School Refusal (cont.)
IN THIS ARTICLE
School Refusal Treatment
Treatment of school refusal includes cognitive behavior therapy along with systematic desensitization, exposure therapy, and operant behavioral techniques.
Principles of Treatment
The goal of therapy is to help the student to restructure his or her thoughts and actions into a more assertive and adaptive framework to allow a rapid return to school. Therapeutic techniques include modeling, role playing, and reward systems for positive behavior change. Play therapy for younger, less verbally oriented children helps to reenact anxiety-provoking situations and master them. Interpersonally oriented individual therapy as well as group therapy can be extremely helpful for adolescents to counteract feelings of low self-esteem, isolation, and inadequacy. Interpersonally oriented individual therapy centers on the person's maladaptive responses to interpersonal interaction (usually involves difficulty in interactions with other people).
What Can Teachers and School Staff Do?
Obviously offering a welcoming and safe environment is the first and most important step. In addition, teachers and school staff should help the student identify and recognize the triggers for school refusal. Zero tolerance for bullying, available guidance staff, and opportunities to practice relaxation techniques can significantly reduce anxiety.
Bettina E Bernstein, DO
Read What Your Physician is Reading on Medscape
According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), separation anxiety is a fairly common anxiety disorder that consists of excessive anxiety beyond that expected for the child's developmental level related to separation or impending separation from the attachment figure (eg, primary caretaker, close family member) occurring in children younger than 18 years and lasting for at least 4 weeks.