Youth Narratives on School-Based Anxiety Prevention by Andrea Felix BA, University of Victoria, 198

150 Pages·2017·1.32 MB·English

A Beacon for Information: Youth Narratives on School-Based Anxiety Prevention

by

Andrea Felix
B.A., University of Victoria, 1983

A Thesis Submitted in Partial Fulfillment of the Requirements for the Degree of

MASTER OF ARTS

in the School of Child and Youth Care

©Andrea Felix, 2017
University of Victoria

All rights reserved. This thesis may not be reproduced in whole or in part, by photocopy or other
means, without the permission of the author.
ii

Supervisory Committee

A Beacon for Information: Youth Narratives on School-Based Anxiety Prevention

by

Andrea Felix
B.A., University of Victoria, 1983

Supervisory Committee

Dr. Marie Hoskins, (School of Child and Youth Care)
Supervisor

Dr. Jennifer White, (School of Child and Youth Care)
Departmental Member
iii

Abstract
Supervisory Committee:
Dr. Marie Hoskins (School of Child and Youth Care)
Supervisor
Dr. Jennifer White (School of Child and Youth Care)
Departmental Member

The newly revised 2017-2018 British Columbian high school curriculum, as a prevention
education response to a growing concern around children and youths’ mental health, indicates
that students will learn the signs and symptoms of stress, anxiety and depression and be able to
explain strategies to promote mental well-being (Province of British Columbia, 2016). Youth
voices may help in shaping this curriculum objective. This study explores the meaning that five
high school students, who were trained to facilitate an anxiety-prevention program, make of the
problem of anxiety and prevention through their narratives, applying a narrative methodology
and analysis. These youth narratives do not provide a singular explanation, truth or
understanding of anxiety; like all narratives, they hold multiple truths. The youth narratives are
drawn from the participants’ local experiential knowledge as well as prevailing discourses that
shape their understanding. The types of narratives in this inquiry include: i) the quest for
problem-free childhoods; ii) the genesis of knowledge; and iii) overcoming giant stigma by
connecting. There are implications and considerations pulled from the narratives, including
how a prevailing psychologized discourse may obscure contextual factors in making sense of
anxiety and prevention. This inquiry may help educators and other professionals to imagine
what else could be possible in conceptualizing the problem of anxiety and implementing
prevention programs. It is hoped that this study will add to the current dialogue around
prevention and support strategies in British Columbian schools and beyond.
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Table of Contents
Supervisory Committee……………………………………………………………………. ii
Abstract…………………………………………………………………………………….. iii
Table of Contents …………………………………………………………………………. iv
List of Figures ……………………………………………………………………………… v
Acknowledgments …………………………………………………………………….……vi
Chapter One: Introduction and Context ….……………………………………………... 1
1.1Thesis Organization ……………………………………………………………. 1
1.2 An Overview and Intentions ……...…………………………………………… 1
1.3 Research Inspiration………………………………………………..…………… 2
1.4 Study Rationale …………….………………………….….…………………… ..5
Chapter Two: Literature Review …………………………………………………………10
2.1 Literature Review Approach ……..…………………………………………….. 10
2.2 The Problem of Anxiety in Children and Youth ……..………………………… 10
2.3 Schools and Mental Illness Prevention ………...………………………………..14
2.4 Youth as Competent …………………...………………………………………. 23
Chapter Three: Methodology ………………………………………………………..……29
3.1 Purpose of Study ……………………………………………………………….. 29
3.2 A Narrative Methodology ……………………………………..……………….. 29
3.3 Methods ………………………………………………………….………………37
3.4 A Narrative Analysis …………………………………………………………….42
Chapter Four: Findings and Discussion …………………………..………………………52
4.1 The Quest for Problem-Free Childhoods……………………………………....... 52
4.2 The Genesis of Knowledge …………………………………………………….. 62
4.3 Overcoming Giant Stigma by Connecting .………..…………………………... 74
4.4 Implications and Considerations ……………………………………………….. 90
References …………………………………………………………………..……………… 97
Appendix A…………………………………………………………..……………………. 109
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List of Figures
Figure 1: Constructing a typology of narratives: problem-free childhoods …..........................45
Figure 2: Stages one to three of the six stage concept map, illustrated with reference to
constructing a narrative typology: the genesis of knowledge………………………49
Figure 3: An example of moving through stages four to six in the six stage concept map,
illustrated with reference to constructing a narrative typology: the genesis of
knowledge .……………………………………………………………………….....50
vi

