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Prescreening is an important part of pre-group planning for school based counseling groups to make sure the work is purposeful and ethical. Individual and group interviews are one way to screen students into groups (Tyson et al., 2004), and we have included 12 questions to interview potential group members to evaluate their fitness.

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Ethical Considerations Stakeholders and Scope of Practice

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Ethical Considerations Stakeholders and Scope of Practice

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The American School Counselor Association (ASCA, 2022) notes in its ethical standards that school counselors must include any relevant stakeholders when conducting group therapy. To keep in line with ethically responsible counseling, school counselors will provide the parents of the identified members with a consent form before beginning the group. All parents should be given the option to ask that their child, a minor, not be included in group sessions.

In addition to the inclusion of stakeholder communication, school counselors will also be careful to stay current on therapeutic techniques and best practices for conducting a group for students with anxiety. Thomas and Pender (2008) suggest that all school counselors engage in continuing professional development on relevant issues. This could include coping mechanisms, anxiety triggers, and seeking professional counseling help of their own if needed.

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Anxiety is the feeling of fear or worry (U.S. National Library of Medicine, 2020). This can manifest physically as sweats, increased heartbeat, and tightened muscles. It is generally a natural reaction to stress when faced with challenges like taking tests (U.S. National Library of Medicine, 2020). Although these responses are normal, it becomes problematic when it chronically affects a person’s daily functioning.

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1.   Have you ever been part of a group before? What was it like?

2.   What are your personal goals for the group?

3.   Are you able to maintain confidentiality and follow the other expectations?

4.    What is hard for you right now in school or with peers?

5.    How are you feeling about school? And your peers?

6.    What are you good at doing at school?

7.    What are you good at doing outside of school?

8.   What are your experiences with anxiety?

9.    Do you feel comfortable talking with the counselor?

10.  Do you feel comfortable talking with other students you don’t know very well?

11.  Are there topics that might be sensitive or difficult for you to discuss?
12.  Do you have any questions for me?

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One way to encourage students to join group counseling sessions is to create fun, creative and inviting promotional flyers to put around the school (Sink et al., 2012).

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By providing students with a needs assessment questionnaire, school counselors will be able to identify students who are at risk of experiencing anxiety that affects his or her school performance (Strand et al., 2021). This needs assessment is a 20-question self-report where students are asked to rate the level to which they identify with a specific scenario or feeling.

This YouTube video, published by Anxiety Canada (2019), can be used by school counselors to help students understand what anxiety looks like and its functions and symptoms.

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School climate is a key predictor of students’ adjustment to middle school. A school’s climate is comprised of many different factors that can affect how well a student adjusts, including perceived social support, family and teacher support, safe learning environments, positive peer interactions, and academic support (Coelho et al., 2020). When a student does not adjust well to their middle school transition, feelings of anxiety can occur from just having to go to school.

School Demographics:
This middle school includes grades 6-8 and is one of three middle schools in the district.

School size: Students population of 653.

Demographics: The middle school is in an upper-middle-class suburban city. Demographics of the school show a largely diverse population; 38% White/Caucasian, 35% Black/African America, 15% Asian, 4% Hispanic/Latino, and 8% of two or more races. Test scores are in the top 52% of the state average. Parent involvement is encouraged but inconsistent. With recent teacher shortages, the class sizes have risen to an average of 26:1 teacher/student ratio.

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Parameters
• Middle school students
• Aged 12-14
• Feeling of anxiety in academic or social settings 2 or more times per week. Feelings of anxiety hinder functionality within their classroom and social settings.

Meeting Logistics
Once participants are selected, the group will meet once a week for 6 weeks. The counselor and 6-8 group members will meet in the library meeting room on Tuesday afternoons for 45 minutes. The school counselor will include 15 minutes after the group to field questions or concerns for group members to discuss individually.

