Strategies for dealing with school avoidance

East Kildonan

Whatever it looks like, school refusal in children and teenagers is real. Whether refusing to attend school through gulps of tears, or giving up after an inability to focus on tasks that will get them out the door, or a staunch refusal that will end with aggression, usually the underlying problem is something absolutely treatable: anxiety.

In a webinar by foremost experts through the Anxiety and Depression Association of America called “What Parents Can Do to Help Their Child with School Refusal,” some strategies are discussed.

“Sometime you have to know a bit about how anxiety works”, said Dr. Lynne Siqueland, “because some things that are the most helpful are different than what parents might feel is needed in the moment.”

“Kids look to parents for help not feel anxious,” explained Dr. Eli Lebowitz. “You want to keep bad things away from your kid, and anxiety looks like a bad thing…” But when trying to somehow keep anxiety away, “what you are saying is that it’s not OK to be anxious, that it’s not good for you, you can’t handle that.”

He described that avoidance of anxiety provocations is a trap.

“Actually, (the child) would be OK. They would get through them and it would be easier if they kept doing them.”

“School refusal is complicated,” Siqueland added, “with different anxiety pathways, and we do have to sort that out.”

School boards have access to psychologists who can help, and it is a good idea to make a doctor’s appointment for your child as well.

“If (a student) has panic (disorder), they are fearing a panic attack. If they are avoiding speaking in class because they have social anxiety, they are avoiding that. If they have obsessive compulsive disorder (OCD), they are getting caught in rituals.”

Refusal may also be situational, such as with bullying and the school must be approached and the issue resolved.

“School should feel like a safe place,” says Dr. Lebowitz. He also said that sometimes a particular school just isn’t a good fit. As well, a big stressor at home, such as worry about a parent could play a role.

Lebowitz said he doesn’t do anything in treatment without a week or two of parents using a simple but powerful communication technique with their child. This involves acceptance and support statements, with no requests. At this point, the child may be dead-set against doing anything at all including receiving help.

An acceptance statement might be, “I get it. You’re anxious. This is hard for you.” This will make the child feel understood.

Support statements show the child they can tolerate some anxiety for some of the time. The child might not be able to cope with this idea the first time — “but you are showing you believe they can,” Siqueland said.

“What anxious children often hear is the opposite,” said Lebowitz, “that their anxiety cannot be handled and they grow up with this message … it becomes a huge thing in their life.”

With an incremental plan, and parent and school support, anxiety avoidance (called accommodation) can decrease and movement towards approaching school again can begin.

For example, teachers and students can call or visit throughout the day. Or, if an anxiety spike occurs when getting out of the car once there, a teacher or classmate can meet the child at curb side.

Even with OCD, the approach is not to suspend function until the problem is solved. Waiting until confidence comes is wrong, because confidence comes with capability, built over time in a planned way. And the wait list for physician referred OCD treatment in Manitoba is lengthy; contact the OCD Centre of Manitoba for more.

It was also not advised to punish a child by taking away extracurricular things like sports that boost feelings of capability.

For parents, these experiences can be exhausting and even traumatic.

To view the presentation, visit www.youtube.com/watch?v=01r-a366pmI&t=949s