Overview

Worrybusters is a series of books and resources based on DSM-IV (1994: Diagnostic and Statistical Manual of Mental Disorders) written by Dr Marilyn Campbell to help prevent and manage anxiety in children. All the stories in this series are about anxious children and animals, set in Australia, that will appeal to children aged from five to twelve.

• Anthony the Shy Alien
  Social Phobia - worry about negative evaluation
• Beulah the Anxious Bully
  Aggressiveness
• Carla the Terrified Koala
  Post Traumatic Stress Disorder - worry about a life threatening trauma
• Cilla the Worried Gorilla
  Separation Anxiety Disorder - worry about harm to parent
• Danny the Frightened Dinosaur
  Physical Phobias - worry about negative physical outcomes
• Dig the Fearful Pig
  Obsessive Compulsive Disorder - worry about physical contamination or physical harm
• Jali the Nervous New Boy
  Generalised Anxiety Disorder - worry about everything; in association with the Yugambeh People of South East Queensland
• Teaching Tips for the Prevention of Anxiety in Children
• A is for Anxiety: A Parent's Guide to Managing Children's Anxiety

Further details on each of the above are available under their title on this website.

Dr Marilyn Campbell is a psychologist currently working within an Australian University. She has published papers on anxiety in children and presented workshops at national and international conferences in the area of children's anxiety. Marilyn has worked as a teacher in primary and secondary schools as well as a teacher-librarian.

Melissa Bates is an innovative artist who is currently working and exhibiting on the Gold Coast in Australia. Her illustrations are highly textured often with embedded figures set in complex patterned backgrounds. Her often stylised work is full of vibrant colour. The illustrations for this book were created using mixed mediums of acrylic polymers, cardboard cut outs, coloured pencil and water colours.

Proudly published by Post Pressed

Reviews

Reviewers:

Angela Hain, DPsych
Psychology, Australian Catholic University, Fitzroy, Victoria

Eleanor Clyne-Kingshott, DPsych
Psychology, Australian Catholic University, Fitzroy, Victoria

Journal of Family Studies
Volume 15/1 - April 2009

Due to increased economic pressure and the complexities of modern life, many Australians have been forced to abandon the pursuit of a healthy work-life balance to prioritize their employment, ensuring their family's basic needs are met. Consequently, parents are left with limited time and energy to maintain their psychological wellbeing, let alone the wellbeing of their children. While some resilient families cope with such changes, families who have children with developmental and/or psychological difficulties are likely to receive inadequate care. Given the amount of daily contact and time that they spend with children, teachers have been pressured to go beyond their traditional teaching role and intervene. Children with externalizing disorders (ie attention-deficit disorder and oppositional defiant disorder), who display overt behavioural symptoms capture the attention of teachers and peers, but children with internalizing disorders (ie anxiety) often go unnoticed within the classroom setting, leaving their problems unaddressed.

In light of these challenges, Dr Marilyn Campbell has published a program called Worrybusters aimed at bringing the issues of anxiety management into the classroom. The program consists of seven illustrated picture books, a teacher and a parent manual and the program is designed for use with children aged 5 to 12 years. The picture books are designed to be used in the classroom as a means of increasing both teachers' and children's understanding of the major DSM-IV anxiety disorders (American Psychological Association 1994: Diagnostic and Statistical Manual of Mental Disorders).The books describe some experiences of the anxious characters (animals, humans and even aliens), specific to their particular disorder, with emphasis on symptoms, precipitating situations, help-seeking and simple evidenced-based psychological intervention.

Each picture book deals with a different disorder and covers: Social Phobia, the link between Anxiety and Aggression, Post Traumatic Stress Disorder, Separation Anxiety Disorder, Specific Phobia, Obsessive Compulsive Disorder and Generalized anxiety Disorder. One of the books also focuses on increasing readers' insight into Aboriginal culture and is dedicated to the Yugambeh People of South East Queensland, an Indigenous community in Queensland.

The books rely on a narrative approach as a means of increasing children's understanding about their thoughts and to assist them in expressing their feelings in adaptive ways. Each book also focuses on help-seeking, with the characters relying on verbal or practical assistance from different supports (a peer, an elder or counsellor) in order to understand and overcome their fears.

