Jackie Rhew, MA, CADC,LPC
Assistant Director, School Refusal Program
Alexian Brothers Behavioral Health Hospital
I work with many schools, and I often hear that students are having a difficult time managing stress and using avoidance and/or refusal behaviors to cope with anxiety. Some students also experience somatic symptoms as a result of their anxiety and/or depressive symptoms. In addition, the growing technological advances with smart phones and other devices overwhelm us with data and information and promote instant gratification, and as a growing sense of entitlement that adolescents need to be “happy” all the time and everything “has to be fair”, has led to many adolescents struggling to experience any displeasure or discomfort. It is all right for the adolescent to be “unhappy” especially if the goal is maturing into a healthy young adult.
Key skills to teach adolescents to cope with school anxiety and school refusal include goal setting; distress tolerance; self-assessment of strengths and weakness; learning to cope with disappointment and failure; and self-advocacy skills.
KEY PARENTING SKILLS AND OBJECTIVES
As a parent, be mindful and aware of your own anxiety and how it manifests in parenting. Every individual has anxiety, but it is critical that as a parent you understand how your anxiety impacts your responses to your child.
Identify goals and objectives for parenting (e.g. assisting your adolescent in becoming more self-motivated, self confident, independent). Write out clear expectations, privileges and consistent consequences and review them with your child (keep expectations simple and consistent). Avoid a lot of talking and reassurance with the anxious and/or avoidant child, this will only lead to increased anxiety, especially around placing expectations and could reinforce more negative behaviors instead, focus on goals for parenting and outcomes. It will be important to move from emotionally reactive parenting to a more goal centered approach. Also, avoid rescuing your child when he/she is uncomfortable and/or not feeling well, rather allow your child to work through discomfort and/or somatic symptoms by setting expectations and reinforcing belief that your child has an option to manage discomfort and can manage. Review expectations regularly.
Some key tips when dealing with school anxiety and/or school refusal:
1. Make school attendance mandatory unless your child has a fever or contagious illness. A child’s anxiety will increase the more school is avoided.
2. If a child is struggling with school anxiety or refusing to go to school, contact school personnel and do not call in (creating an excused absent).
3. Establish and maintain open communication with school personnel regarding your child’s feelings about school, difficulties with school, etc. Avoid negative comments or statement about school or school staff in front of your child; this may reinforce negative thoughts/feelings about school.
4. Create an environment at home that fosters structure and consistency. Expectations should include rules, chores, privileges and limits. This will allow children to learn to structure themselves, as well as understand rewards and consequences. Likewise, expectations should be clear regarding school attendance and homework, as well as privileges and consequences given for not meeting expectations. Based on research, structure, routine, and consistency, work to alleviate anxiety in children.
5. Encourage children to enroll in school extracurricular activities to feel more connected to school. Have child choose at least one activity per school term.
6. Provide positive feedback for successes made at school.
7. Seek support from school and/or external resources when your child first starts displaying symptoms of school anxiety/school avoidance.
8. If patterns of academic failure are present, psychological and/or neuro-cognitive assessment and/or intervention may be needed due to possible learning disabilities or neuro-cognitive deficit issues that may be present.
9. Negative peer relations may result in school avoidance/anxiety issues. Contact the school social worker if your child is struggling with peer relations, ie: bullying, difficulty getting
along with peers, etc. Therapeutic intervention on the school level may be needed.
10. Make sure the child has gone to your primary care physician at least once a year to rule out medical causes.