Practitioner Review: Signposts for Enhancing Cognitive-Behavioral Therapy for School Refusal in Adolescence

Abstract

Abstract. Factors associated with adolescent development influence the occurrence and presentation of school refusal (SR). Cognitive-behavioral therapy (CBT) manuals for the treatment of SR account for these developmental issues to varying degrees. Some multimodal treatments aim to address the complexity of adolescent SR by incorporating interventions alongside CBT, such as medication, inpatient treatment, and educational support in a special setting. However, CBT manuals and multimodal treatments appear to fail to help approximately one-third to two-thirds of adolescents, with respect to achieving regular school attendance. This paper provides an overview of suggestions in the literature for improving treatment for SR, with a focus on adolescent SR. Seven signposts emerge from the literature, namely, increased number or frequency of sessions, greater attention to social anxiety disorder and social functioning, greater attention to depression, greater attention to emotion regulation, careful consideration of the role of parents, greater attention to parent-adolescent communication and problem-solving, and the use of alternative educational settings. Professionals may find these signposts helpful when planning and delivering treatment for SR in adolescents. Research is needed to determine the benefit of including one or more of these adaptations alongside an existing SR treatment.

School refusal: mapping the literature by bibliometric analysis

“…Indeed, emotion regulation difficulties are considered an individual risk factor for school refusal ( Filippello et al, 2018 ). In line with all these evaluations, Heyne (2022) suggested that emotion regulation skills should be included in the intervention of school refusal. In a study conducted by Carpentieri et al (2022) , adolescents seeking psychological help were grouped as those with school refusal and those without school refusal.…”

Efficacy of cognitive-behavioral therapy combined with habit reversal training on anxiety disorders in children with Tourette’s syndrome

“…On the contrary, HRT focuses on increasing awareness of tic behaviors and implementing competing responses. The integration of these two therapies targets the dual aspects of TS-its physical manifestations and associated psychological impacts, thereby providing a comprehensive treatment approach[ 25 ].…”

Pendidikan Damai dalam Mereduksi School Refusal pada Siswa SMP

“…Beberapa perawatan multimodal bertujuan untuk mengatasi kompleksitas SR remaja dengan menggabungkan intervensi bersama CBT, seperti pengobatan, perawatan rawat inap, dan dukungan pendidikan dalam pengaturan khusus. Namun, keterbatasannya CBT dan perawatan multimodal tampaknya gagal membantu sekitar sepertiga hingga dua pertiga remaja (D. Heyne, 2022).…”