Children and adolescents who are bullied are experiencing a traumatic event. Bullying can be physical, verbal, emotional, relational or electronic (cyberbullying). Bullying is for most students a traumatic experience (an accumulation of smaller or less pronounced events can still be very traumatic. This is referred to as a small “t”, as opposed to big “T”, combat for example).

This trauma can develop into anxiety, depression, and other mental health issues. If the experience is not handled skillfully at home and school and especially if left untreated, self-harm behaviors and even suicide can occur. Bullying is a national epidemic.

Sudden changes in behavior, or mood are often the key to identification and intervention. Parents and school staff need to be vigilant about withdrawal, avoidance, loss of interest, social isolation, sleep disturbance, and nervousness; being keyed up or on-edge. Skillful means in exploring these behaviors is required. The student must feel safe and have a sense that things can change by taking the “leap of faith” to reveal the abuse they, or another, are experiencing. Along with assuring an end to the bullying (the responsibility of school staff and parents) psychological treatment should be considered and is likely indicated, especially if the bullying was prolonged and severe.   

If psychological intervention is required it is essential to address all the effects of bullying. A review of relevant research recommends an integrated treatment.  Integrated treatment includes cognitive and behavioral therapies, to address low self esteem, poor self concept and feelings of inadequacy that result from being bullied. Integrated treatment also incorporates trauma therapy such as EMDR (Eye Movement Desensitization Reprocessing Therapy) to weaken intrusive anxious/trauma related thoughts, and reduce avoidant behaviors while simultaneously strengthening the student’s confidence through improved alignment to their values and improvement in accessing their inner resources (re-building resilience).  

If school refusal is an issue the use of exposure therapy or Exposure and Response Prevention (ERP) must be included in the integrated process. ERP allows students to return to the social world on their own terms, at their own pace in a safe and comfortable way. 

The Integrated Protocol described herein evolved from my experience in treating children and adolescents with anxiety disorders, PTSD and mood disorder for 20 years in clinical practice and 20 years in public educational settings, primarily as a school psychologist. In utilizing this integrated protocol I have seen significant improvements in outcomes and client comfort (tolerance) when compared to utilizing only one methodology.

Dr. Perry Passaro

Licensed Educational Psychologist, a Licensed Psychologist and a credentialed school psychologist. He earned his doctorate in Educational Psychology, with an emphasis in Measurement, Evaluation and Statistical Analysis from the University of Kentucky, in Lexington.  His dissertation studied the effects of perceptual errors on complex problem solving. He currently practices privately, in the areas of Cognitive Behavioral Therapy (serving children, adolescents, families and adults) as well as in the area of psycho-educational assessment, in Newport Beach. Dr. Passaro has worked in public education for over 20 years, primarily as a school psychologist.  He has taught at the university level and has published numerous articles in professional journals related to education and psychology. He is a member of the Association of Behavioral and Cognitive Therapies (ABCT), a Diplomate in Cognitive Therapy granted by the Academy of Cognitive Therapy (ACT) and EMDR certified.

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