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Paranoid about others talking, thinking, saying things in late elementary

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Please describe the behavior:
Paranoia

How old is the student?
Late elementary

Where and when does the behavior occur?
Classroom, playground

Frequency and duration of behavior?
Daily

What happens before and after behavior?
Other students talking

What does the student get from engaging in the behavior?
Unsure

What is the emotional state of the student during the behavior?
Upset

Who is the behavior directed at?
Other students

Is the behavior intentional or involuntary?
Unsure

Relevant health and mental health conditions?
ADHD

Medication side effects?
Tired and agitated easily by others

Student strengths and interests?
Strong reader

Have you noticed any patterns?
No

Possible Interventions:
I've had a number of students that are like this. The most recent I've worked with was about the same age, also ADHD, and always thought others were talking about them. There are various approaches you could take. One concept is to not try to convince the student what they are thinking is not true, rather giving them tasks and expectations that will keep them otherwise too busy to focus on those things that they are paranoid about. For example, if the student starts to complain about another student or group of students talking about them, you redirect them to face the front and look at the assignment they are working on rather than around the room.

Another method would be expanding the paranoid student's thinking in general. For example, when the student complains about others talking about them, you have the student write down or verbalize 2 or 3 alternative explanations for why the students may be talking, what they may be talking about, or who they may be talking about. After doing this consistently over time, the student may become less sensitive about others talking and more open to alternative explanations.

Another idea would be to not focus on whether others are talking about the paranoid student or not, but that even if they are, who cares. In other words, focusing on teaching the student to better cope with when others are talking about them. If they learn to not be so concerned about what others say about them, they may become less paranoid or preoccupied with others talking. Bullies 2 Buddies, a bully prevention program, has some good strategies for teaching students how to deal with others talking about them. The basic idea is that others talk about you to make you angry, upset, and mad (or paranoid), because its funny to watch others get mad, angry, hurt, upset, etc. It's similar to how America's Funniest Home Videos are funny to everyone, even though people in the videos are generally getting hurt, looking stupid, being made fun of, etc. Therefore, if you know people are saying things to and about you to make you upset, paranoid, angry, etc, choose not to get paranoid, angry, upset about words. This involves a lot of self talk and scripting. You could teach the student a set of scripts they would say to them self. Write these phrases or scripts down and have the student keep them in their desk or in a folder. Keep a copy at the teacher's desk as well so the student will always have access to them. Keep it to 3 or 4 scripts, such that the teacher can easily and quickly refer to them by number. For example, when the student starts to complain about others talking about them, the teacher would just give a quick verbal cue, "number 3", and the student would know to say the 3rd script in their head. Make sure to formally layout this strategy, teach it to the student, and practice it with the student before implementing it. This will help keep the strategy structured, clear, and consistent for the student and staff.

Here are some links to info and ideas on the topic of paranoid students as well:
http://www.studentdepression.org/over_personalisation_and_paranoia.php
http://apt.rcpsych.org/content/12/6/404.full
http://kidshealth.org/teen/your_mind/mental_health/social_phobia.html
http://www.socialanxietydisorder.net/coping/going-to-school-with-social-anxiety-disorder.html
http://myrondueck.wordpress.com/2011/03/01/social-anxiety-in-students/

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