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American School Counseling Association. (2016). ASCA ethical standards for school counselors. Retrieved from https://schoolcounselor.org/getmedia/44f30280-ffe8-4b41-9ad8-f15909c3d164/EthicalStandards.pdf https://www.schoolcounselor.org/About-School-Counseling/Ethical-Legal-Responsibilities/ASCA-Ethical-Standards-for-School-Counselors-(1)

American Speech-Language-Hearing Association. (2020). Issues in ethics: Ethical use of social media. American Speech-Language-Hearing Association. Retrieved September 17, 2022, from https://www.asha.org/practice/ethics/ethical-use-of-social-media/

Anxiety Canada. (2019, March 25). Fight flight freeze: A guide to anxiety for kids [Video]. YouTube. https://www.youtube.com/watch?v=FfSbWc3O_5M

Ball State University. (2021, April 6). Principal-school counselor relationship [PDF]. Indiana Association of Principals. https://www.iasp.org/wp-content/uploads/2021/04/district-6-april-6-meeting-handouts.pdf

Canva. (n.d.). Tips: Help a child with anxiety [Image]. Retrieved September 16, 2022, from https://www.canva.com/design/DAFMntdT2co/zcFpm9AqfuLD8eGtm-NBkQ/edit?utm_content=DAFMntdT2co&utm_campaign=designshare&utm_medium=link2&utm_source=sharebutton

Coelho, V. A., Bear, G. G., & Brás, P. (2020). A multilevel analysis of the importance of school climate for the trajectories of students’ self-concept and self-esteem throughout the middle school transition. Journal of Youth & Adolescence, 49(9), 1793–1804. https://doi.org/10.1007/s10964-020-01245-7

Crawford, Dana. (2017). Culture-based Countertransference. 10.13140/RG.2.2.20986.49602.

DeLucia-Waack, J. L. (2006). Chapter 3. In Leading Psychoeducational Groups for Children and Adolescents. essay, SAGE Publications, Inc.

Derobertis, E. M. (2006). Charlotte Buhler’s Existential- Humanistic Contributions to Child and Adolescent Psychology. Journal of Humanistic Psychology, 46(1), 48–76. https://doi.org/10.1177/0022167805277116

Dube, R. (2021, January 15). Why ethics matter for social media, Silicon Valley and every tech industry leader. Forbes. Retrieved September 17, 2022, from https://www.forbes.com/sites/robdube/2021/01/14/why-ethics-matter-for-social-media-silicon-valley-and-every-tech-industry-leader/?sh=5cd5f8a316f2

Hackensack Meridian Health. (2021, July 02). Is your teen or preteen suffering from anxiety? Retrieved from https://www.hackensackmeridianhealth.org/en/HealthU/2021/07/02/is-your-teen-or-preteen-suffering-from-anxiety#.YyZUaHbMJD8

Hunt, C., Campbell-Sills, L., Chavira, D., Craske, M., Sherbourne, C., Sullivan, G., Roy-Byrne, P., Stein, M. B., & Bomyea, J. (2022). Prospective relations between anxiety sensitivity and transdiagnostic anxiety following cognitive-behavioral therapy: Evidence from the coordinated anxiety learning management trial. Behaviour Research and Therapy, 155, 1–9. https://doi.org/10.1016/j.brat.2022.104119

Jones, T., Riggs, A., & Kuo, N.-C. (2019). Helping Middle School Students Acknowledge and Navigate Anxiety: An Action Research. Current Issues in Middle Level Education, 24(2).

Lee, K. (2021). How can you ease back-to-school anxiety and stress? Verywell Family. https://www.verywellfamily.com/tips-to-ease-back-to-school-anxiety-620832

Linehan, M. (n.d.). Accepts skill. Dialectical Behavior Therapy (DBT) Tools. Retrieved from https://dbt.tools/distress_tolerance/accepts.php

Pinterest. (n.d.) 50 coping skills for kids [Image]. Retrieved September 18, 2022, from https://www.pinterest.com/pin/617345061399416452/?nic_v3=1a6DgEnie

Sink, C. A., Edwards, C., & Eppler, C. (2012). School based group counseling. Belmont, CA: Brooks/Cole.

