Bullying Prevention and Intervention

Definition and Forms of Bullying

Bullying involves aggressive or deliberately harmful behavior between peers that is repeated over time and involves an imbalance of power, and can take several forms, including direct-physical, direct-verbal, indirect-relational, and cyberbullying 1

Bullying can lead to significant distress, anxiety, depression, and reduced school performance, with children who are bullied being at higher risk for mental health problems, including anxiety disorders 1, 2
Sleep disturbances can be both a symptom and risk factor for mental health problems in bullied adolescents 1
Substance use may be used as a coping mechanism by adolescents who have experienced bullying 1

The Centers for Disease Control and Prevention recommends creating a safety plan for school, home, and online environments, and establishing a reporting strategy that includes identifying trusted adults and teaching the difference between reporting and tattling 3
Determining the frequency, duration, and severity of bullying incidents is critical for assessing the level of risk and developing a safety plan 4
Asking directly about safety concerns related to the bully or their friends is necessary to assess the level of risk and develop a safety plan 4
Determining if threats have been made or if weapons are involved is crucial for assessing the level of risk and developing a safety plan 4
Considering whether the adolescent feels safe attending school is necessary for developing a plan to ensure their safety and well-being 1

The American Academy of Pediatrics recommends cognitive restructuring, including helping the child challenge negative thoughts and recognize the "cognitive triangle" - how thoughts impact feelings, which impact behavior 5
The American Academy of Pediatrics also recommends teaching emotional awareness, including helping the child identify and name their emotions, and creating an "emotional container" where the child can safely express feelings 5

The Centers for Disease Control and Prevention recommends establishing consistent routines, using visual schedules, and preparing the child for changes in routines to reduce anxiety, as well as encouraging participation in structured activities and practicing social skills through role-play 3, 5
Encouraging the adolescent to share information with parents or trusted adults is necessary for developing a supportive network 6
Educating parents about bullying and its potential consequences is crucial for promoting their involvement in addressing the issue 6
Guiding parents in advocating for their child at school is essential for ensuring the adolescent's safety and well-being 7

The American Academy of Pediatrics recommends considering professional mental health support if the child shows persistent anxiety or depression, sleep disturbances, school avoidance, significant changes in behavior or mood, or suicidal thoughts or self-harm behaviors 1
Referring for trauma-focused cognitive behavioral therapy is recommended as it has shown effectiveness for adolescents who have experienced trauma 6
Screening for depression, anxiety, suicidal ideation, and self-harm behaviors in adolescents who have experienced bullying is recommended 1

The Centers for Disease Control and Prevention advises against telling the child to ignore the bully, encouraging physical retaliation, confronting the bully's parents directly, or assuming the problem will resolve on its own, as these strategies can be ineffective or even harmful 3

LGBTQ+ youth, youth with disabilities, and those with weight concerns may need additional support due to intersecting forms of stigma that may compound bullying effects 1, 7
Addressing intersecting forms of stigma that may compound bullying effects is necessary for promoting the well-being and safety of vulnerable populations 7

Scheduling regular follow-up appointments to assess progress is necessary for monitoring the adolescent's well-being and adjusting interventions as needed 1
Monitoring for development or worsening of mental health symptoms is crucial for promoting early intervention and preventing long-term consequences 1
Recognizing that effects of bullying may persist even after the bullying stops is essential for providing ongoing support and care 1