & AccommodationSupport PlanCADDRA TeacherAssessment Tool
Tips for Teachers of Anxious StudentsWhat is anxiety?Human beings have normal anxieties when facing developmental changes, new situations and potential threats. Whenchildren’s fears and worries become excessive, they may interfere with academic or social functioning. The anxiety responseincludes physical symptoms (e.g., racing heart, stomachaches, sleep problems), behavioral symptoms (avoidance ortantrums) and anxious thoughts and feelings. The tendency to excessive anxiety runs in families, and is increased bylosses, changes, and stresses. Clinical “Anxiety Disorders” take various forms. The name usually explains itself, as inseparation anxiety, social anxiety, generalized anxiety, obsessive compulsive disorder, panic disorder and so on. Typically,treatment involves providing practical support, teaching specific coping strategies and sometimes the addition of medicationsto reduce symptoms.How common is it?About 10% of children have symptoms at the mild end of the anxiety continuum at any given time. About 2% have moresevere symptoms leading to difficulty functioning, attending school, or participating with peers. At any given time, severalchildren in a classroom will be struggling with some form of anxiety disorder.What effect does anxiety have on schoolwork?Anxious children and teens have trouble concentrating, are easily discouraged, will often be tired in class and may beirritable. They are often somewhat perfectionistic. Due to sleep problems, anxious children may miss school or come in late.They may not participate much during class, and grades may drop significantly. Despite these difficulties, anxious childrenand teens are usually advised by their doctor to attend school because it gives the day structure, prevents "school phobia",and keeps them socially connected. It also keeps them moving along academically. Many children with anxiety areachievement-oriented, and the key to feeling successful is attendance at school.How can you help?1. Check with the counsellor: If you have concerns that a child or teen in your class may be anxious, talk to thestudent's counselor, who can give you some guidance as to how serious the problem is and what adaptations areneeded. If the counsellor was not aware of the problem, your inquiry could lead to more help being offered.2. Communicate with parents: Be in touch with the parents, in a positive, problem-solving way. Perhaps they can helpby getting a tutor, or keeping the child on track with assignments. They will often have ideas for strategies that work fortheir child.3. Take the child’s concerns seriously & offer practical support: Check in with the child regarding how they aremanaging: is there anything they don't understand, do they need extra help? Express confidence in the child’s ability todeal with the situation but if it seems they are overwhelmed, it may be necessary to reduce expectations for a definedtime period. Regular class attendance is a lifeline. However, with marked anxiety, it may be helpful for a child or teen tobe able to “take a break” to work in a quieter place, such as the resource room or library. You can also quietly remindstudents to implement whatever coping behaviors have been helpful to them, such as breathing deeply, using distractiontechniques, and practicing positive self-talk.4. Be consistent: All children thrive on reliable, consistent schedules, and for the anxious child this need cannot be statedstrongly enough. If change is anticipated, cue the child and provide active support for transitions.5. Adjusting work expectations: Short answer, multiple choice and match type questions may be easier, whileproducing essays may be overwhelming. It helps to break larger tasks such as projects into individual steps. You couldhelp by providing intermediate deadlines, checking how they are coming along, and providing encouragement to keep itup. Anxious children often have perfectionist standards, which results in assignments “not being good enough” to turnin. Encourage submission of any part of an assignment. A doctor's letter may suggest that material be "omitted" for partof a term or that course-load be reduced. At times, a core subject such as math needs to be repeated in summer schoolor the next year. Please be encouraging in this situation, as students can feel very ashamed and worried about theiracademic future.6. Interaction in the classroom: Anxious children and teens are easily embarrassed, and do not like to be singled out.This includes having their name put on the board, being selected for special projects, getting disciplined in front ofothers, or being asked to volunteer for reading aloud. Working with a peer that the anxious child trusts can help themfeel more comfortable.7. Establish a cue and place for “time out”: Under stress, anxious children may have a “fight or flight” response, withan emotional outburst or angry reaction. If you cannot ignore the behavior, try staying calm, talking quietly and beingreassuring, rather than challenging the child. Do not try to physically remove a child from this situation, as this mayescalate the panicky reaction. It is helpful if the child has a pre-planned safe place in the school building that they canretreat to, if they feel they are going to lose control. Prepare in advance a system whereby the child can signal theteacher, and quietly leave the classroom in order to go to another safe place in the building.8. Work as a team with parents, counsellor, other teachers and mental health professionals to work out a “plan” together.Revised:16.Mar.2010 Dr. E. J. Garland BCCH/VRHB BCCH/VRHB Mood and Anxiety Disorders Clinic 2009
Page 1 and 2: MOA TasksTools/ResoucesMH Screening
Page 3 and 4: Child/Parent or Youth:Child and You
Page 5 and 6: PSP Child and Youth Mental Health M
Page 7 and 8: Child and Youth Mental HealthPSP Mo
Page 11 and 12: Child Functional Assessment (CFA)Th
Page 15 and 16: Never or Sometimes Often or Very of
Page 17 and 18: Never or Sometimes Often or Very of
Page 19 and 20: WEISS FUNCTIONAL IMPAIRMENT RATING
Page 21 and 22: Tool for Assessment of Suicide Risk
Page 23 and 24: Let’s be clearer with words - Dru
Page 29 and 30: Psychotherapeutic Support for Teens
Page 31 and 32: Worry Reducing PrescriptionThere ar
Page 33 and 34: Safety Card- Emergency Contact Numb
Page 35 and 36: DSM-IV Multi-axial SystemPsychiatri
Page 37 and 38: CBIS Lifestyle SkillsHealthy Habits
Page 39 and 40: Healthy Habits for SleepingDepressi
Page 41 and 42: IT’S TRUE: YOU ARE WHAT YOU EAT!