The accompanying teacher's manual, Teaching Tips for the Prevention of Anxiety in Children, is divided into three main sections. The initial chapter aims to increase teacher's understanding and identification of childhood anxiety disorders by providing specific information on signs and symptoms. The manual uses case studies and provides additional referral sources to websites and books for further information. The manual also includes practical tips to assist teachers in managing anxiety within the classroom and advice on how to increase children's overall resilience against stress as a form of anxiety prevention. The final chapter provides creative structured classroom activities that involve each of the storybooks in the series that promote a collaborative approach to anxiety identification and management (eg art, drama and discussion).

While the program relies heavily on classroom-based intervention (collaborative work between teachers and students), Dr Campbell also aims to empower parents to feel effective in providing emotional support to anxious children. The accompanying parent's manual, A is for Anxiety: A Parent's Guide to Managing Children's Anxiety, provides an array of practical tips that parents can utilize within the home setting, including verbal communication, praise, reward and problem-solving.

In terms of the layout, the six picture books are aesthetically pleasing and rich, but at times the illustrations are confusing and somewhat overwhelming considering the target audience, who may already be oversensitive to stimulus. The text is too dense in some parts, and certain language used may not be familiar to the target audience given their age (eg ravine, muttabuttasaurus).

The strategies provided for children in the picture books are at times helpful, but in several of the texts, lip-service is provided to evidence-based cognitive behavioural principles (which identify thoughts as the cause of emotional disturbance leading to the acting out of unhelpful behaviour). However, the concrete strategies that are provided are limited or even absent in some cases. An example of this is in Danny the Frightened Dinosaur, where the main character is told that he needs to stop thinking in such as negative way, which leads this character to a miraculous recovery.

To their credit though, the books encourage children to openly communicate their struggles with social supports including family, friends, teachers and school counsellors, in order to address their anxiety symptoms. This is consistent with the non-remittent nature of anxiety disorders, which require psychological intervention for symptom exacerbation to occur and functional impairment to improve.

The teacher's manual that accompanies the books suggests that they are to be used in a group classroom setting. Considering the density of the text and the complexity of the images, this purpose seems both unrealistic and impractical. However, the notes for teachers and parents are informative and useful as the psycho-education is brief, clear and non-clinical. The books also provide referral sources to kid's helpline and parent line, so teachers and parents are able to refer on when they feel the child's symptoms have reached clinical significance.

Overall, the books are good as a starting point that will hopefully lead to better identification and treatment of these disorders within a school setting. Dr Marilyn Campbell should be congratulated for attempting to address the issue of clinical anxiety disorders in children in a new, interesting and interactive way. Children in the classroom environment who do not have severe anxiety will undoubtedly benefit from this resource as all children will experience anxiety to some degree throughout their time at school.

The complete program is a very useful psycho-educational tool, which aims to empower those who often feel that they are unable to be of use in understanding and/or managing mental illness in children.

References

American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders. Washington, DC: Author.

Campbell M (2007) A is for Anxiety: A Parent's Guide to Managing Children's Anxiety. Post Pressed: Teneriffe, Australia. ISBN: 978-1-921-214-08-0.

Campbell M (2006) Anthony the Shy Alien. Post Pressed: Teneriffe, Australia. ISBN: 1 876920 01 7.

Campbell M (2006) Beulah the Anxious Bully. Post Pressed: Teneriffe, Australia. ISBN: 1 876920 02 5.

Campbell M (2006) Carla the Terrified Koala. Post Pressed: Teneriffe, Australia. ISBN: 1 876920 03 3.

Campbell M (2006) Cilla the Worried Gorilla. Post Pressed: Teneriffe, Australia. ISBN: 1 876920 04 1.

Campbell M (2006) Danny the Frightened Dinosaur. Post Pressed: Teneriffe, Australia. ISBN: 1 876920 02 5 X.

Campbell M (2006) Dig the Fearful Pig. Post Pressed: Teneriffe, Australia. ISBN: 1 876920 06 8.

Campbell M (2006) Jali the Nervous New Boy. Post Pressed: Teneriffe, Australia. ISBN: 1 876920 07 6.

Campbell M (2007) Teaching Tips for the Prevention of Anxiety in Children. Post Pressed: Teneriffe, Australia. ISBN: 1 876920 00 9

Reviewer: Kathy Griffiths
Centre for Mental Health Research
The Australian National University
Canberra ACT, Australia

Health Sociology Review
Volume 17/1 - March 2008

The Worry Busters program is designed to tackle anxiety in primary school-aged children aged five to twelve years. It comprises parent and teacher guides for managing children's anxiety and a series of seven books for children, each of which focuses on a character with a different type of anxiety condition. The conditions include social phobia (Anthony the Shy Alien), generalised anxiety disorder or worry (Jali the Nervous New Boy), separation anxiety disorder (Cilla the Worried Gorilla), physical phobias (Danny the Frightened Dinosaur), obsessive compulsive disorder (Dig the Fearful Pig), post-traumatic stress disorder (Carla the Terrified Koala) as well as aggressiveness (Beulah the Anxious Bully).