Acknowledgments
First and foremost, I would like to express deep thanks to my supervisor, Dr. Marie
Hoskins who pushed me to clearly articulate my questions and who gently but persistently
nudged me to deepen my thinking with a narrative approach and sharpen my writing
throughout this process. Thank you for your patience and mentorship. I would also like to
extend by deep gratitude to my committee member, Dr. Jennifer White, who freely trusted me
with methodology books from her personal library and who opened the door to my thinking
with ethics. This influenced both my thesis work and my ongoing work with student peer
counsellors. I am grateful to Dr. Sandrina de Finney, Dr. Jessica Ball and Dr. Veronica Pacini-
Kethabaw in the Child and Youth Care department who exposed me to poststructural thinking
and opened paradigms I had never considered in the problem of anxiety; these professors
pushed me out of the prevailing psychologized discourse box. I would also like to acknowledge
Dr. Wayne Mitic, Dr. Gord Miller and Dr. Robert Lees who supported me in the initial research
project that led to this thesis.
Finally, I am indebted to my family, friends, students and colleagues for their ongoing
support and encouragement. I am especially grateful to my husband for his unconditional love
that buoys my confidence when I am anxious and helps me to overcome my own normal
problems of living. I dedicate this research to my students who inspired me to dig deeper into
making sense of the problem of anxiety.
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Chapter One: Introduction and Context
Thesis Organization
This thesis is organized in five chapters. I begin the first chapter with an introduction of
the topic of school-based anxiety prevention, which also includes my research questions. My
personal inspiration for this research is described, followed by a rationale for this study; this
includes explaining why it was important to me, as a child and youth practitioner to draw from
youth narratives. In chapter two, I provide background on the problem of anxiety, school-based
approaches to mental health concerns and youth leadership in addressing mental health
interests. The literature review in this section will deepen the background and provide a
foundation to underpin the findings of this inquiry. The third chapter of this thesis includes the
study rationale, methodology, and methods, including narrative inquiry techniques that were
utilized to explore the research questions. The fourth chapter presents the findings, and
discussion, followed by a consideration of the implications of the findings. My hope is that this
qualitative study will contribute to the body of knowledge that informs school-based mental
health prevention policies developed by the Ministry of Children and Family Development
(MCFD), the Ministry of Health and the Ministry of Education in BC.
An Overview and Intentions
In this chapter I provide a brief overview of school-based mental health literacy
programs, as well as present my research questions and inspiration for this study. The British
Columbia (BC) Ministry of Education (Province of British Columbia, 2016) has made recent
revisions to the health education curriculum for high school health education programs that
require some examination. BC high school students, beginning in the 2017-2018 school year,
will be required to learn the “signs and symptoms of stress, anxiety and depression” and be
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expected to “explain strategies to promote mental well-being of the school and community”
(Province of British Columbia, 2016, p. 2). This follows programs instituted in BC elementary
schools to teach emotion regulation and management through mindfulness and cognitive
behavior strategies (Kutcher, Wei & Morgan, 2015; Wei, Hayden, Kutcher, Zygmunt &
McGrath, 2013). Programs being implemented in schools seem to be heavily influenced by a
cognitive psychological explanation of the problem of anxiety and depression. This
psychological, biomedical view, according to social constructionist thinkers, such as Cassell
(2004), Gergen (1985,1994, 1997, 2015), Kleinman (1987) and Priya (2012), may increase
human suffering, since it reifies the problem within the individual while paying minimal
attention to individual meaning-making, including the experience of being marginalized for
having a mental illness. Further, there is little literature that highlights the meaning that youth
make of the problem of anxiety or school-based prevention strategies (Bulanda, Bruhn, Byro-
Johnson & Zentmyer, 2014; Smith, Stewart, Poon, Peled, Saewyc, & McCreary Society, 2014;
W.H.O., 2005). This study explores how youth make sense of anxiety and prevention
programs.
Research questions. Essential questions in the study are: What meanings do youth
