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Brigid Bergin: It's The Brian Lehrer Show on WNYC. I'm Brigid Bergin from the WNYC and Gothamist newsroom, filling in for Brian. In March of 2020, I'm sure you never imagined that in August of 2021 we'd be looking ahead to a third school year affected by COVID but, here we are. In New York and New Jersey, mask mandates and vaccination requirements are mostly in place for staff but student testing and quarantine procedures are still in flux.

In Southern States where schools have been opened for almost a month already, parents and teachers already are having to make tough calls. Burbio, a website that tracks school openings, has already identified over 100 school closures across 70 districts because of COVID. Across the country, we're seeing fights over mask mandates, fights over remote learning options, and social distancing guidelines. If this was the year things were supposed to go back to normal at school, normal feels very, well, stressful, which brings me to my next guest.

She's a psychologist who specializes in treating children and adolescents with anxiety disorders, and she says that anxiety around back-to-school is at an all-time high, maybe even worse than last year. Let's talk about what we're all collectively going through as we send our kids back to school, and maybe get some tips to alleviate some of that stress if we can. With us now is Dr. Mary Alvord. She's a psychologist and founder of Resilience Across Borders, a charitable non-profit, and director of a large mental health practice in Maryland. She's also the co-author of Conquer Negative Thinking for Teens and Resilience Builder Program for Children and Adolescents. Dr. Alvord, welcome to WNYC.

Dr. Mary Alvord: Thank you, my pleasure.

Brigid: Now, I'm sure you hear about back-to-school anxiety most summers, but is the tenor of this year different even from last year when we were also going into September with so much uncertainty, and what's making it different?

Dr. Alvord: Absolutely. It's always a time of transition, but particularly this year, I think it has so much to do with expectations. We were expecting that we would be looking at more of what we would say is a normal or typical school year, being back in person. Now with the recent surge, that has upended much of the planning, and it's making administrators and parents scurry to really determine what is in their children's best interest and safety measures.

Brigid: I think there are probably some kids and parents out there who are still feeling exhausted and think like, "Wait, school already? I just got a break from the worrying." What should parents and kids do if they feel like this summer didn't do enough to alleviate some of the burnout from the past year-plus?

Dr. Alvord: Well, I think we all have a certain amount of resilience, and the goal is to keep building our resilience. Resilience is our ability to deal with all the stresses, not just the big hardships and challenges but the daily challenges that go. One of the keys is remaining-- Well, I guess I'll start with sleep. Because we're all exhausted, and the mind and the body are connected, so we want to make sure we get to sleep. Then that our children get back to the routines that they'll be expected when they go to school so that they can think clearly and not be grouchy. [unintelligible 00:03:59] really important for parents. We need to take care of ourselves so that we can then take care of our children. What that means is we're going to make some mistakes, and we're going to have ups and downs. We need some respite, and figure out how we're going to trade off some of the tasks that we have as well.

Brigid: You've said that you've been hearing a lot of catastrophizing, that is, the what if statements anticipating worst-case scenarios. Can you talk a little bit about that? When is it healthy to expect the worst, and when is it not so healthy? How do you turn that off?

Dr. Alvord: Well, we do not want to just turn off thoughts because if we just say, "Stop thinking about that," it actually gets stickier and makes us think about it more. What we want to do instead is challenge it with different ways to think about it. If we have, "What if something really awful happens?" you think about, what are the chances of that happen, how likely is it to happen? What are other possibilities that perhaps are not at that extreme and that are more realistic?

I use this often with children, teens, and my parents, I say, "What would you tell your friend who was having those same catastrophic what if thoughts?" You wouldn't say, "Oh yes, the worst is going to happen." You'd probably say, "Well, this might happen or that might happen," then turn to how we can cope with things. Think about how you've been coping for the last 17, 18 months, we should give ourselves a pat on the back. We're all in this together, you're not alone in this. Focus on what have you done to help you get through, and how can you cope, which helps with the catastrophic thinking.

Brigid: Listeners, are you and your family experiencing back-to-school anxiety? Call in and tell us about it at 646-435-7280. Is your child excited for school? If so, what are they looking forward to? If they're anxious or dreading it, what in particular are they worried about? Are they concerned about seeing their friends, being social after so much time at home, or are they worried about getting sick, or is it simply the anxiety of not knowing whether school will be closed again? How is that anxiety manifesting? Is it endless screen time, breakdowns, tantrums? What are you doing to help or maybe you have a question about the best way to help?

My guest is Dr. Mary Alvord. She's a psychologist who specializes in treating children and adolescents with anxiety disorders. The number, one more time, 646-435-7280. Dr. Alvord, some public schools, at least in New York City, are actually reporting a drop in enrolled students. An elementary school in Park Slope, Brooklyn for example, reported a 30% decrease in enrollees. If my child is really nervous about going back to school, should I consider something like homeschooling?

