STRESS REDUCTION AND COPING SKILLS FOR ELEMENTARY STUDENTS

by

MARGARET HUNTINGTON

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A Dissertation Submitted to the Graduate
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Faculty of the University of West Georgia in Partial

Fulfillment
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of the Requirements for

the Degree of

Educational Doctorate in Professional Counseling and Supervision

CARROLLTON, GEORGIA

2019




ProQuest Number: 13902639




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 STRESS REDUCTION AND COPING SKILLS FOR ELEMENTARY STUDENTS

by

MARGARET HUNTINGTON

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Approved:
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____________________________________
Dr. Christy Land
Dissertation Chair
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____________________________________
Dr. Julia Chibbaro
Dissertation Committee Member

Approved:

________________________________
Dr, Dianne Hoff
Dean, College of Education

_________________________________________
Date
 ABSTRACT

MARGARET HUNTINGTON: Stress Reduction and Coping Skills for Elementary Students
(Under the direction of Dr. Christy Land)

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As students progress through their education, pressure increases through more rigorous

coursework, heightened demands on time, and expectations to achieve one’s highest potential.
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Some amount of stress may be helpful to students; however, possessing insufficient skills to cope
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with stress can have deleterious effects on students’ well being and healthy development. This

study examined the effects of teaching stress reduction and coping skills via core curriculum

lessons and small counseling groups. Pre-post surveys were used to measure students’ stress
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levels and coping skills. Additionally, pre-post surveys were administered to teachers and parents

to measure their knowledge of indicators of stress in their students or children. Information was

taught over four core curriculum lessons and over seven small group counseling sessions. All

third-grade students received the core curriculum lessons and third-grade students showing

significant stress related behaviors were invited to join the small group. Students were taught

how to recognize stress responses in their bodies and coping skills to manage the stress when it

arises. Findings from the study highlighted effects of coping skills on students’ improved mood

and social functioning. Additionally, parents and teachers showed significant increases in

learning about students’ symptoms of stress. Recommendations include using data to drive direct

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services in a comprehensive school counseling program, collaborating with teachers to offer

relevant core curriculum, offering incentives to encourage more parents to attend presentations,

and expanding stress management and coping skills lessons to all grade levels.

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 DEDICATION

To my loving parents, Emily Stephens and Michael Thompson, for telling me to keep going even

when I didn’t know if I could finish. To my sweet daughter Sophie Grace for her faith that it was

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worth it in the long run for both of us for me to pursue this goal. I hope that this whole process

serves as fuel for you to achieve all of your dreams too! I love you!!
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 ACKNOWLEDGEMENTS

I would like to acknowledge my gratitude to the people who supported me intellectually and

emotionally throughout this process: to my cohort friends, Rebecca Hall, and Heather Boyle,

whose group chats, texts, and late night calls created a sense of camaraderie that we are all in this

together. Thank you to Dr. Christy Land and Dr. Julia Chibbarro for walking and talking me

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through the many revisions and edits that helped me to create this dissertation. Thank you also to
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Dr. Matthew Varga for being a reliable and responsive source of clarity in a winding road to

completing a doctoral program.

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 TABLE OF CONTENTS

ABSTRACT………………………………………………………………………………. iii

DEDICATION……………………………………………………..……………………... v

ACKNOWLEDGEMENTS……………………………………………………………..... vi

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LIST OF TABLES............................................................................................................... ix
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LIST OF FIGURES……………………………………………..……..………………….. x

CHAPTER
I. INTRODUCTION………………………………………………………………. 1
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Stress and Children’s Future Outcomes…………………………………... 3
Comprehensive School Counseling Programs…………………..……….... 6
School-based Interventions………………………………………………... 7
Purpose Statement and Evaluation Questions………………………...….... 8
Target Population and Stakeholders……………………………………….. 10
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Description of the Current School Counseling Program………………....... 11

Overview of Chapters………………………………………………............ 12
Definition of Terms……...…………………………………………............ 12

II. LITERATURE REVIEW....................................................................................... 14

Early Research on Stress……...…………………..…..……………............ 14
Children’s and Adolescents’ Experience of Stress………………................ 16
Coping Theory……………………………………………………………... 19
Children’s and Adolescents’ Coping Strategies……………………....….... 20
Comprehensive School Counseling Program Interventions………….....…. 21
School Wide Interventions…………..…..……..……….................. 22
Responsive Interventions…….……..…..………….…..................... 23
Cognitive-Behavioral Small Group Interventions…....……. 24
Mindfulness Small Group Interventions......……………….. 24
Chapter Summary……………………………………………...…………... 25