Strand, P. S., French, B. F., & Austin, B. W. (2021). Assessment of the risks and needs of middle school students: Invariance properties related to gender and ethnicity. Assessment. https://doi.org/10.1177/10731911211062505

Thomas, R. V., & Pender, D. A. (2008). Association for specialists in group work: Best practice guidelines 2007 revisions. The Journal for Specialists in Group Work, 33(2), 111-117. 10.1080/01933920801971184

U.S. National Library of Medicine. (n.d.). Anxiety. MedlinePlus. Retrieved September 17, 2022, from https://medlineplus.gov/anxiety.html#:~:text=Anxiety%20is%20a%20feeling%20of,before%20making%20an%20important%20decision.

YouTube. (2017). Managing Worry and Anxiety for Kids. YouTube. Retrieved from https://www.youtube.com/watch?v=l7g8Atv27Q8&t=1s.

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Selection criteria- narrowing down the pool

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Parents and staff may need some guidance on what symptoms to look for in their children and students. School counselors will offer tip sheets and fact sheets on what to look for. Stakeholders can reference this and refer students to the counseling office if in fact they believe the child is displaying these behaviors.

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School counselors will send monthly emails to parents. The emails will offer suggestions for mindfulness techniques to practice with their child(ren), warning signs that a child is experiencing anxiety and tips to help their child cope with anxiety.

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Along with providing guidance to school staff on warning signs of at-risk students, school counselors will also keep an open line of communication with staff to offer suggestions and updates on what the counseling office is doing for its students struggling with anxiety.

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Keeping administration active and aware of school counseling initiatives is incredibly important in the success of small group instruction (Sink et al., 2012). School counselors will schedule monthly meetings with their administration to go over plans, data, and their vision for group initiatives within the school.

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Anxiety symptoms are different from one person to the next. However, additional signs of anxiety found in teens and preteens include:

-          Chronic worry about family, relationships, and school

-          Staying clear of social interactions

-          Losing interest in previously loved activities

-          Failing performance in schools

-          Worry of embarrassment

-          Having a lack of confidence

-          Carrying inner turmoil

-          Insomnia

-          Exhaustion, stomach pains, and headaches
(Hackensack Meridian Health, 2021).

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Humanistic theory looks at the whole individual to focus on free will, human potential, and self-discovery. Charlotte Malachowski Bühler, an existential-humanistic psychologist stresses the importance of using “the whole person as a model” with child psychology as well as with adults. Bühler uses this holistic theory to highlight human growth, healthy development, and being open to the world of possibilities (Derobertis, 2006).

Humanistic theory will be the approach used for the school-based group counseling sessions. As mentioned above in the definition, anxiety is a normal part of human development. Humanistic approach focuses on free will and achieving one’s full potential and anxiety can get in the way of that. In order to achieve the goals set by humanistic theory, the psychoeducational group will educate students on how to recognize when they are feeling anxious, and teach self-regulation skills to assist in self-discovery.

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https://www.youtube.com/watch?v=l7g8Atv27Q8

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Ethically, while taking each case of anxiety seriously, we must be careful not to influence it within students. We want to avoid manifesting unnecessary worry as well. Gauging the situation is important; not every situation calls for a high-level mental health intervention. For example, treating someone with test anxiety can be misused language and resources if that individual never encounter formal tests beyond school age (Jones, 2019).

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The American School Counseling Association (ASCA) ethical standard (A.7.i):

"Select topics for groups with the clear understanding that some topics are not suitable for groups in schools (e.g., incest survivorship, eating disorders, dating violence) and accordingly take precautions to protect members from harm as a result of interactions with the group." (ASCA, 2022)

We also know that all group counseling services should be based on the needs of the school, students and community which are evaluated through relevant data including a referral process (ASCA, 2020)

Anxiety is an appropriate topic that is relevant to the needs of the school and will strongly benefit the students. With a trained facilitator, well thought screening and pre-group planning process it will do no harm to members.

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1. How to recognize when they are feeling anxious, everyone is different.
2. Coping skills that they can use when they feel anxious.
3. Self-Regulation techniques.
4. How to develop and implement a Crisis Plan.

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Present each student with the above resource to obtain a baseline for each student, and then again after completion of the group (Penn State Worry Questionnaire (PSWQ) - novopsych).

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It is essential to consider the cultural identities of students while screening them into school based counseling groups. This image provides the intersections of one's cultural identity. All parts of our identities affect how we see the world (Crawford, 2017).