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Student anxiety is less frequently identified and treated in school settings relative to other mental health concerns (e.g., externalizing behavior problems). Considering the perspectives of school-based mental health providers is critical for improving supports for students with anxiety in schools. The present study examined patterns and predictors of school-based provider perceptions of student anxiety, as well as factors influencing provider self-efficacy when addressing student anxiety concerns. Participants (N = 87) were providers working in a very large school district serving students from highly diverse socioeconomic and racial/ethnic backgrounds. Providers reported on their perceptions of the top-ranking student mental health concerns, as well as their own emotional exhaustion, beliefs about accommodating students who experience anxiety, and perceived self-efficacy responding to student anxiety. 71.3% of providers identified student anxiety within their top five student mental health concerns. Providers in schools with higher proportions of economically disadvantaged students were significantly less likely to consider anxiety a top five concern. On average, providers reported feeling somewhat confident addressing anxiety. Greater emotional exhaustion predicted poorer self-efficacy, whereas prior training in anxiety predicted higher self-efficacy. Beliefs about accommodating anxious students in ways that run counter to anxiety guidelines was not significantly associated with provider self-efficacy. Although anxiety is a well-recognized student mental health concern among school providers, student anxiety is less commonly perceived as a top five concern by providers working with economically disadvantaged students, which may underscore the importance of addressing acute stressors and trauma exposure in such populations. Offering more anxiety-specific training and efforts to reduce emotional exhaustion may improve provider self-efficacy for addressing anxiety. To provide more equitable mental health services and supports for anxiety in school settings, more work is needed to improve identification of student anxiety as well as provider self-efficacy for addressing it within districts serving predominately racial and ethnic minority students.

Despite recent advances in the treatment of early child social anxiety, the broad accessibility of brick-and-mortar services has been limited by traditional barriers to care, and more recently by new obstacles related to efforts to slow the spread of COVID-19. The present waitlist-controlled trial examined the preliminary efficacy of a family-based behavioral parenting intervention (i.e., the iCALM Telehealth Program) that draws on Parent-Child Interaction Therapy and videoconferencing to remotely deliver clinician-led care for anxiety in early childhood. Young children (3–8 years) with a diagnosis of social anxiety disorder (N = 40; 65% from ethnic/racial minority backgrounds) were randomly assigned to iCALM or waitlist. Intent-to-treat analyses found that at post, independent evaluators classified roughly half of the iCALM-treated children, but only 6% of waitlist children, as “Responders” (Wald test = 4.51; p = .03). By Post, iCALM led to significantly greater reductions than waitlist in child anxiety symptoms, fear, discomfort, and anxiety-related social impairment, and also led to greater improvements in child soothability. By 6-month follow-up, the percentage of iCALM-treated children classified as “Responders” rose to roughly 60%. Exploratory moderation tests found iCALM was particularly effective in reducing life impairments and parental distress among families presenting with higher, relative to lower, levels of baseline parental accommodation. The present findings add to a growing body of research supporting the promise of technology-based strategies for broadening the portfolio of options for delivering clinician-led mental health services.