III. METHODS……………………………………………...........…………………. 27

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 Research Design…………………………………...........…………………. 28
Sample and Sampling…………………………………………...……..…... 29
Data Collection………………………………...........……………......……. 29
Procedures………………………………...........……………..............……. 30
Analysis of Data…………………………………...........…………………..33

IV. RESULTS………………………………...........……………......…......….......... 35
Evaluation Question 1……......…......…........................................................36
Evaluation Question 2…………...........……………......…......…................. 43
Evaluation Question 3....................……………......…......…........................ 48
Evaluation Questions 4 and 5...........………........……......…......…............. 55

V. DISCUSSION…………………………...........……………......…......…............ 63
Introduction………………………….............................……………......…. 63
Summary of Results for Core Curriculum Lessons …………......… 64
Summary of Results for Small Group Counseling…………......….. 67
Summary of Results for Parent/Teacher Presentation……........…... 68

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Limitations ………………………….............................……….….. 69
Recommendations for Professional School Counselors…………… 70
Recommendations for Administrators...........................…………… 72
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Recommendations for Working with Parents...............……………. 73
Recommendations for Counselor Educators...............…………….. 73
Conclusion……………………...........……………......…......…...... 74
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REFERENCES………………………………...........……………......…......….. 75

APPENDICES
A. Stress and Coping Skills Survey...…...........……………......…......……. 84
B. Recognizing Children’s Stress Pre/Post Survey………......…......……... 87
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 LIST OF TABLES

TABLE PAGE

1. Q7: Inferential Statistics..……................……………................……...…….......... 38

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2. Q8: Inferential Statistics..……................……………................……...…….......... 39

3. Q11: Inferential Statistics..…................…………..…................……...…….......... 41

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4. Q13: Inferential Statistics..…................…………..…................……...…….......... 42

5. Q16: Inferential Statistics..…................…………..…................……...…….......... 44

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6. Q7: Inferential Statistics for 3rd Graders and Group Student Answers.................... 50

7. Q8: Inferential Statistics for 3rd Graders and Group Student Answers.................... 51
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8. Q11: Inferential Statistics for 3rd Graders and Group Student Answers.................. 53

9. Q13: Inferential Statistics for 3rd Graders and Group Student Answers................... 54

10. Q16: Inferential Statistics for 3rd Graders and Group Student Answers .................. 56

11. Q1: Inferential Statistics for Parents’ and Teachers’ Answers ............................... 58

12. Q2: Inferential Statistics for Parents’ and Teachers’ Answers ............................... 59

13. Q3: Inferential Statistics for Parents’ and Teachers’ Answers ............................... 61

14. Q4: Inferential Statistics for Parents’ and Teachers’ Answers .............................. 62

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 LIST OF FIGURES

FIGURE PAGE

1. Percentage of Student Answers for Question 7……………...…...………….....…. 38

2. Percentage of Student Answers for Question 8. ……………...............…………... 39

3. Percentage of Student Answers for Question 11. ……………...............…………. 41

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4. Percentage of Student Answers for Question 13. …………................……...…… 42

5.
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Percentage of Student Answers for Question 16.………................……...….….... 44

6. Percentage of Students’ Pre/Post Coping Skills Knowledge. …................……..... 46

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7. Percentage of Students’ Pre/Post Stress Management Knowledge.........……........ 47

8. Percentage of Students’ Pre/Post Cognitive Reframing Knowledge.........……...... 48

9. Percentage of 3rd Graders and Group Student Answers for Question 7....……...... 50
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10. Percentage of 3rd Graders and Group Student Answers for Question 8....……...... 51

11. Percentage of 3rd Graders and Group Student Answers for Question 11............... 53

12. Percentage of 3rd Graders and Group Student Answers for Question 13............... 54

13. Percentage of 3rd Graders and Group Student Answers for Question 16..……..... 56

14. Percentage of Parent and Teacher Answers for Question 1..................................... 58

15. Percentage of Parent and Teacher Answers for Question 2..................................... 59

16. Percentage of Parent and Teacher Answers for Question 3............... ..................... 61

17. Percentage of Parent and Teacher Answers for Question 4................................... 62

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 Chapter One

Introduction

According to the Center for Disease Control (CDC), mental and behavioral health

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disorders in children are a more common occurrence than one might realize. In their National
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Survey of Children’s Health, the CDC found parents reported a mental or behavioral disorder in

one out of seven children between the ages of two and eight (CDC, 2013). The CDC found in the
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United States, children aged three to 18, nearly three percent are diagnosed with an anxiety

disorder (CDC, 2013). Without proper treatment of mental illness, adolescents may turn to

maladaptive coping choices such as aggression, substance abuse or high-risk behavior. For
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example, in the United States, nearly nine percent of children aged 12 to 17 had diagnosable

disorders of alcohol or drug abuse (CDC, 2013). Additionally, suicide is the second leading

cause of death in this age group (CDC, 2013). Thus, in the United States, children’s mental

health is a need that must be addressed to in order to develop, maintain and improve children’s

psychological well-being.

