Anxiety and School Refusal
On visiting a community club that I belong to, I got to speak with a parent who found out that I was a teacher. She then proceeded to tell me that she was at a complete loose end as she had a child who was a school refuser. She burst into tears and said that she had tried everything and was at the point of giving up in terms of being able to get her child to come to school.
Your child may not be in the same situation as this parent, but all students have at one time or another experienced varying degrees of stress and anxiety due to the challenges that school provides whether it be due to workload or friendships or even just to the pure routine of a school day.
I decided that I would do some research into strategies that I could give this lady to help her. I felt that it would also be beneficial to share these with our Bayside Community.
Whilst fears are a normal part of everyday life, anxiety is a problem when normal worries become intrusive, extreme and have an adverse effect on a child’s life.
I managed to find some really good strategies on anxiety and school refusal by Professor Michael Gordon who is a child and adolescent psychiatrist. His key message is that the treatment for school refusal is exposure to school. The longer students are away from school the harder it is to reintegrate. Three reasons for this are:
- A foundation of learning can be lost and students
can feel behind academically
- Friendships can be difficult to re-establish
- The student can exaggerate the concept of returning to school more than the reality.
Professor Gordon recommends a number of practical
strategies to assist with anxiety and school refusal:
1. School refusal is a problem: The research shows that students who do not return to school have future disadvantages with regards to academic achievements, work, relationships and social functioning. Non-attendance can lead to lowered academic success and higher risk of mental health problems. It is for this reason that if a child is showing signs of school refusal it is most important to address the problem quickly.
2. Encourage the Stretch Zone: Picture three concentric circles. The inner circle is the comfort zone, the middle is the stretch zone and the outer is the danger zone. By default we prefer to stay in the comfort zone, but it is very important for our mental health to move into the stretch zone every day. The stretch zone varies for each individual. For some children, coming to school is in the stretch zone, but they confuse it with the danger zone. The child needs to understand that they
are safe at school and the uncomfortable stretch feeling is important and good in the long run.
3. Routine: Establish a consistent routine for night-time and morning. Children need sleep to manage their emotions effectively, so a consistent early bed time is critical. Likewise, morning routine is central to arriving at school on time. Expectations drive outcomes. So if there are clear expectations and routines, children will soon stop questioning or pushing back. There is also security and safety in knowing and keeping to a set routine.
4. Tip the seesaw: A child experiencing anxiety and
school refusal is in constant mental flux, like the tipping back and forth of a seesaw. It is important to tip the seesaw just enough to get the child to school. This involves frequent positive reminders and prompts from adults in the child’s life, such as the parent, teacher, counsellor or school leadership team. If the child feels all the adults in their life are encouraging the same message, the seesaw is more likely to tip towards school.
5. Changed drop off : Have a different adult drop the student to school, such as the father, neighbour, family friend or school mate. Often a school refusing child struggles with separation anxiety from the mother. So removing this separation in the morning can be advantageous.
6. Red and green apple choice: Offer the child choice, but the outcome will still be to return to school. So they can choose who takes them to school, where they are dropped off, which teacher will meet them at the gate or whether they participate in all lessons during the day. These choices are like selecting a red or green apple - the child must still choose an apple (coming to school) but they have a sense of a control.
7. Be aware of difficult days: The research shows that returning to school after a holiday period or after the weekend is always the hardest. Therefore, anticipate that Monday will be more difficult
and put in place a plan that sets the child up for success.
8. Shared Locus Of Control: Imagine a line that has ‘Parents’ at one end and ‘School’ at the other. Where on the line does the responsibility lie to assist a child with anxiety and school refusal? Professor Gordon believes that it is a shared responsibility. Therefore, schools and parents must work together in partnership.
9. Mirror Neurons: Children look to adults to moderate their behaviour. Research on mirror neurons has shown us that children will reflect
or mirror anxiety displayed by adults. Therefore, as the child dials up the anxiety, the adult needs to dial down. Anxiety is highly contagious. So as the adult we need to become increasingly calm or de-escalate as the child gets anxious or escalates.
10. Menu: When dealing with anxiety and school refusal, children have a menu they can choose from. They have the option of healthy
or unhealthy ‘food’ choices. For example, when feeling anxious a healthy food choice might be to have a bath, do some exercise, read a book or talk to an adult. An unhealthy food choice might be to hide in your bedroom or throw a tantrum. It is important for children to tell an adult if they are anxious so they can choose a healthy option from the menu. If they decide to just show by negative or unproductive behaviours, they are choosing an unhealthy option from the menu.
11. Internal Dialogue: A key to changing a child’s perspective on school is their internal dialogue. It can be helpful to decide on four or five key phrases that the child needs to repeat in their head when they are anxious. For example: ‘I can control my nerves’; ‘I’ve been to school 1000 times before and I can do it again’; ‘Nothing bad is going to happen to mum and dad’; ‘I can get out the car’. A good exercise to establish these thinking routines is to have a table of positive and negative thoughts. The child brainstorms all the negative thoughts that they ruminate upon and then the child and parent create a list of counteractive positive thoughts. When driving to school, the parent can prompt the child to say these positive thoughts out loud.
12. We Agree: When speaking to the child, all the adults need to be on the same page when dealing with school refusal or anxiety more broadly. Parents or teachers may be in disagreement as to the exact strategies or causes for anxiety or school refusal. Conversations to agree on the plan or approach must be done with the adults and away from the child. There can be robust discussion between the adults. However, with the child present there needs to be a unified approach with little wriggle room. This creates a sense of safety and trust for the child because all the adults are saying ‘we agree’.
13. Tag Team: Managing anxiety and school refusal is emotionally and physically exhausting. At times it can feel unsolvable. Therefore, use the adults in the child’s life to tag-team. When mum is exhausted and can’t push any more, allow dad to step in with fresh energy. Research shows greatest successes come from a team approach.
14. Which Key: Treatment of school refusal is first and foremost exposure to school. However, there are a number of strategies that might be effective in tipping the seesaw so that the child is able to move into the stretch zone and regularly attend school. A helpful illustration is a set of keys. There are many keys or strategies that can be used. It can take a while to work out which key is most effective. Parents and teachers need to collaboratively make a plan that might involve trying a number of keys before seeing success. Effective management of anxiety and school refusal necessitates a growth mindset. Students, teachers and parents must exercise determination, persistence, resilience and grit. Real growth takes place when students push through anxiety to overcome personal challenges. Growth and learning involves struggle. Feeling anxious and overwhelmed is an opportunity for real growth, as children are at the edge of their competence and entering the stretch zone. It is vital that parents and teachers project a sense of hope and expected growth for the child that they can overcome their anxiety and flourish at school.
I hope that some of these strategies will prove to be useful for your family not only for school refusal but also for helping to manage anxiety in your child wherever it may lie on the continuum.
e-Teaching May 2017 (14) –ACEL by Emma Clemens, Deputy Head of Primary, Emanuel School, Randwick. Think Teach Learn - www.emmaclemens.com
Blessings in Christ
Head of Secondary