Abstract:This paper describes the use of family therapy with adolescent school refusers. School refusal is assessed and formulated from a family systems perspective, and therapy proceeds with the crisis precipitated by insisting on the adolescent's early return to school. Some of the common problems encountered in this approach are considered along with its results.
“…Clearly, involving the family in the intervention, alongside school staff, is likely to be essential in most cases (Doobay, ). While family therapy has long been advocated for the treatment of school refusal (Bryce & Baird, ; Lask, ; Richardson, ), there continues to be insufficient evidence that such an approach, in isolation, is as effective as individually focused therapies for the treatment of school refusal. Instead, family work is now often seen as more appropriately embedded within a CBT programme (e.g.…”
While several sound publications are available to guide intervention for school refusal, there is a continuing need for rigorous studies that can provide evidence to support individualised and tailored responses to an incapacitating problem with many causes and manifestations. While a multisystemic response to intervention approach is considered attractive, the practicalities of operating this across disparate professional borders are likely to present a long-term challenge.
“…Clearly, involving the family in the intervention, alongside school staff, is likely to be essential in most cases (Doobay, ). While family therapy has long been advocated for the treatment of school refusal (Bryce & Baird, ; Lask, ; Richardson, ), there continues to be insufficient evidence that such an approach, in isolation, is as effective as individually focused therapies for the treatment of school refusal. Instead, family work is now often seen as more appropriately embedded within a CBT programme (e.g.…”
While several sound publications are available to guide intervention for school refusal, there is a continuing need for rigorous studies that can provide evidence to support individualised and tailored responses to an incapacitating problem with many causes and manifestations. While a multisystemic response to intervention approach is considered attractive, the practicalities of operating this across disparate professional borders are likely to present a long-term challenge.
“…Although family therapy techniques are widely advocated for the treatment of school refusal (Bryce & Baird, 1986 ;Lask, 1996), it is rare that these, in isolation, are the preferred approach. In a recent survey of U.S. psychologists, Kearney and Beasley (1994) found that work with families tended to focus upon parent training and contingency management ; family therapy did not register as a key treatment.…”
Developments in the assessment and treatment of school refusal have often been hampered by a failure to recognise its essentially heterogeneous nature. This paper provides a review of major conceptual complexities that have helped to undermine developments in clinical practice. In particular, it considers the distinction between school refusal and truancy, and school phobia and separation anxiety. Common approaches to the assessment and treatment of school refusal are outlined. Although behavioural and cognitive behavioural approaches are now widely accepted as central to treatment, it is increasingly recognised that individually tailored programmes, utilising a range of approaches, are most likely to prove successful. An approach focusing upon the functions, rather than the symptoms, of school refusal is advocated as having most promise for assessment and the subsequent formulation of individual prescriptive treatment.
“…It also helps to promote the family's development of a circular (vs. linear) understanding of the problem (Rhodes, ), which sets the scene for the whole family's participation in the process of change. Exploring past attempts at solutions also yields valuable information about family functioning (Bryce & Baird, ).The ‘nodal point’ for the Black family appeared to be related to a family life cycle transition: Amy completing school and becoming more separate from the family. Jane's school refusal also provided a shared focus for Terry and Ann, without which I suspected the couple's marital tensions threatened to come to the fore.Jane's school refusal caused conflict between Terry and Ann.…”
Section: A Systemic Formulation Of the Problemmentioning
confidence: 99%
“…I prompt parents to consider what the young person's future might look like if they do not address the issue; how they foresee the young person's development progressing should they continue to refuse to engage in school, and later work; what it might be like for the family to have the young person remain at home for years to come. Often this line of questioning helps the family to grasp the serious implications of continued school refusal, while at the same time highlighting the possibility that the family may be ambivalent about change (Bryce & Baird, ).Terry and Ann were uncertain how seriously to take the problem because Jane continued to achieve high grades and lead a healthy social life. We talked about the prognosis and risks of untreated school refusal.…”
Section: Raise Awareness About the Seriousness Of The Problemmentioning
confidence: 99%
“…Within the existing body of research, there is little agreement about how school refusal is defined. Several authors appear to use the terms 'school refusal,' 'school phobia,' and 'truancy' interchangeably (Bernstein et al, 1999;Kearney, 2006;Ek & Eriksson, 2013); while others draw a distinction between school refusal and truancy, the latter more commonly associated with conduct disorder and antisocial behaviour (Hawkes, 1981(Hawkes, , 1982Lang, 1982;Bryce & Baird, 1986;Fremont, 2003;Kearney, 2008;Heyne, Sauter, Ollendick, Van Widenfelt, & Westenberg, 2014). The absence of a clear and universally accepted definition makes it difficult to develop a thorough understanding of this complex problem (Kearney, 2008).…”
Child and adolescent school refusal is a complex problem that can paralyse parents and professionals alike. Families often present in desperation, often after the problem has become well established. The literature concerning ‘what works’ is clear: addressing the problem early relates to better prognosis, and supporting the child to return to school is the primary priority. In practice, however, the ‘how to’ is often complicated by parental anxiety or complacency, complex family dynamics, therapist uncertainty about how to help, and poor partnerships between family and school. In this paper, I will present a framework for intervention informed by Structural and post‐Milan ideas, developed from practice‐based evidence – witnessing what works for families in everyday practice. A model for family therapy intervention is presented and discussed, illustrated with a case vignette.
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