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1. How can schools stop the stigma associated with mental illness? What roles do teachers, students, administration, and the community play in this movement?

2. What support groups can schools offer where students can talk to someone other than their parent if they are struggling with mental illness?

3. How can general education teachers incorporate coping strategies in their classroom for school related stressors like test anxiety, failure, social relationships, and more?

4. How can I become trained to make effective accommodations & modifications for my students with OCD and anxiety disorders? What professional development programs in this area already exist?

5. What is the process for referring a student with clear signs of an anxiety disorder?

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Connection to OCD Community- Children's Film 

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Connection to OCD Community- Children's Film 

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Unstuck is a film capturing the lives of children with OCD and their personal stories. Below are two short trailers about the movie and clips of children from the movie.

https://www.youtube.com/watch?v=w85CVMmgJ8o

https://www.youtube.com/watch?v=AAumaH3HPyc

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Connection to OCD Community- Children's Literature 

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Connection to OCD Community- Children's Literature 

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Picture Books for Elementary Students Showing Children Living with OCD

Up and Down Worry Hill, by Aureen Pinto Wagner, Ph.D

What to Do When Your Brain Gets Stuck: A Kid’s Guide to Overcoming OCD, by Dawn Huebner

Practice Being Brave: Owning My OCD, by Molly Gambrel

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Connection to OCD Community- For Children & Teens 

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Connection to OCD Community- For Children & Teens 

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Program for children with OCD: a non-profit organization that mails free handmade cards written by people with OCD to others with OCD.

Find out more information or Request a Letter at https://www.notalonenotes.org/

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Dear The Dale Tribe, from Not Alone Notes

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Connection to OCD Community- For Teachers

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Connection to OCD Community- For Teachers

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Resource for Teachers of Students with OCD: this website is also a resource for students and parents. There is information on talking about OCD with students and parents, accommodations & support strategies, examples 504s and IEPs. This resource is sponsored by the International OCD Foundation.

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Anxiety in the Classroom is an online resource center for school personnel, students, and their families.
This website provides useful information, resources, and materials about anxiety and OCD as they relate to the school setting. In addition, it offers specific tools for teachers, administrators, and other school personnel who may work with students with anxiety and/or OCD. Parents and students can also find tools and information to help them advocate for school accommodations, as well as to educate their teachers and classmates about OCD and anxiety.

Impact of Anxiety in the Classroom Setting:

OCD and anxiety are very common in children and can take a tremendous toll on the child's school performance and social functioning. Approximately 1 in every 200 children in the United States suffers from OCD or a related disorder.

Over half of adults with OCD report that their symptoms began before age 18.

The National Institute of Mental Health estimates that around 30% of youth have experienced an anxiety disorder.

A recent IOCDF-funded study has shown that OCD significantly impairs an individual's ability to take advantage of educational opportunities.

A recent study showed that OCD has a pervasive and profound impact on education across all educational levels, particularly when it has an early age of onset.

Need for Anxiety in the Classroom Resources:

Unfortunately, the professionals who interact with youth the most (such as school personnel and pediatricians) are not trained to recognize or work with anxiety/OCD in children. This means that the average child with a mental health condition will wait years after displaying symptoms to receive an accurate diagnosis and treatment.

Anxiety in the Classroom was developed by the International OCD Foundation to reduce the negative impact of anxiety and OCD on youth.

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Anxiety In The Classroom | School Anxiety | Free Resources

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Anxiety in the Classroom is an online resource center for school personnel, students, and their families. This website provides useful information, resources, and materials about anxiety and OCD as they relate to the school setting. In addition, it offers specific tools for teachers, administrators, and other school personnel who may work with students with anxiety and/or OCD.

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The most common and effective treatments are a combination of specialized therapy and medication

Therapy

“Cognitive Behavior Therapy: This is a therapy approach that focuses on changing problematic thoughts and behaviors as a way to decrease symptoms. CBT is effective for all of the anxiety disorders, including OCD and related disorders” (IOCDF).

