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.