School Phobia: An Overview of Research and Intervention Decision Matrices for School Personnel

Abstract

School phobia has been frequently discussed since the 1930's, yet there has been little agreement regarding etiology or appropriate treatment. Although the incidence is only approximately 2% of the school aged population (Kennedy, 1965, Millman, Schaefer, & Cohen, 1981), there has been much attention paid to this behavior in the literature. There is little agreement regarding the demographics, personality characteristics or family structure of the school phobic. Popular theories were psychoanalytically oriented in the past, and there has been considerable debate that school phobia is actually a form of separation anxiety. Current explanations are more behaviorally inclined, yet there is still no consensus. Treatment recommendations have followed the same pattern of emphasis being initially psychoanalytic and more recently behaviorist in nature. Although it is agreed that treatment should be rapidly initiated, there are no \state of the art\ treatments. The lack of adequate, empirical, and comparative research is discussed. There is a need for practical guidelines for school professionals in order to provide rapid and effective treatment. A Treatment Guideline and Decision Matrices were developed in order to provide a frame work for school personnel to use in identifying, evaluating, and treating school phobia, were found to be very valuable in identifying school phobia, for collecting and organizing data, and for developing comprehensive treatments. Suggestions for further research were also discussed.

School refusal.

“…Also, collaborative team interven-SCHOOL SUSPENSION A N D EXPULSION 183 tions should involvc the student, family, school, and other service providers. Examples of treatment modalities are psychotherapy, hypnosis, family counseling, parent and social skills training, and behavioral treatments (including systematic desensitization and contingency management, which involves applying consequences for appropriate and inappropriate behaviors) (Paige, 1993). Although drug therapy should be considered in the multidimensional treatment of school refusal (particularly when depression and/or separation anxiety are involved), it must be used with caution because of the possibility of drug side effects (King et al, 1995).…”