Helping pupils to handle anxiety and stress

Written by: HTU | Published:

The pressure that our primary school children can face as they grow-up is increasingly being recognised as something that schools must play a part in tackling. Sal McKeown reports from two schools in Coventry which are using different approaches.

Exam worries, peer group pressure, body image – children in primary schools are seemingly more stressed than ever. The good news is that, despite cuts, there also seems to be more of an awareness of children’s needs now and a better climate for understanding – but it has become clear that schools need to be as vigilant at spotting emotional and social difficulties as they are at identifying learning issues. 

Some primary schools in Coventry have been looking at new approaches, including hypnotherapy and Cognitive Behavioural Therapy (CBT).

Cognitive Behavioural Therapy

Lisa Sabotig, a senior educational psychologist with company CPA, has been working with Courthouse Green Primary School on Friends for Life, a programme for vulnerable primary-aged children who suffer from depression and anxiety. 

The aim is to build emotional resilience and help children to recognise and manage their feelings. In the words of SENCO and assistant headteacher Claire White: “You are with you for life. You are your own best friend.” 

It offers a framework for emotional growth. Some children are quiet and introverted and staff need to be vigilant and monitor those who may seem to be quite indifferent to new experiences, appearing passive and withdrawn. Other children can exhibit mood swings and impulsive behaviours. 

At Courthouse Green, six boys from years 5 and 6 were identified and became part of a Friends for Life Group run by two teaching assistants, Louise Whetstone and Clare Wilkins. At first, they tended to focus on the negative things in their lives, the things that had gone wrong in the day or at home, but over time they wanted to share good things as well. All of them have become more settled and are enjoying school life more. 

One of the key issues has to be whether the children and their parents feel stigmatised, but this has not been the case at the school. 

Ms White explained: “Parents have been very supportive. They were getting lots of phone calls from school about their child’s progress but they feel we are all doing something to address it and that their children are getting the help they need.”

The Friends for Life programme uses CBT approaches and provides the child with coping mechanisms to deal with anxiety and depression. They work on investigating relationships between thoughts and feelings. There are many practical elements. They learn about relaxation techniques and start to use them in their lessons when things get fraught. One example of its application has been in the run up to key stage 2 assessments. For example, they have ready access to a stress ball in their lessons. They can also use a “Feelings Wheel” which helps them to recognise and convey emotions.

James used to fly off the handle very easily. He would not accept constructive criticism of his work and was very impulsive, but these days he can regulate his behaviour and staff have noticed an improvement. Whereas in the past he would have stormed out or thrown objects, now he is able to control feelings and think through his options. 

Ethan had word-finding difficulties. He had no self-confidence and stuck like glue to one particular friend. After a few months in the Friends for Life programme, he is walking round the school head up, making eye contact, smiling and speaking.

Ms Sabotig is delighted by the progress the boys have made, but not surprised: “Mental health problems are often under-identified,” she explained. “Children can become very self-critical, struggling with anxiety. The things we work on – relaxation techniques, reading other people, recognising helpful and unhelpful thoughts – can support them to recognise they are getting distressed and find a space for themselves where they can take control.”


Anxiety, confidence and self-esteem are key issues for many children in primary schools and another solution being used by some is hypnotherapy.

“A hypnotherapist doesn’t need to know why a child has problems but can give him ways of managing stress and some coping strategies,” explained Caroline Dyson, founder of the Hypnotherapy in Schools Programme (HISP).

As a teacher with a background in psychology, she has experience working in mainstream schools, specialist SEN settings and is currently working part-time for the Learning and Behaviour Support Service in Coventry.

When she first meets them, Ms Dyson talks to children about hypnotherapy as a form of relaxation, a way of playing imaginary games and telling stories and deals with some misconceptions. Some children are surprised that they do not have to close their eyes. 

They talk about school and home, what they like to do, pets and friends. She also asks them what job they would like to do when they grow up and what would be their chosen magic superpower: “Many children with autism spectrum disorder opt for mind-reading.”

By the end of the first session she has an overview of the child and what makes him tick and a list of up to four mutually agreed targets such as: to feel less anxious, to stop self-harming, to control rage. 

Before the second session she makes sure she has prepared a CD which has a piece of music and her voice talking to them: “They can use this at any time as way of anchoring themselves. A teacher might let them listen in lesson time with headphones.”

Generally children have six sessions with Ms Dyson and each time they look at their targets and grade them on a scale of one to 10 so they have a way of measuring where they are on the scale of anxiety. 

Ms Dyson works from their chosen interests. For a child who likes computer games and wants to develop confidence, she creates an imaginary game where he fills a gun with confidence and shoots anxiety aliens. A child who likes horses might see themselves sitting on a horse, sitting tall with a different perspective on things. For anxiety around SATs they might visualise an energy bar – turning up confidence, visualising it: “This is surprisingly successful,” Ms Dyson added.

Children come to understand that panic and anxiety are the body’s way of keeping itself safe, and while a little anxiety is useful it needs to be kept under control.

Ms Dyson teaches them breathing techniques so they learn how to relax, to manage the fight and flight instincts. Colour breathing helps – this is where they breathe out negative thoughts, feelings and behaviour and visualise them as one colour. 

Then as they breathe in, they fill their mind with another colour for positive thoughts, feelings and responses. Colour makes it less boring but for some children other senses work well so she might get a child to describe feelings as hot /cold.

A boy with Crohn’s Disease has been able to halve his pain medication using these techniques and a girl with autism, who was very distressed if she had to go on public transport, has developed a strategy to help her cope. She now mutters the word “tomato” over and over again as a trigger for her colour breathing and can travel by train with her family. 

One little boy was referred because he was experiencing night terrors. He would wake up in great distress but with no memory of what he had dreamt. He had one session of hypnotherapy and his mother reported there has been no recurrence.

While some successes may be almost inexplicable, Mr Dyson is clear that there are certain ingredients for success: “Children must opt in. Those with behavioural problems might be reluctant so I suggest they try one session and see if it works. It often does. Possibly this is because they see me as a partner whereas they can associate teachers with pressure.”

Ms Dyson also trains teachers and teaching assistants to run sessions on guided imagery so they are able to help children with lower levels of anxiety. She believes that children want to be happy and social but there are too many pressures from their home life and from education.” 

Approaches to therapy – key advice

  • Look at small group work to promote and reinforce strategies.
  • Give them an identified space to work in.
  • A whole-school approach is essential in delivering an intervention.
  • Academic and pastoral information must be joined up.
  • Involve parents and support them to support the child. Give them strategies: relaxation techniques, “catch them being good”, active listening skills.


  • Sal McKeown is a freelance education journalist, specialising in SEN.


  • Observing Children with Attachment Difficulties in School: A Tool for Identifying and Supporting Emotional and Social Difficulties in Children Aged 5-11 by Kim S. Golding (Jessica Kingsley Publishers).
  • Running a Nurture Group by Simon Bishop (Sage Publications).
  • Cool Connections with Cognitive Behavioural Therapy: Encouraging Self-Esteem, Resilience and Well-Being in Children and Young People Using CBT Approaches by Laurie Seiler (Jessica Kingsley Publishers).
  • Hypnotherapy in Schools:
  • CPA:

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