Dr. Alvord: That's an interesting question, and I think it gets down to value system. If it were not for this situation, would you consider homeschooling because there are some plusses and minuses, but a hallmark of anxiety is avoidance. We don't really want to avoid because once we start on that avoidance path then we start avoiding so many things. We want to be cautious, we want to be thoughtful and judicious, but we don't want to avoid situations because then that can lead to a pattern of withdrawal and isolation, and really limiting your life. It's a value judgment for parents, but I would say that if it's only to avoid some of the ups and downs that we're certain in this life of uncertainty--

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We're certain there's going to be a lot of uncertainty, so if it's just to avoid that uncertainty then I think you probably don't want to consider homeschooling. Again, it's a personal decision. So much of what the kids have missed has been those social interactions, peer interactions are so critical at every stage in school and even post-school and adulthood. We want to maximize it as much as possible with the physical distancing. I think the kids do fairly well with the masks, they're like, "Sure, we'll wear a mask."

Brigid: Parents and families, as you get ready to go back to school, what are the concerns you're feeling and experiencing? What are you talking about with your neighbors in those final barbecues before the post-Labor Day back-to-school rush? If there's anxiety that you're trying to manage, Dr. Mary Alvord may have some advice for how to deal with that, and what are some of the strategies for coping with that, the number is 646-435-7280. We probably have time for a couple people to get questions to Dr. Alvord.

Again, the number is 646-435-7280, on strategies for coping with your kid or your own anxiety as kids head back to school in just a few weeks from now. Dr. Alvord, you have said one good way to alleviate maybe some of the dread going back to schools is to see if administrators will let you and your kids take a tour of the school ahead of time. What do you think that could do?

Dr. Alvord: Well, first of all, that decrease as some of the unknown, particularly for children who have never been to that building before. Even if they have been, it's just a re-exposure. I even advocate for parents, if the child is going to take a school bus or they're a walker or however it is they're going to get to school, actually go on that route with them. That's one less unknown.

Then the building and for the younger kids, the playground, so they can see what that is like. I think as much as we can prep them for what is known, the less the anxiety is because so much of anxiety is feeling like you don't have control over what is happening. All of that information, particularly the young children, I think the concrete building, maybe not made out of concrete, but seeing the building and the playground and just the surrounds, can make a huge difference.

I'd also recommend trying to have some play dates, even if they're outdoors, bike riding, walking, skateboarding, whatever it may be, to connect with other children, other teams, who are going to be going to the same school. The teams usually will figure that out and connect themselves with, particularly the younger kids and even with middle school, to really facilitate some of those so when we go in, they don't feel like they're the only ones. Because even if they've been in the school before, they may not have been connecting with most of these peers.

Brigid: Dr. Alvord, it's important to stay health-conscious and vigilant about things like masking and distancing. What should you do if your child seems to have become may be overly anxious about getting sick or even getting you sick? I've heard, for example, stories of kids refusing to take their masks off, even at home. I'm wondering, are you hearing similar things and where do you start unwinding that level of anxiety because it's just in the air?

Dr. Alvord: We have to look at behavior, as a psychologist, and also really looking at what is a typical or unexpected anxiety versus when it starts interfering with their lives. I think when you get to that point when you feel that it's really impacting their functioning and they're staying up at night and they're worrying about it and they're not removing their mask. Sometimes some information can be helpful especially with kids, we are learning the science as we go. There's still questions about aerosols, et cetera. Helping children to understand that we're there to help them be safe, and this is what we know now to keep them safe. This is when it's good to wear a mask, this is when we're at home when we don't need to wear a mask, whatever the situation may be. Then it's their catastrophizing, so it gets back to that, "What if this, and what if that," and help them not overestimate the risk because that's what anxiety is. We're always overestimating the risk, life is full of risks. We really want to have them under control as much as possible, so just challenge their thinking.

Brigid: Robyn in Brooklyn. Robyn, welcome to WNYC. Do you have a question for Dr. Alvord?

Robyn: Yes, I do. Thank you so much for taking my call. I wanted to find out a little bit about what your thoughts are on screen time after school and whether or not watching TV or playing video games either contributes to more anxiety after, what I imagine will be, stressful days at school or could be a good way to just like have that downtime after school. I have a fourth-grader and a sixth-grader. The fourth-grader has been home for a year and a half and she'll be going back into school after a very long time, and I'm just wondering what your opinion is on screen time.

Dr. Alvord: Well, I think it's safe to say that we know that kids spent a lot more time on screens, that is not even--

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Brigid: I think we lost our guests there for just a moment. This is WNYC, you're listening to The Brian Lehrer Show. I'm Brigid Bergin, filling in for Brian today. We were speaking with Dr. Mary Alvord. She's a psychologist who specializes in treating children and adolescents with anxiety disorders. We were talking a little bit just then, in response to a question from a caller with a fourth-grader and a sixth-grader, about screen time. Just to recap some of what Dr. Alvord was saying, our caller wanted to know how much do we want to be concerned about it when it could be something that kids just use as a way to unwind during a stressful time.

Dr. Alvord made the point that a lot of kids get a lot of screen time and that that may be something to consider, and yet part of what we are trying to do is think about the risks associated with certain behaviors, and how much risk is really there in the moment. She was advising, I think, as we lost her, that it's something that needs to be weighed as parents make some of those decisions and keeping in mind that we are all going through an extremely stressful time and that perhaps you might be modifying some of your behaviors just to adjust to that. I think I was summing up some of your answers there, Dr. Alvord. Do we have your back?

