Anxiety & Worry

The SEND Code of Practice names anxiety as an example of a social, emotional and mental health need, and is explicit that behaviour is not itself a category of SEN — an underlying need should be looked for. The practical effect is to move the question from "is this child anxious?" to "in which situations does this child struggle to participate, and what have we changed?"

The DfE's 2025 rapid evidence review on identifying and supporting children with SEMH needs is the current departmental evidence base. It is published as research rather than policy, and it is careful about the strength of the underlying studies — worth reading before adopting any named programme.

• Assess — describe barriers with evidence from more than one context, including pupil and family views.
• Plan — a small number of specific adjustments agreed with the class teacher, with named responsibility and a review date.
• Do — the class teacher remains responsible day to day; interventions supplement quality teaching rather than replacing it.
• Review — against what was actually agreed, with a willingness to stop things that are not working.

Proportionality matters. The EEF's implementation and SEL guidance point the same way: fewer things, done consistently by prepared staff, beat a broad menu delivered thinly.

• Soft start or alternative entry, time-limited and reviewed.
• A named adult and a known place, with a plan for that adult's absence.
• Adjustments to public participation: rehearsal before answering, reading to one adult, no cold calling without warning.
• Predictable warning before change of routine, staff or room.
• Reduced incidental demand — shorter instructions, scaffolded starts, less copying — so capacity goes to the actual learning.
• Adjustment to how the behaviour policy is applied — timing, privacy, processing time — while the expectation itself stands.
• A planned approach to trips, assemblies, tests and transition points, agreed in advance with the family.

Anxiety and attendance are closely connected, and DfE guidance on mental health issues affecting attendance is explicit that these situations generally require support and adjustment alongside expectation, rather than enforcement alone. The statutory attendance guidance sets the same 'support first' expectation where health or SEND is a factor.

Where attendance is falling, the most useful early work is granular: which day, which lesson, which part of the morning, and what happened the last time the child did get in. Reintegration plans that specify small, agreed, increasing steps — with the child's involvement — tend to hold better than plans built around a target percentage.

Consider external advice when difficulties persist across settings despite adjustment, when a child's distress is significant, when attendance or participation is materially affected, or where there is risk. Local routes usually include mental health support teams, educational psychology, school nursing, early help, counselling, and referral through the GP to children and young people's mental health services.

DfE advice on mental health and behaviour in schools is a useful reference for the boundary between what a school can reasonably provide and what needs a clinical service. NICE CG159 is a reminder that recognition, assessment and treatment of an anxiety disorder sit with health, not education.

• Participation: lessons accessed, time in class, attendance at the parts of the day previously avoided.
• Attendance and punctuality, read alongside participation rather than instead of it.
• Recovery time after a difficult moment — this often improves before frequency does.
• Pupil view: does school feel more manageable than last term?
• Family view: what are mornings and evenings like now?
• Whether the adjustments are actually happening, checked directly rather than assumed.

1. NHSProfessional guidance
   Anxiety in children — advice for parents

   The plainest UK statement of the distinction this guide rests on: all children feel worried sometimes, and anxiety becomes a concern when it is out of proportion, persistent, and getting in the way of ordinary life.

2. NHSProfessional guidance
   Anxiety disorders in children

   Describes recognised anxiety difficulties and the routes to help — GP first, then local children and young people's mental health services. Diagnosis sits here, not with schools.

3. NHSProfessional guidance
   Children and young people's mental health — advice for parents

   The parent-facing hub, including what to do first and where support exists locally.

4. National Institute for Health and Care ExcellenceProfessional guidance
   Social, emotional and mental wellbeing in primary and secondary education (NG223) (2022)

   Recommends a whole-school approach: supportive climate, trusted relationships, universal curriculum content, targeted support for those who need more, and staff training to deliver it.

5. National Institute for Health and Care ExcellenceProfessional guidance
   Social anxiety disorder: recognition, assessment and treatment (CG159) (2013)

   Clinical guidance covering children and young people. Referenced here only to be clear where the clinical threshold and treatment decisions sit — with health services.

6. Department for EducationProfessional guidance
   Mental health and behaviour in schools (2018)

   Non-statutory advice on the line between what a school can reasonably provide and what needs a clinical service — the question most often at issue with anxiety.

7. Department for EducationProfessional guidance
   Mental health issues affecting a pupil's attendance: guidance for schools (2023)

   Directly addresses anxiety-related absence: attendance is usually improved by support and adjustment alongside expectation, rather than enforcement alone.

8. Department for EducationStatutory guidance
   Working together to improve school attendance (2022, statutory from 2024)

   Sets out the 'support first' expectation and the duties schools and local authorities hold where attendance is affected by health or SEND.

9. Department for EducationStatutory guidance
   SEND Code of Practice: 0 to 25 years (2015)

   Names anxiety as an example of a social, emotional and mental health need, and sets out the graduated approach — assess, plan, do, review.

10. Department for Education (research by University College London)Research evidence
    Identifying and supporting children and young people with social, emotional and mental health needs: a rapid evidence review (2025)

    Part of the DfE's SEND evidence programme. Published as research; the DfE states it does not endorse the approaches described.

11. Education Endowment FoundationResearch summary
    Improving Social and Emotional Learning in Primary Schools — guidance report (2019, updated 2021)

    Recommends teaching social and emotional skills explicitly and using them across the day. Rated by the EEF as moderate impact for very low cost, on moderate evidence.

12. Public Health England / Department for EducationProfessional guidance
    Promoting children and young people's mental health and wellbeing: a whole-school and whole-college approach (2021)

    The eight-principle framework most UK schools audit their wellbeing provision against.

13. Anna FreudProfessional guidance
    Mentally Healthy Schools

    Quality-assured UK resource bank for primary schools — useful when choosing classroom materials that are not simply commercial products.