Collectively, anxiety conditions are the most common mental disorders in children. Moreover, they often persist throughout life, causing significant distress and interfering significantly with social life and achievement both during the child's formative years and later in adulthood. Early intervention to prevent or treat anxiety in childhood has the potential to avert some of these debilitating consequences. Campbell's program is intended to provide strategies and information to assist parents, teachers and children to do this.

The parent's guide provides, in readable form, information about how to recognise the behaviours, thoughts and physical reactions associated with anxiety conditions. It also gives practical day-to-day strategies a parent can use to assist a child with anxiety. These include ideas about communication and modeling, and brief descriptions of evidence-based strategies such as graded exposure, cognitive restructuring (coping self-talk) and behavioural techniques. These strategies are likely to be of use both in a self-help context and also as a resource for parents whose children are receiving professional help.

The teacher's guide is more technical and is designed to provide the teachers with classroom strategies for managing children with anxiety, to use the children's Worry Buster book series in class to teach children to label feelings of anxiety, develop coping behaviours and seek help. It incorporates suggested exercises to accompany the children's books and resources which can be photocopied for this purpose.

The seven extensively illustrated children's books each centre around a different character whose behaviour and responses are typical of a child with an anxiety disorder. These stories are designed to assist children to better understand their own or other childrens' anxiety problems and, in the case of the child who has an anxiety condition, to learn they are not alone in experiencing these difficulties. The narratives also include some strategies for coping (eg graded exposure) and all stories model a help seeking approach. There is an appropriate gender mix among the characters and the type of helper varies across books (eg teacher, counsellor). One of the key characters, Jali, is a young boy of Aboriginal background.

The series is likely to be a useful resource for parents, teachers and children to better understand childhood anxiety. Its strength lies in providing a coherent program which targets the child, the family and the school, thus ensuring an integrated approach to addressing the anxiety problem. In addition, the suggested, whole-of-classroom approach, maximises the chances of the program contributing to primary prevention, since it involves children who have no symptoms of anxiety as well as those with an anxiety disorder. Although it contains some evidence-based strategies for coping with anxiety, it is primarily an informational rather than a structured self-help manual. Consequently it may be most useful as a resource to increase anxiety literacy, appropriate help-seeking and parental and teacher support rather than providing specific 'worry-busting' self-help tools.

The program originates in a university. However, no evidence is provided in the material supplied as to its acceptability or efficacy either in improving anxiety outcomes or in increasing knowledge about anxiety in any of the target groups. The book explicitly states that it targets five to twelve year olds. The appropriateness of the format and the text for such a diverse age range is unclear. Older children may benefit from separately developed material, possibly including more explicit self-help exercises. Although the illustrations are striking and likely to appeal to many readers, some children may find some of the darker illustrations and strong graphical style anxiety provoking.

Finally, the children's books contain notes at the end for teachers and parents. While this is likely to be helpful to adults, there is no explicit labeling of the anxiety conditions in the text for children. In the absence of an explanation from any other source, some older children may be concerned after reading the information targeted to parents and teachers. Finally, there is a tendency in the teacher and parent guides to use phrases such as 'the anxious child' and 'naughty children' rather than 'the child with anxiety' and 'children who have been naughty. The children's books are labeled similarly (eg the 'anxious bully', 'the terrified Koala'). Parsimony, particularly in choosing titles for children's books is important, but this must be balanced against the desirability of modelling appropriate language for children, parents and teachers.

Despite the above limitations, this is a creative series of books which is likely to be of significant utility in a neglected area of health. The series will be of interest to teachers, parents and appropriate-age children. As a treatment program, its greatest utility may be as an adjunct to interventions delivered by professionals who have specific expertise in evidence-based interventions for anxiety. In addition, it may serve as a useful primary preventive resource and as a program for modifying negative attitudes among teachers, parents and children.

Source:http://hsr.e-contentmanagement.com/archives/vol/17/issue/1/review/485/the-worry-busters-program-an-anxiety