A Scoping Review of Constructs Measured Following Intervention for School Refusal: Are We Measuring Up?

Abstract

Reviews of the effectiveness of interventions for school refusal (SR) rely upon wellconducted primary studies. Currently there are no guidelines for those conducting primary studies about the measurement of outcome following intervention for SR. Most people would agree that it is important to measure school attendance as an outcome but there has been little discussion about other constructs that warrant measurement. To facilitate this discussion and support the development of guidelines, we conducted a scoping review of constructs measured in studies evaluating intervention for SR. We screened the title and abstract of 3,213 publications found in peer-reviewed journals between 1980 and 2019. After full text review of 271 publications, 50 publications describing 51 studies were included. Results address the frequency with which constructs were measured, along with instruments used, informants, and time-points for measurement. Based on the results, we offer guidelines for choosing constructs to measure following intervention for SR and considerations for how to measure the constructs. Guidelines can increase consistency across primary studies, with benefits for future meta-analyses and international comparisons. They also provide support for practitioners contemplating routine evaluation of their interventions for SR. Ultimately, a core outcome set for SR can be developed.

Outcome of a Multi-modal CBT-based Treatment Program for Chronic School Refusal

“…In research of SR, anxiety is a commonly used primary outcome measure. 24 In this study, the proportion of youth with a possible or probable anxiety disorder decreased. The improvement in mental health among youths is even more distinguishable in the parent ratings, with larger effect sizes.…”

“…A thorough description of the target group and a standardized way of evaluating outcome should help facilitate comparisons between methods, contexts, and subgroups. 24 …”

“…Moreover, the study uses the appropriate measuring points—pre-test, post-test, and follow-up—to determine whether the effect is long lasting. However, standardizing how to measure outcomes of interventions needs further investigations, 51 , 52 such as Heyne et al’s 24 review of the way SR interventions have been evaluated over the past 40 years.…”

“…That is, both children and parents often suffer from mental health problems due to SR. 18 In addition, outcomes of interventions targeting SR is usually assessed by measuring school attendance and anxiety. 18 , 24 …”

An Approach for School Counselors: Behavioral Consultation with Parents of Youth with School Attendance Problems

“…Recent studies have also emphasized the importance of early identification of and intervention for SAPs upon their onset (e.g., Brouwer-Borghuis, Heyne, & Sauter, 2019;Heyne, 2019;Ingul, Havik, & Heyne, 2019;Kearney & Graczyk, 2014). Of several approaches to address SAPs, cognitive behavioral therapy (CBT) and behavioral intervention are commonly utilized (Heyne, Strombeck, Alanko, Bergstrom, & Ulriksen, 2020), and the importance of close cooperation between parents and school staff is widely recognized (Elliott & Place, 2019).…”