trained in an anxiety-prevention program take up in making sense of the problem of anxiety and
prevention; further, where do their narratives lead school professionals in conceptualizing and
implementing school-based mental health literacy and anxiety prevention programs?
Research inspiration
As a long time educator and counsellor in an independent boarding high school my
colleagues and I observed an increasing number of youth, over the past five years, showing
signs of being overwhelmed and expressing that they felt anxious and unable to cope; yet
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nothing had particularly shifted in the program or staffing in our school. According to the
school nurses that I work with, almost 20% of our students seek help for anxiety or depression
despite coming from a place of privilege and being afforded what students described as, a safe,
caring school community. Youth in our school were appealing to me and my colleagues for
more counselling and more coping skills to manage stress, panic attacks and anxiety. I felt ill-
equipped to respond to this phenomenon without stepping back to contextualize the problem.
Thus began my quest and return to university hoping to make sense of our students apparent
increasing relationship with anxiety. One step into my studies as a Master of Arts student in
Child and Youth Care and it quickly became apparent that the relationship with anxiety as a
problem was not unique to our students or our school. The statistics and trends that our school
nurses reported were mirrored in the literature review I conducted and in conversations with
professors and in seminars I attended. One such seminar with University of Victoria’s Student
Affairs Division provided the following overview: Universities across North America report
that 60% of students are wanting more information on anxiety and depression; 30% indicate
experiencing mental illness, especially anxiety, which supersedes both learning disabilities
(17%) and chronic health (11%) as the most prevalent student disability across North American
universities (Canadian Association of College and University Student Services, 2016). Clearly,
many youth and young adults were experiencing similar relationships with anxiety as the
students that I had been teaching and counselling.
The other concern I held was that there seemed to be a predominantly psychologized
response to youth who were suffering with over-stress and anxiety, such as the teaching of
emotion regulation or cognitive coping skills; this seemed to set aside the social context and
changing social landscape such as the predominance of social media in youths’ lives and
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competitive environment for their futures. The students I worked with prior to this research
were looking for ways to talk about, cope with and normalize their over-stress. We collaborated
on a school-wide “if you really knew me” campaign that was included in a student-led mental
health awareness week. This has now run for four years. The students’ initial authentic and
compassionate response, school-wide, touched me deeply and their collaborative development
of this program impressed me. A small part of this campaign included psychological education,
such as learning about the neurobiological stress-response system and the influence of cognitive
distortions. On reflection, the psychological education was initiated by me. This led me to
wonder how the students were making sense of the problem of anxiety.
My thoughts were more clearly articulated as I learned about social constructionism. I
was drawn to this paradigm to help me understand both the relationship youth were having with
anxiety and schools’ response to it. This framework helped me to question prevailing
discourses in biomedicine and cognitive psychology that guide school-based mental health
literacy (see for example, Miller, 2008; Barrett, Fisk, Cooper, 2015; Fowler & Lebel, 2015).
Early psychologist Karen Horney, in the 1950’s, questioned if anxiety is embedded in our
system of schooling, including the performance of assessment (Gergen, 2015). Gergen (2015)
echoes the same concerns; he wonders if problems such as social anxiety are generated by the
cultural meaning we place on events in our lives. He also questions the routine practice of
prescribing drugs as the first response to what he describes as common problems of living
(Gergen, 1994). Gergen (2015) also expresses concern about the lack of critique of the 2016
revision of the Diagnostic Statistical Manual (DSM) that expands the criteria for labeling and
categorizing misery as illness. Well before the latest 2016 revision of the DSM, Kleinman
(1987) also questioned the inappropriate use of diagnostic categories and suggested that this