Treatment for School Refusal Among Children and Adolescents

Abstract

Objective: School refusal is a psychosocial problem associated with adverse short-and long-term consequences for children and adolescents. The authors conducted a systematic review and meta-analysis to examine the effects of psychosocial treatments for children and adolescents with school refusal. Method: A comprehensive search process was used to find eligible randomized controlled trials and quasi-experimental studies assessing the effects of psychosocial treatments on anxiety or attendance outcomes. Data were quantitatively synthesized using meta-analytic methods. Results: Eight studies including 435 children and adolescents with school refusal were included in this review. Significant effects were found for attendance but not for anxiety. Conclusions: Evidence indicates that improvements in school attendance occur for children and adolescents with school refusal who receive psychosocial treatment. The lack of evidence of short-term effects on anxiety points to the need for long-term follow-up studies to determine whether increased attendance ultimately leads to reduced anxiety.

Practitioner Review: School refusal: developments in conceptualisation and treatment since 2000

“…Maynard, Heyne et al. () describe the contents of five CBT manuals for treating school refusal (Heyne & Rollings, ; Heyne, Sauter, & Van Hout, ; Kearney & Albano, ; Last, ; Tolin et al., ). All but one (Last, ) utilise a form of individualised treatment based upon the functions served by the nonattendance together with consideration of ‘predisposing, precipitating, perpetuating, and protective factors’ (Maynard, Heyne et al., p. 3).…”

“…A recent systematic review and meta‐analysis (Maynard, Brendel et al., ; Maynard, Heyne et al. ()) identified six RCTs involving psychosocial interventions for school refusal (with five studies utilising CBT). Two further studies reviewed incorporated a quasi‐experimental design.…”

“…Nevertheless, they concluded that the results provided ‘tentative support for CBT for the treatment of children and adolescents with school refusal’ (Maynard, Heyne et al. , p. 6). Interestingly, findings from this study showed that gains made in respect of attendance were not mirrored by decreases in anxiety levels.…”

To go or not to go: School refusal and its clinical correlates

“…The majority continues to have significant impairment needing professional help. The results of a recent systematic review provide support for cognitive behaviour therapy (CBT) for the treatment of children and adolescents with school refusal, at least for the improvement of school attendance . Very few studies have used a rigorous methodology in assessing the efficacy of treatments.…”

Effectiveness of Morita Therapy-Based Consultation for a School-Refusing Adolescent with Psychogenic Fever

“…Previous studies have shown that somatic complaints associated with emotional distress are common features of school refusers (Honjo, Kasahara, & Ohtaka, 1992), and in some cases, headaches, stomach aches, nausea, fever, and vomiting have been reported (Blagg, 1987;Heyne & King, 2004). General clinical interventions for school refusal have mainly focused on CBT, which has provided clear evidence regarding its overall effectiveness (Bernstein, Hektner, Borchardt, & McMillan, 2001;Heyne et al, 2002;Maynard et al, 2015;Last, Hansen, & Franco, 1998;Ollendick & King, 1999;Wimmer, 2008). CBT for school refusal generally employs psychoeducation, cognitive restructuring, contingency contracting, parental-management strategies, and exposure, all of which are based on a detailed assessment and functional analysis of the child and his/her parents (King & Bernstein, 2001).…”