School Refusal And Anxiety – Part 2

Last week I wrote about school refusal and anxiety after attending a very thought provoking course presented by child and adolescent psychiatrist, Professor Gordon. The key message throughout the day was that the treatment for school refusal is exposure to school. The longer students are away from school the harder it is to reintegrate. The reason for this is:

1. A foundation of learning can be lost and students can feel behind academically
2. Friendships can be difficult to reestablish
3. The student can heighten the concept of returning to school larger than the reality

Professor Gordon offered 14 practical strategies to assist with anxiety and school refusal. In my last post I wrote about the first 7 strategies and below are the final 7 strategies.

1. Shared Locus Of Control: Imagine a line that has ‘Parents’ at one end and ‘School’ at the other. Where on the line does the responsibility lie to assist a child with anxiety and school refusal? Professor Gordon believes that it is a shared responsibility. Therefore school and parents must work in partnership.
2. Mirror Neurons: Children look to adults to moderate their behaviour. Research on mirror neurons has shown us that children will reflect or mirror anxiety displayed by adults. Therefore as the child dials up the anxiety, the adult needs to dial down. Anxiety is highly contagious. So as the adults, we need to become increasingly calm or de-escalate as the child gets anxious or escalates.
3. The Menu: When dealing with anxiety and school refusal, children have a menu they can choose from. They have the option of healthy or unhealthy food choices. For example, when feeling anxious a healthy food choice might be to have a bath, do some exercise, read a book or talk to an adult. An unhealthy food choice might be to hide in your bedroom or throw a tantrum. It is important for children to tell not show. They need to tell an adult if they are anxious so they can choose a healthy option from the menu. If they decide to just show by negative or unproductive behaviours, they are choosing an unhealthy option from the menu.
4. Internal Dialogue: A key to changing a child’s perspective on school is their internal dialogue. It can be helpful to decide on four of five key phrases that the child needs to repeat in their head when they are anxious. For example: ‘I can control my nerves’ ‘I’ve been to school 1000 times before and I can do it again’ ‘Nothing bad is going to happen with Mum and Dad’ ‘I can get out the car’. A good exercise to establish these thinking routines is to have a table of positive and negative thoughts. The child brainstorms all the negative thoughts that they ruminate upon and list these on the left hand side of the table. Then the child and parent creates a list of counteractive positive thoughts and adds them to the right hand side of the table. When driving to school, the parent can prompt the child to say these positive thoughts out loud.
5. We Agree: When speaking to the child, all the adults need to be on the same page when dealing with school refusal or anxiety more broadly. Parents or teachers may be in disagreement as to the exact strategies or causes for school refusal or anxiety. Conversations to agree on the plan or approach must be done with the adults and away from the child. There can be robust discussion between the adults. However, when with the child present, there needs to be a unified approach with little wriggle room. The creates a sense of safety and trust for the child because all the adults are saying ‘we agree’.
6. Tag Team: Managing anxiety and school refusal is emotionally and physically exhausting. At times it can feel impossible to solve. Therefore, use the adults in the child’s life to tag team. When Mum is exhausted and can’t push any more, allow Dad to step in with fresh energy. Research shows greatest successes come from a team approach.
7. Which Key: Treatment of school refusal is first and foremost exposure to school. However, there are a number of strategies that might be effective in tipping the seesaw so that the child is able to move into the stretch zone and regularly attend school. A helpful illustration is a set of keys. There are many keys or strategies that can be used. It can take a while to work out which key is most effective. Parents and teachers need to collaboratively make a plan that might involve trying a number of keys before seeing success.

Question for you: Are you proactive in managing school refusal in order to develop a plan for success before the problem escalates?

School Refusal

• Part 1: Strategies 1-7
• Part 2: Strategies 8-14