Page 43: CBIS MANUAL | ADOLESCENT VERSION |
Page 47 and 48: LETTER REQUESTING PSYCHOEDUCATIONAL
Page 49 and 50: • • • • • • • • •
Page 51 and 52: LETTER REGARDING SCHOOL SUPPORTS AN
Page 53 and 54: Patient Name:Date of Birth:Physicia
Page 55 and 56: Motor Skills (gross/fine): Does thi
Page 59 and 60: Have Trouble Getting Up in the Morn
Page 61 and 62: 2Child: Um. Lots of things I guess.
Page 63 and 64: 4For children who have worries abou
Page 65 and 66: Use with Permission. Guidelines for
Page 67 and 68: DSM-IV TR criteriaDSM-IV-TR. Primar
Page 69 and 70: DSM-IV-TR. Primary Inattentive type
Page 71 and 72: ADHD Assessment ToolsSNAP IV18 Item
Page 73 and 74: 12 Often runs about or climbs exces
Page 75 and 76: SNAP-IV 26 RATING SCALE: SCORING IN
Page 79 and 80: Reason for ReferralReferred by: Pho
Page 83 and 84: Functioning and Lifestyle Evaluatio
Page 85 and 86: Functioning at School (if not at sc
Page 87 and 88: MENTAL STATUS EXAMINATION (clinical
Page 89 and 90: Treatment PlanPatient Name: _______
Page 91 and 92: PSP Child and Youth Mental Health -
Page 93 and 94: Collaborative Prescribing Agreement
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Referral FlagsReferral of the child
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PSP Child & Youth Mental Health Mod
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6 - item KADS scoring:In every item
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Permission to use the KADSThe KADS
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Depression in Children and YouthA G
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Use with Permission. Guidelines for
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CHALLENGE NEGATIVE THINKINGQuestion
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2HOW TO DO IT!Step 1: Teach younger
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It is ver y useful to help a child
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CBIS Cognition SkillsAnti-Depressio
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Small GoalsThe concentration, fatig
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Problem SolvingDepression can make
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Common Thinking ErrorsThe situation
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Thought StoppingDepression often ma
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Use with Permission. Guidelines for
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Referral FlagsReferral of the teen
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DSM-IV TR. Oppositional Defiant Dis
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Specific PhobiaA. Marked and persis
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Social Anxiety DisorderA fear of on
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SCARED - Child VersionPg. 1 of 3 (T
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SCARED Scoring - This page is for o
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Screen for Child Anxiety Related Di
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Section B: Fear/Avoidance - Seminal
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Not at all Somewhat Pretty much Ver
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Not at all Somewhat Pretty much Ver
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Weiss Symptom Record (WSR) Instruct
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CY-BOCS Symptom ChecklistChildren
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CY-BOCS Symptom ChecklistChildren
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RESOURCES.RESULTS.RELIEF.© Anxiety
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© AnxietyBC3
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CBIS ToolsIntroduction toRelaxation
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Abdominal/Belly BreathingPurpose•
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PurposeGroundingGrounding is a calm
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Passive RelaxationPurpose• Passiv
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CBIS MANUAL | ADOLESCENT VERSION |
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MindfulnessMindfulness originally c
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ThoughtsMindfulness Meditation• A
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For teens: Although you should enco
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This STOP Plan is for:_____________
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FEELING: _____________________FEELI
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THINKING TRAPSThinking TrapsExample
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REALISTIC THINKING FORM (E.g.)Situa
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REALISTIC THINKINGWe can all be bog
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Step 3: Challenge your “anxious
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Tip #3: Alternative balanced statem
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phobia - when you are afraid of som
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Chester the Cat feels anxious!How d
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Panic DiaryDate Trigger Symptoms Se
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FluoxetinePSP Child and Youth Menta
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Referral FlagsReferral of the teen
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ChildandYouthMentalHealthPSPModule
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AnxietyResources for youth and fami
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Practice Support ProgramAdditional
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Practice Support ProgramAdditional
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FH Referral Flags in the Electronic
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What doesEPI provide?The EPI Progra
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Child and Youth Crisis ProgramProgr
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Fraser Health Child and Youth Neuro
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Fraser Health Child and Youth Neuro
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MapContact InformationAddress:Shirl
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FRASER HEALTH CHILD AND YOUTH PSYCH
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Fraser Health Infant Psychiatry Cli
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FRASER HEALTHINFANT PSYCHIATRY CLIN
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Child & Youth Mental Health Algorithm - GPSC

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