“Exposure and Response Prevention: a type of cognitive behavior therapy in which a person is asked to repeatedly confront situations which trigger anxiety, not engage in the compulsive behaviors to manage the anxiety, and see that anxiety decreases on its own. ERP is the first line treatment for OCD” (IOCDF).

“Newly researched Acceptance and Commitment Therapy: The focus of this therapy is to help clients experience obsessions and anxiety, but still continue to move in directions in life that are meaningful. The focus of ACT is learning to behave with flexibility rather than resort to compulsive behavior” (IOCDF).

Medication

SRIs: serotonin reuptake inhibitors

Brand Names: Zoloft, Prozac, Paxil, and others

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Students with obsessive compulsive disorder (OCD) can either receive a 504 or IEP for extra support in school depending on the severity of the disability.

Typically, students who qualify for an IEP fall under the category of “emotional disturbance” which includes mental illnesses such as "schizophrenia, anxiety, OCD, conduct disorders, phobias, and self-mutilating behaviors"

Emotional disturbance is considered a higher incidence disability because it is most commonly seen among school-age children . This makes sense because the main character of OCDaniel is a thirteen-year old boy whose OCD makes middle school challenging.

It is important to note that emotional disturbance is more commonly found in males than females at a 3.5:1 ratio. The main character of OCDaniel is a male.

A student has to qualify for only ONE behavior characteristic of emotional disturbance. From reading OCDaniel, I observed a couple of behaviors that Daniel demonstrated at school.

“An inability to build or maintain satisfactory interpersonal relationships with peers or teachers”

Example in Book: He avoids large social settings because of his anxiety. He has one best friend at school but besides that he has trouble fitting in with other social groups like the football team.

“A tendency to develop physical symptoms or fears associated with personal or school problems”,

Example in Book: He physically experiences his OCD which he calls “zaps” and he describes them as “the worst feeling you have ever felt in your whole life, a tingling down neck and spine, stomach turns into an overcooked Bavarian pretzel and hits shoes” (King, p.9). He experiences zaps anywhere when he does not repeat an action for a specific numbers of times or something action/movement does not feel right.

Adaptations based on student characteristics

Daniel is a very bright student with an advanced vocabulary, strong writing skills, and an interest in current news and history.

I think Daniel would benefit from expressing his anxiety through writing as a coping strategy.

Also, Daniel mentions that he had a good relationship with one teacher who showed an appreciation for his intellect and maturity. Daniel’s teachers need to realize that his knowledge and skills can be significant contributions to the classroom. Turning his differences into strengths will make him feel special instead of isolated from his peers.

I think Daniel would be a great peer tutor for a student with a learning disability because he is smart, kind, and understanding.

Since Daniel might have an emotional disturbance, it is important that his teachers implement emotional/behavioral adaptations in the classroom. One example that would help Daniel is a “safe place” in the classroom where he can go to relax or write if he experiences a “zap” in class.

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I chose to read this book because I started showing signs of OCD in middle school but I was not aware of it. At an early age, I was diagnosed with anxiety after seeing a therapist and taking diagnostic tests. I continued to see a therapist for my anxiety for about a year but the treatment was not successful because I refused to open up to my therapist. My parents tried very hard to help with my anxiety but the combination of being ashamed and stubborn prevented from getting better.

In middle school, my anxiety manifested itself into moderate obsessive compulsive disorder to control the negative thoughts that took up my mind. I remember hiding my OCD symptoms from my family and friends, and lying about the compulsions if they caught me in the act. Like Daniel explains in the book, the compulsions develop subconsciously as a coping strategy for soothing obsessive thoughts. I do not think I made a conscious decision to start using my compulsions. I would start repeating movements or adding rules to daily actions when my anxiety was strong. My mom says today that as a child I would express to her “I feel different than everybody else” which is exactly how Daniel felt.

