Evaluation of a School-Based Tier Two Anxiety Intervention: The Worry Box Technique

Date of Award


Degree Name

Specialist in Education (Ed.S.)


Department of Counselor Education and Human Services


Advisor: Elana Bernstein


Anxiety disorders are the most commonly diagnosed mental health disorders in youth in the United States. Anxiety can have long-term adverse effects on the child's academic, social, and emotional functioning if left untreated. Children spend the majority of each day in a school setting, placing school professionals in an ideal situation to identify and provide interventions to address childhood anxiety as a part of the students' everyday routine. Due to the constraints of the school setting school-based providers often utilize less resource-intensive intervention strategies adapted from websites and social media, which may sometimes lack empirical support. The present study examined the effectiveness of a cognitive-behavioral strategy found on social media, blogs, and "Pinterest"---the worry box technique---when implemented as a tier two intervention with (n = 3) students who demonstrated elevated levels of anxiety in the school setting. Students participated in an eight-week intervention designed to teach children to compartmentalize their anxiety, focusing on their present thoughts, and addressing the identified anxious thoughts at a designated worry time. Each student completed the Multidimensional Anxiety Scale for Children 2nd Edition Self Report (MASC-2 SR; March, 2013) before and after the intervention period, and completed self-reported ratings of anxiety during each session, to measure the efficacy of the intervention. Results of the present study cannot definitively assert that the worry box technique was the primary reason for the reduction of self-reported anxiety levels in participants. Other components of the intervention were considered as possible mitigating factors to the participants' anxiety levels. Suggestions are made for future research.


Counseling Education, School Counseling, Psychology, Counseling Psychology, anxiety, school-based interventions, worry box, childhood anxiety, tier two anxiety intervention, cognitive behavioral therapy, school psychology, school counseling

Rights Statement

Copyright © 2018, author