Dr. Alvord: Yes, I'm back.

Brigid: Okay. You were just addressing this caller's question about screen time. I think where you're going is that during this pandemic, as you were evaluating the risks of certain behaviors, this is another behavior whose risk you need to evaluate. I'll let you pick it up as the expert from there.

Dr. Alvord: Absolutely. I think as with anything, it's how is something used and how long, and is it interfering with other activities? I think that we all want and aim for balance with our children. Screen time, I think is fine. Parents make decisions about what screen time actually means, and there's parental controls on it, but that's for a bigger conversation. I think if you decide, some screen time is fine, then I think, how can you do that so their other activities are balanced, and they may be able to do a little bit of screen time when they get home? You may say, "No, it's outdoor time, run out," because there's a lot of research now being in nature, and how calming that can be, as well as just movement is really positive. Then time with friends and time with family and then, of course, there'll be homework time now and reading time. How do you balance all those activities?

Brigid: There's a lot that parents need to consider just to make sure that their kids are getting the academic rigor that they need as they cope with some of the jitters associated with that. We have just a couple of minutes left. One of the questions I think parents just really probably want to make clear is, what's the difference between normal or expected back-to-school jitters and really the over-the-top unhealthy levels of anxiety that maybe they should be thinking about getting someone involved with to help? Can you give us some things to be watching out for?

Dr. Alvord: Sure. What we look at is not just the behavior, a temper tantrum developmentally may be fine but what is the severity? What is the intensity? How long has it been going on? We want to really look at their behaviors to assess, is it more interfering with what they need to do? For example, if they're saying and they're verbalizing that they're worried about school, validate that, talk about that, "We understand, here are some things that we can do to help, but it's normal." But if they're saying I'm not going to school or they refuse to go to school, then that's a sign that we really need to step it up because we don't want to get into the school avoidance. It's often a matter of degree and how impairing it is. How much does it get in the way of just a simple landmark?

The other thing is, are there sudden changes in sleep or appetite? Are they suddenly withdrawn or making negative statements about themselves or self-harm? We need to be as parents which is-- The hardest job in the world is parenting because you have multiple children, they're all different. You think you get it set with one and then all of a sudden, another child is different and then situations are different. We need to be mindful and watch their behavior as well as what they say and do.

Brigid: For a moment, I'm wondering if you could talk just a little bit about social anxiety. Grade school is an infamously difficult time for friendships and bullying. Did remote learning alleviate social anxiety for some, and how do we ease those kids back into, what are potentially difficult or maybe even harmful, social interactions?

Dr. Alvord: I think that's two categories. One is how do we ease them back into healthy friendships and the social interactions that are so critical to developmental or normative development. Then it's how do we help them become assertive so that they know where to draw the line and the boundaries if someone is being mean to them or even beyond that.

Brigid: As you were talking about, these are two different things we're talking, social anxiety and bullying and how to help kids go back into settings where they're going to be interacting with people face to face, for some, maybe for the first time in a long time if they were in remote schooling. Again, we were looking for some of your tips about how to prepare kids for some of those potentially difficult situations.

Dr. Alvord: If we start with social anxiety, we see that elementary school and even more so at the high school level as they get older. Adults suffer from social anxiety, and what we do about that is we take small steps and we face our fear, and we actually go into a situation, but that doesn't mean that we then suddenly go to a large gathering. That's why I say preparing for school means, not just getting your school supplies, but also preparing for what the expectations are, and especially given the pandemic and the isolation preparing by getting kids together, in small pods or however, it is safe so that they do have that interaction going in because it is difficult.

For so many kids, they just haven't experienced it for such a long time, and they're going to have to get back into reciprocity and taking turns and sharing and all of that. For those kids who are worried or who have been teased and bullied in the past, I would say really work on with them some scripts, what can they say as well as how can they hold their body. I teach kids to bring their shoulders up, back, and down. If you try that, it makes your posture straighten up, head up, and make eye contact.

Sometimes the eye contact is sufficient to give the message of, "I'm not putting up with this," I say to kids have the self-talk, the self-talk in your head is, "What's your problem?" If you think that often that will come across with a facial expression, without having to say anything [unintelligible 00:24:42] appropriate to walk away. I think it's important to stand tall, and if you can't handle on your own, then get an adult. There are a third of the skills that we can teach kids.

Brigid: We're going to have to leave it there with Dr. Mary Alvord. I have to say, as you were describing the posture recommendation, I couldn't help but do what you were saying. I think my posture thanks you, and I'm sitting up straighter now as a result. She's a psychologist and founder of Resilience Across Borders, a charitable non-profit, and director of large mental health practice in Maryland. She's also the co-author of Conquer Negative Thinking for Teens and Resilience Builder Program for Children and Adolescents. Thank you so much for coming on and for some of the great tips you shared with us.

Dr. Alvord: Thanks for having me.

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