It was not until college that I received treatment for my OCD, because I was placed into an eating disorder program that also manifested from my anxiety. I learned that many people with eating disorders suffer from anxiety and obsessive compulsive disorder. I am curious as to whether taking my anxiety treatment seriously at an earlier age would have prevented my OCD and eating disorder from developing.

Interestingly, after my treatment, I learned that a best friend of mine for ten years had struggled with obsessive thoughts and compulsions for his entire life but he never connected his symptoms to OCD. Now, my friend is receiving specialized treatment for OCD which he believes has the been roots of his struggles in life.

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Acknowledging the Truth

The truth about her father causes a mix of feelings in Sara. On one hand, she is devastated that her father will never come back and that he suffered with mental illness for her entire life without her knowing; but on the other hand, her relationship with her mother and mother’s boyfriend improves because she understands why they protected her from the truth. This moment ignites a change in Sara as her communication with her family increases and anger towards them lessens. In addition to Sara, the truth profoundly affects Daniel by changing his view on mental illness. Before he refused to read the book about OCD, but now he realizes that he has the control to heal his mental illness and it is critical to heal yourself so the illness does not consume you. The book ends with Daniel agreeing to talk to someone about his OCD and Sara supporting his decision and standing by his side.

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Closing the Investigation
The investigation of the disappearance of Sara’s dad thickens as Sara and Daniel find more evidence at John’s house. They find a handgun which they suspect is the murder weapon and her father’s watch on his dresser. This evidence urges them one more time to visit John’s house for incriminating evidence. Sara tracks John’s pickup truck with her mother’s phone so she can hide in the bushes and alert Daniel when John is returning home. Also, she pretends to be her mother and sends text messages to John saying Sara is suspicious about her father and he needs to hide any evidence in his house. John reveals over text messages that the only thing not hidden is a letter about the disappearance of her father written by her mother to John. Within minutes of entering the house, Daniel finds the note on John’s bed asking John for help to get her husband (Sara’s father) out of her life.” Then, suddenly Daniel sees the shadow of someone in the doorway and he is now standing in front of John holding the letter.

Very quickly, the scene turns from frightening to heartbreaking as Sara joins Daniel in the house and John opens up about the truth behind her father’s disappearance. John is not the murderer of her father but her father is not missing, he is dead. Her father suffered from a similar mental illness to Sara that caused an extremely bad drinking and drug addiction. Her mother needed help getting Sara’s father out of the house to protect Sara from the negative influence of her father. John helped Sara’s mother move her father into a hotel room by himself and two days later he was found dead. He killed himself with a drug overdose.  This devastating reality was kept secret from Sara because her mother did not want Sara to think that the only outcome of mental illness is addiction and death.

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Football & Girls

Even at school, Daniel experienced another series of unusual events. Daniel, who is usually the football team’s waterboy, became the starting kicker on the Erie Elephants Football Team for two of the biggest games of the season. Despite Daniel never making a field goal at practice, he was the team’s good luck charm for both games running a winning touchdown and taking out a strong player on the opposing team. These incidences did not completely change his reputation at school but the football players were talking to him more and it caught the attention of his crush, Raya.

This leads to a new struggle for Daniel which is managing his relationship with two girls that he cares about and they both seem to care about him. Sara reminds Daniel of himself, she is different and an outcast but he desperately wants to feel “normal.” Raya is the opposite of Daniel, she is everything he wishes he was and being with her makes him feel “normal.” Although Raya seems to be Daniel’s obvious first choice, he chooses Sara as the main character in the novel he is writing. Throughout the book, Daniel is grappling with the fact that Sara might be the one for him and not Raya. Sara is the first person to tell Daniel that he might be suffering from OCD. She gives him a book about the behaviors and thoughts of someone with OCD and he realizes that his “zaps” and “the routine” are his compulsive behaviors that are triggered by obsessive thoughts. This becomes a huge realization for Daniel because he knows he is not alone and they are treatments for this mental illness.

