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Psychiatry, Psychosomatics & Psychotherapy

Causes of Social Anxiety

Socially anxious children and adolescents are often characterized by low self-esteem and fear of criticism. Socially anxious children have an increased risk of not being able to adequately defend themselves against bullying, ridicule or physical violence by classmates or teachers in a class and school climate that may be unsocial. The multitude of possible factors is great.

Even on the way to school, stressful events can repeatedly lead to school anxiety - such as intolerance of the child when driving the bus (shame of vomiting on the bus and the disgust of others), confrontation with aggressive classmates, etc.

School anxiety is an anxiety disorder that arises in the school context and has to be reduced again there. In order to combat fears in the school environment, targeted cooperation between all those involved (parents, teachers, children, child and youth psychiatrists and psychotherapists, school psychologists, social pedagogues) is desirable (Lehmkuhl and Lehmkuhl, 2004).

Most of the time, the affected children do not go to school knowing their parents. Parents often feel sorry for their scared children and want to do them some good by writing apologies. By staying away from school, however, they also support the avoidance behavior of their children and thus only strengthen the vicious circle. It is better to help them get rid of their fear of school, with comfort (no insults!), Encouragement through praise and acceptance (socially fearful children are very afraid of being deprived of love!) And a lot of patience. In order to strengthen the child's personal self-confidence, a sense of achievement should be created - for example, by giving the child tasks that it can do well.

Treatment options for performance anxiety

In order to be able to rule out excessive demands at school, performance and intelligence diagnostics are advisable. Such an examination can be carried out with the child and adolescent psychologist or school psychologist, who can also review the student's learning techniques and draw up suitable curricula.

In the event of excessive performance in the primary school, targeted support measures (remedial lessons, tuition) should be used, whereby special educational support should also be considered if necessary. If, after changing school or moving to a secondary school, the performance requirements do not correspond to the student's level, another school or class change must be considered. No student should have to remain in an inadequate ability group under pressure.

The respective teaching methodology at the school should also fit. Teachers should strive to create a comfortable learning environment. An understanding and considerate treatment of students who are under performance anxiety - for example through occasional calming down, individual guidance, encouragement - can make a big difference.

In the case of persistent fear of school with learning blocks and fear of exams (without actually being overwhelmed), so-called cognitive behavioral therapy by the specialist can help effectively. In such therapeutic accompaniment, techniques such as self-verbalization ("I have to do one thing after the other, then I can do it"), role-playing, anchoring (anchoring confidence), or thought-stopping in connection with relaxation techniques (e.g. progressive muscle relaxation according to Jacobsen) as well as the processing of distorted thought patterns ("I always do everything wrong") carried out.

Basically, children need to learn to cope with fear and anxiety-inducing situations and to tolerate fear to a certain extent as a normal part of life. For this reason, parents should not give an anxious child - except in exceptional cases - any medication to calm them down; also no means such as valerian drops or globules.

Treatment options for social anxiety

Parents, friends, and teachers can do a lot to help develop a child's coping skills. You should help avoid focusing on a child and embarrassing them in front of others because of their shyness. Shyness can be gradually and carefully reduced through positive social experiences.

In persistent cases, an examination by a specialist is indicated, who will, for example, conduct an anxiety history (biographical research into the cause) or an anxiety-specific diagnosis using questionnaires. Cognitive behavior therapy or social skills training can be recommended to promote self-esteem, contact skills, social skills and frustration tolerance.

Stress and conflict management training is offered for teachers and students in order to improve the school climate and to create a social, bullying and non-violent class environment in the school. Discussions should be held with all parties involved to resolve the conflict. In addition, teachers can acquire preventive and anxiety-reducing techniques and strategies for designing lessons in advanced training courses. Special information and training courses are also offered for interested parents.

For older adolescents who suffer from persistent fears in the sense of a social phobia, psychotherapeutic treatment as part of an individual healing attempt can also be combined with drug treatment with a so-called selective serotonin reuptake inhibitor.