Exploring children’s experiences of anxiety support informed by cognitive–behavioural principles: A qualitative study within educational and policy contexts

Abstract

Childhood anxiety is an emerging social health issue that has become a problem especially in highly competitive educational systems. This qualitative paper investigates the experiences of anxiety support by children who are informed by the principles of cognitive-behavioural therapy (CBT) in educational and policy settings in China. Thirty (30) children aged between 10-16 years who had attended school-based CBT-informed anxiety support programmes were interviewed semi-structured and in focus groups, and 5 school counsellors and 3 educational policymakers were also interviewed. Thematic analysis was employed in analysing data with the aid of NVivo software. The results suggest that three-quarters of the children involved found this approach based on CBT as effective in addressing anxiety symptoms including cognitive restructuring and relaxation techniques, stating that they have better emotional regulation and feel confident in a school-based setting. Nevertheless, one-third of them said that they were sceptical about the long-term efficacy of CBT, especially in high-pressure events like examination. Moreover, one-fifth of the respondents also said they had had problems with practicing CBT techniques outside the laboratory setting. Academic workload, time constraints, and cultural stigma of mental health were also found to be significant barriers to engagement, whereas positive relationships with school counsellor and peer-based group sessions were supportive to the engagement. Significant differences were noted between school participants in urban and rural areas with the urban participants reporting more access to counsellors (90% vs. 40%) and satisfaction with CBT (80% vs. 60%).