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The Starchild & the Investigation

One day, Daniels receives an anonymous letter asking for his help from one fellow star child to another star child. Daniel wants to figure out who wrote the letter and what is a star child. Within a few days, the fellow star child reveals herself to Daniel, it is “Psycho Sara.”  Sara calls Daniel and herself a star child because they have extraordinary minds. She needs help from someone with an extraordinary mind to help her solve the disappearance of her father. The two of them meet after school to discuss their investigation plan and start looking for clues. Sara believes that the main suspect in the case is her mother’s boyfriend, John. Sara convinces Daniel to go snooping in John’ house for evidence that John murdered her father. The most important piece of evidence they find is a note in John’s handwriting that is an identical match to the handwriting in her father’s letter.

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Daniel at School & His OCD

Daniel Leigh is an 8th grade student at Erie Hills Middle School. In school, he resides on the outside of the popular group because his best friend, Max, is popular but Daniel feels different from the rest of his grade which lowers his self-confidence and socialness. There is a specific reason why Daniel feels different, his “zaps”, which are compulsive actions that come over him and feel out of his control.  His “zaps” are unpredictable and he receives comfort when he can repeat the same actions until “it feels right” in his body and mind. The “zaps” are the strongest at bedtime as he goes through what he calls “the routine” which is a series of actions he must repeat before bed. These actions are typical of a bedtime routine like walking to the door, turning the light on and off, and brushing his teeth. However, this routine takes him hours to complete every night because if he does not do it for the exact amount of time or it just does not feel right he starts the routine over again and repeats it until every action is done correctly. These rules for the routine are self-imposed but Daniel says they are necessary in order to prevent disastrous situations as serious as death. Some nights he will start the “routine” at 11pm and not finish until 3am. Almost every night, his gums are bleeding and raw from brushing his teeth for hours and his fingers are sore and calloused from flipping the light switch on and off. There has NEVER been a night where Daniel has not done in the routine even when he is exhausted or needs to wake up early.

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Daniel Leigh (main character): a middle school boy whose best friend says “he looks like a used qutip”. He is the backup kicker on the football, but spends most of his time at practice as the team’s waterboy. There is something about Daniel that makes him feel different than everyone else at school and in his family. His greatest struggle in the story seems to be the “routine.”

Max: Daniel’s best friend since he was young, he is the opposite of Daniel meaning he is popular, a football star, and wavers between arrogance and confidence. He is accepting of his best friend’s different behaviors but he does not always understand why Daniel thinks and behaves the way he does.

Raya Singh: a middle school girl who is well-liked, popular, and smart. She is the girl of Daniel’s dream because she is pretty, intelligent, and friendly. She forms a connection with Daniel during a group activity during class where both of them are the only contributing members.

Sara: a middle school girl who goes to the same school as Daniel, Max, and Raya. Her grade has labeled her as “Psycho Sara” because she seems to isolate herself and refuses to talk to any students. In the beginning, the only person she willingly talks to at school is her 1:1 assistant. There is a commonality she finds between herself and Daniel that creates a sense of comfort for her with him.

Daniel’s Family: a middle-class family of five with three children and a biological mother and father. Daniel’s younger sister (name) is extremely intellectual, reserved, and enjoys reading books with Daniel. Daniel’s older brother (name) acts like he is too cool for his family, especially Daniel. He does not care about school and spends most of his time sneaking around with his girlfriend. His mother is caring towards all her children and wants to be involved in their lives. His father tries to relate to him but there is mismatch between what the father enjoys and what Daniel feels is important.

Sara’s Family: a blended middle-class family of three with one daughter, one mother, and her mother’s boyfriend. Sara misses her father who left and blames her mother’s boyfriend for her father’s disappearance. She rarely talks to her mother and has never talked to her mother’s boyfriend. Her strongest relationship at home used to be with her father.