Such rising mental health diagnoses in children and adolescents garnered increased

attention from leading health and governing organizations. The CDC, the United States Surgeon
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General’s Office, and the World Health Organization (WHO) produced research and action plans

aimed at remedying children’s mental health needs (Center for Disease Control, 2013; U.S.

Surgeon General, 2000; World Health Organization, 2013). In 2000, The United States Surgeon

General’s Office held a conference dedicated to studying children’s mental health and

consequently published the Report of the Surgeon General's Conference on Children's Mental

Health: A National Action Agenda (U.S. Surgeon General, 2000). Additionally, in 2013 the CDC

published data highlighting the importance of providing resources for prevention and treatment

of children’s mental illness (Center for Disease Control, 2013). Furthermore, the World Health

Organization published the Comprehensive Mental Health Action Plan 2013–2020 to aid in early

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identification of children’s mental health needs (World Health Organization, 2013). The lack of
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mental health services available to children was also a common concern addressed in these

reports (CDC, 2013; US Surgeon General, 2000; WHO, 2013). Based on the findings of these
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organizations and current literature, children’s mental health needs are a pressing concern in

society and warrant immediate attention.

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A contributing factor in the development of such mental illnesses as anxiety, depression

and addiction is chronic or excessive stress (Cannon, 1914, 1936; Matheny & Riordan, 1992;

Ranabir & Reetu, 2011; Richardson, C. M. E., 2017; Selye, 1936; Tielbeek, Al-Itejawi, Zijlmans,

Polderman, Buckholtz, & Popma, 2018). It follows that providing mental health services and

interrupting the negative effects of excessive stress may lead to more healthy futures for our

children. Teaching children relaxation techniques and coping skills are two protective factors in

promoting mental wellness in the elementary school setting (Altshuler & Ruble, 1989; Band &

Weisz, 1988; Clarke; 2006).

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Stress and Children’s Future Outcomes

An extensive amount of early research and current literature highlight the impact chronic

stress can have on both physical and mental health (Cannon, 1914; Matheny & Riordan, 1992;

Ranabir & Reetu, 2011; Richardson, 2017; Rosch, 2017; Sapolsky, 1998; Selye, 1936; Smith &

Carlson, 1997; Tielbeek, et al., 2018; Van Ameringen, Mancini & Farvolden, 2003). When the

brain perceives stress, it causes the body to adjust its levels of several different hormones to

respond to the stressor. These hormones are released in order to make greater amounts of energy

available to respond to the stressor in either fight or flight mode (Matheny & Riordan, 1992;

Ranabir & Reetu, 2011; Sapolsky, 1998; Selye, 1936). However, not all circumstances call for

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either of these responses, yet the body still has excessive amounts of adrenaline and cortisol in
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the bloodstream to manage the stress (Matheny & Riordan, 1992; Ranabir & Reetu, 2011;

Sapolsky, 1998; Selye, 1936) In fact, the effects of excessive and chronic stress can lead to
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future compromised functioning (Harvard Center on the Developing Child, 2007, Tielbeek et al.,

2018). The Harvard Center on the Developing Child (2007) published research showing

exposure to consistently high levels of stress hormones, such as cortisol, can cause
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developmental damage and compromised functioning in young children. If a child repeatedly

perceives situations as stressful, the brain becomes effectively bathed in cortisol and other stress

hormones which can compromise the brain’s development (Harvard Center on the Developing

Child, 2007). More recently, researchers Tielbeek et al., (2018) discovered that rodents who were

exposed to chronic and excessive stress, showed reduced growth in the prefrontal cortex area of

their brains. Based on the results of these experiments Tielbeek et al., suggested that this could

be true in humans’ brain development as well. The researchers posited that exposure to chronic

stress in adolescence can “result in an increased vulnerability to maladaptive aggression in

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adulthood” (Tielbeek, et al., 2018, p.187). Thus, an initially protective function of the body can

possibly cause a variety of developmental problems if the stress is chronic and excessive

(Harvard Center on the Developing Child, 2007, Tielbeek, et al., 2018). Learning to cope in

healthy ways with stress, whether it is short-term or chronic, is necessary for children’s normal

development and future psychological well-being.

