Successfully Confronting School Refusal Behavior
"I don't want to go to school!" Who hasn't heard that phrase before? While we may chuckle remembering the lengths we might have taken to avoid school, there are many children who truly struggle with going to school. School refusal behavior is a real issue that is stressful for children, their families, and even school personnel. School refusal is often associated with co-morbid disorders such as anxiety or depression. Not addressing these problems carefully could result in significant effects on children’s social, emotional, and educational development.

This 1-day seminar examines the complexity of school refusal behavior and explores solutions to help children successfully return to school. Learn to perform functional analysis to determine the motivation and particular reinforcement systems that support school refusal behavior. Examine psychological disorders that may be causing/co-morbid with school refusal including separation anxiety, generalized anxiety, social phobia, panic attacks, major depression, Persistent Depressive Disorder, Disruptive Mood Dysregulation disorder, ADHD, and Oppositional Defiant Disorder. Review the latest evidence-based treatments with a focus on tailoring standard approaches to specific situations. Lastly, participants engage in several case studies and develop intervention plans for cases of school refusal.

Course Content

TRUANCY VS. SCHOOL REFUSAL

• The four significant factors in school refusal
  • emotional sensitivity
  • lack of parental awareness
  • concurrent antisocial behaviors
  • incomplete academic work

CHARACTERISTICS OF SCHOOL REFUSERS

• Prevalence
• Age, sex, race
• Associated fears
• Family history
• Associated medical conditions

UNDERLYING PSYCHOLOGICAL DISORDERS (DSM-5®) & CO-MORBID CONDITIONS

• Separation Anxiety Disorder
• Generalized Anxiety Disorder
• Social Anxiety Disorder
• Panic Disorder
• Major Depressive Disorder
• Persistent Depressive Disorder
• Attention Deficit Hyperactivity Disorder
• Oppositional Defiant Disorder
• Disruptive Mood Dysregulation Disorder
• Learning disorders

DIAGNOSTIC & ASSESSMENT ISSUES

• Multiple information sources
• Structured interviews and instruments
• Self-report and parent-teacher reports
• Direct observation
• Monitoring systems
• Diagnostic issues unique to children and adolescents

FUNCTIONAL ANALYSIS OF SCHOOL REFUSAL

• Categorical-dimensional approach
• Reinforcement contingencies

TECHNIQUES TO COMBAT AVOIDANCE OF NEGATIVE AFFECT SITUATIONS

• Negative affectivity—avoidance hierarchy
• Somatic control
• Desensitization
• Guided imagery
• Positive self-reinforcement

TECHNIQUES TO COMBAT ESCAPING AVERSIVE SOCIAL & EVALUATIVE  SITUATIONS

• Social anxiety
• Lack of social skills
• Social/evaluative anxiety hierarchy
• Cognitive restructuring
• Behavioral exposure

TECHNIQUES TO COMBAT ATTENTION SEEKING BEHAVIOR

• The role of separation anxiety
• Ignoring
• Fixed routines
• Rewards/consequences
• Forced attendance

USING POSITIVE REINFORCEMENT

• Contracts
• Escorting
• Peer refusal training

TECHNIQUES FOR EDUCATORS & SCHOOL PERSONNEL

• Support and encouragement
• Structural changes
• Partial attendance strategies
• Forced school attendance
• Escort programs

TREATMENT PLANNING FOR SCHOOL REFUSAL

• Individual treatment
  • Desensitization
  • relaxation training
  • cognitive therapy
  • behavior modification
  • social skills training
• Family therapy
  • structural interventions
  • systemic interventions 
  • communications
• Pharmacological intervention
  • Tricyclics
  • SSRIs
  • beta blockers
  • benzodiazipines

CASE STUDIES

• “School Makes Me Want to Throw Up”
• “Everybody There Hates Me”
• “Can’t I Stay at Home and Have You Teach Me”
• “The School of Hard Knocks”