A survey conducted annually by the Georgia Department of Education found as children

matriculate through the grade levels, their school connectedness, satisfaction with academic

performance, feeling safe at school, and satisfaction with peer relationships decreased each year

(GaDOE, 2017). Additionally, the percentage of students reporting thoughts and actions of self-

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harm, suicidality, and substance abuse increased as the children progressed to higher grades
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(GaDOE, 2017). The Georgia Department of Education offers the Student Health Survey to

students in every public school and 75% of students in the school must respond for the survey’s
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results to be included in the total results for the state. There is an elementary version for third to

5th grade students and a middle/high school version for 6th to 12th grade students. In the district

where this study will be conducted, the results from the middle and high school surveys show
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14% of 6th grade students report feeling sad and/or withdrawn six or more days in the previous

month. However, that number more than doubles in this district’s 10th and 12th grade students,

with 34% of these students feeling sad and/or withdrawn six or more days in the previous month.

Regarding stress specifically, when asked how many days students felt overwhelmed to the point

of experiencing fast breathing and a racing heart, only 5% of 6th grade students reported feeling

this way six or more days in a month. By 10th grade this number quadrupled to 21%, and by

12th grade, 23% of students reported feeling these symptoms six or more days in the previous

month. When 6th grade students were asked how often intense fear or worry stopped them from
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their daily activities, only 4% of students reported feeling this way 6 or more days in the

previous month. By contrast, 14% of 10th grade students felt that intense fear hindered their

daily activities, and by 12th grade, 20% of students felt this way 6 or more days in the previous

month (GaDOE, 2017). Based on these statistics, educating students about stress and teaching

them healthy coping skills may mitigate the debilitating feelings of stress and anxiety that appear

to grow exponentially as students matriculate through elementary, middle and high school.

Smith and Carlson (1997) categorized children’s social and psychological stressors as

acute, unusual, ordinary and chronic. Acute stressors include situations such as divorce or a

parent’s death. Unusual stressors include situations such as a family member’s serious illness or

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surviving a natural disaster. Ordinary stressors would be moving to a new school, challenges
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with relationships, and academic schoolwork. Children’s chronic stress situations include abuse,

living in an unsafe neighborhood, or persistent neglect of basic needs. In the study conducted by
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Smith & Carlson, children exposed to multiple stressors developed internalizing behaviors such

as withdrawal from interacting with others, somatic complaints and anxiety, and externalizing

behaviors such as delinquency and aggression (Smith & Carlson, 1997).

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Research shows that school-aged children experience a variety of stressors and employ coping

skills with varying degrees of success in managing them (De Anda, et al., 1997; Fernández, Trianes,

Escobar, Blanca & Munoz, 2015; Smith & Carlson, 1997; Sotardi, 2016). In fact, several studies have

found schoolwork and peer relationships significantly contribute to children’s daily stress. While many

students could name some coping skills to manage the stressors, few employed them effectively (De

Anda et al., 2007; Fernandez, et al., 2015; Sotardi, 2016). Findings suggest when faced with stress, some

students chose maladaptive skills such as aggression and the use of substances to cope with their

problems (Smith & Clarke, 1997).

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Research by C. M. E. Richardson compared the effects on stress levels when using two responses

to stressful situations. The participants were instructed to record in a daily diary the stressful situations

they had encountered, their resulting levels of stress and if they had chosen “reappraisal” or

“suppression” to cope with the stressor. Reappraisal can be described as a way to adjust one’s

perspective of a situation so that the emotional impact is positive rather than negative. Suppression

refers to choosing to suppress or inhibit one’s emotional reaction to a stressor. Richardson’s study

showed that reappraisal led to more positive affect when managing daily stressful situations, and

suppression was associated with increased negative affect (Richardson, 2017). Considering this research,

a need for coping skills and teaching healthy ways to manage problems will be imperative to helping

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students build their foundation for a healthy future. One way to effectively teach skills to help students
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cope is through a comprehensive school counseling program.

Comprehensive School Counseling Programs

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According to the American School Counselor Association (2017), comprehensive school

counseling “programs are comprehensive in scope, preventive in design and developmental in nature”

(ASCA, 2017, p. 17). The goal of a data-driven, comprehensive school counseling program is to provide
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services that support an equitable education for all students in the school. The framework of a

comprehensive school counseling program is made up of four components: foundation, management,

delivery and accountability. The foundation refers to the developmental domains that inform the core

school counseling curriculum; these are academic, career and social/emotional domains. The foundation

component also includes ensuring counselors possess the professional competencies necessary to

effectively meet the demands of the position. Management refers to organization of the program

including the use of time, annual agreements with administrators and forming advisory councils with

community and staff represented. The delivery component refers to the direct and indirect services a
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school counselor provides to students. Direct services encompass all services which involve face to face

interaction with students; these include lessons on core curriculum lessons for all students, responsive

services such as small group counseling sessions, and individual student planning. School counselors

also indirectly serve students through collaboration and consultation with staff, parents and the

community. The leadership aspect of school counseling provides opportunities to advocate for positive

systemic change for underserved students. The accountability component involves analyzing data

collected in order to meet targeted student needs and measuring if and how students are different

because of the school counseling program (ASCA, 2017).

School-Based Interventions

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Social emotional learning (SEL) theory is a model of education that incorporates children’s
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psychological and social development into the core curriculum (Collaborative for Academic, Social, and

\Emotional Learning, 2013). The Collaborative for Academic, Social, and Emotional Learning (CASEL)
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(2013) organization defines social emotional learning as a way students “acquire and effectively apply

the knowledge, attitudes, and skills necessary to understand and manage emotions, set and achieve

positive goals, feel and show empathy for others, establish and maintain positive relationships, and make
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responsible decisions” (p. 4). Core curriculum based on social emotional learning theory teaches

students to identify and regulate feelings, develop empathy and problem-solving skills, peacefully

resolve conflicts, increase self-awareness and reduce stress (CASEL, 2013). Research on social

emotional curriculums showed increased positive social behavior, reduced emotional distress, reduced

conduct issues, and improved academic achievement (Barrett, Farrell, Ollendick, & Dadds, 2006;

Cohen, 2006; Dubow & Tisak, 1989; Kraag, Van Breukelen, Kok, & Hosman, 2009; Maloney, Lawlor,

Schonert-Reichl, & Whitehead, 2016; Weissberg, Goren, Domitrovich, & Dusenbury, 2013). Teaching

core curriculum lessons based on social emotional learning theory could ensure that students learn
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coping skills necessary for managing greater stress that appears to develop for some students as they

matriculate through school.

Purpose Statement and Evaluation Questions

The purpose of this research was to explore whether stress reduction interventions have

an effect on third-grade students’ stress levels and the coping skills they use. Additionally, the

research will show any changes in parent and teacher knowledge regarding children’s symptoms

of stress. At the conclusion of this program, the data should provide answers to the following

questions:

1. To what extent do students who participated in a series of core curriculum lessons

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aimed at stress management report a positive change in the ability to manage

stress?
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2. To what extent do students who participated in a series of core curriculum lessons
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aimed at stress management report an increase in their knowledge, skills, and

beliefs to manage stress in a healthy way?

3. To what extent do students who participated in small group counseling aimed at

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stress management report a positive change in the ability to manage stress?

4. To what extent do teachers who attend a presentation on recognizing stress in

children report an increase in their knowledge, belief and skills to recognize signs

of stress in their students?

5. To what extent do parents who attend a presentation on recognizing stress in

children report an increase in their knowledge belief, and skills to recognize signs

of stress in their children?

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The researcher employed quantitative data collection methods to answer the study’s

guiding research questions. The methods of data collection included pre/post questionnaires on

stress and coping skills for third-grade students participating in core curriculum lessons on stress

reduction and to members of small group counseling for stress reduction. Further, a pre/post

questionnaire was administered to parents and teachers participating in stress reduction

workshops to assess their knowledge, beliefs, and skills related to recognizing students’ stress.

To address the first question regarding changes in students’ stress levels, the Stress and Coping

Questionnaire was used. This questionnaire is comprised of questions selected from the

Perceived Stress Scale for Children (White, 2014). The purpose of White’s assessment is to

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measure the degree of stress experienced due to typical life experiences such as schoolwork,
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family dynamics and friendships (White, 2014). This information showed changes in students’

stress levels prior to receiving core curriculum lessons and small group counseling on stress
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reduction. To measure changes in the students’ knowledge, belief and skills for managing stress

in a healthy way, the Stress and Coping Questionnaire was utilized. Questions in section 2 of the

questionnaire were taken from the Children’s Coping Strategies Checklist and indicated changes
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in the variety of children’s coping skills as well as the frequency with which they use them

(Ayers & Sandler, 1999). To address the fourth and fifth questions regarding teacher and parent

knowledge of children’s stress related behavior, the Perceived Stress Scale for Children (White,

2014) was adapted for use with teachers and parents. The questions were also adapted to measure

teachers’ and parents’ perceptions of their children’s stress levels and behaviors. The

questionnaire was given before and after teachers and parents participated in a presentation on

the topic of recognizing children’s stress related behaviors.

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