School refusal is one of those problems that many children face sooner or later. However, not everyone develops a true school phobia. The incidence of this disorder is believed to range between 0.4 and 1.7 per 100 school-aged children. However, fear of school and the repercussions that this brings make it one of the most common problems in Psychology consultations.
Broadly speaking, school phobia can be defined as a maladaptive pattern of anxiety responses to school situations.
In school phobia, as in any other similar psychopathology, we must take into account the three response systems:
– Motor system: The child avoids going to school at all costs or escapes from it. Then complaints of pain and feigned illnesses usually appear. The child shows negativistic behavior: he does not get dressed, he does not want to eat breakfast, he cannot find or stains his clothes… Obviously, if the parents decide to take him to school using force, the child will cry, scream and even tremble.
Due to the pressure normally exerted by parents and teachers, the child finally remains in school but his behavior is very disruptive and manifests itself through the usual tantrums. In other cases, the little one opts for passivity, then he withdraws into himself and neither speaks nor plays.
– Physiological system: Responses such as sweating, high muscle tension, tachycardia, feelings of dizziness or even fainting usually appear. Upset stomach, vomiting, diarrhea, and urinary urgency are also common. In addition, the child may also suffer from headaches and eating or sleeping disorders.
– Cognitive system: The child begins to have negative thoughts or images about different school situations. Normally, he anticipates all kinds of unfavorable consequences (being laughed at, being reprimanded by the teacher, having his abilities negatively evaluated because he will not know how to answer the questions adequately, that the exam will be very difficult…).
As can be assumed, these worries cause a series of somatic reactions such as vomiting or the frequent urge to urinate (which in this case can be understood as the somatization of a desire to flee).
School phobia usually develops as a consequence of negative experiences experienced in the school context or due to aversive events that the child has witnessed. Obviously, stressful events such as changing schools, moving, a prolonged illness or problems between parents can be the last straw that breaks the camel’s back and triggers the problem.
At this point it is important to distinguish between “school phobia” and “separation anxiety disorder.” In the first case, difficulties in going to school are caused by intense fear of some aspect of the school situation, while in the second the fear originates from the possibility of separating from parents.
In the same way, we must separate “school phobia” from “truants.” In the latter case, school rejection is usually due to difficulties in school performance, problems with the discipline imposed by the school or the simple fact that motivation for school has been lost.
How should parents act?
First, parents should insist on an immediate return to school. The best therapy for this problem focuses on facing the fears and realizing that they are unfounded. Almost always, daily school attendance will improve the child’s physical symptoms until they disappear completely.
Obviously, at first the child will test his parents’ determination to send him to school every day. In these cases, parents must summon willpower and make school attendance a strict rule.
You should keep in mind that mornings are particularly difficult. If you ask the child how he feels, you will be encouraging him to complain. Of course, this doesn’t mean you shouldn’t worry about his health. Keep in mind that if your child is well enough to stay up and walk around the house, he or she will also be well enough to go to school.
If you have doubts about his state of health, you can always tell the teacher to monitor him and notify you of the slightest symptom.
In the same way, it does not matter if it is late, the child must attend school. Sometimes the child adopts rough manners and cries or screams. In that case you should talk to him about his fears but not compromise.
In the event that the child stays home because you suspect that he is really sick, take him to the doctor immediately to evaluate his symptoms. If the symptom is caused by a disease, appropriate treatment can be initiated. On the contrary, if it is caused by anxiety, the child will have to return to school.
The child should stay home when he or she has any of the following symptoms:
– Fever of more than 37.8°C
– Vomiting
– Frequent diarrhea
– Frequent cough
– Generalized skin rash
– Ear or toothache
On the other hand, children with a sore throat, moderate cough, runny nose or other cold symptoms, but who do not have a fever, can be sent to school. Children should not be kept home because they “look sick,” “have bad color,” “have dark circles under their eyes,” or “are fatigued.”
It can also be of great help for the child to spend more time with other peers. It has been shown that many children with school phobia avoid contact with their peers and prefer to stay at home with adults.
If the resistance to attending school persists, parents should talk to the teachers and the child to find the causes of their fear. Sometimes the child is relieved to be able to talk about his concerns about his classmates or the teacher’s expectations. If the child can point out a specific problem (such as test anxiety or being bothered by someone), then parents should immediately talk to the teacher, who will implement appropriate strategies to resolve the problem.
If the child’s resistance lasts more than two weeks and physical symptoms appear, it is advisable to consult a psychologist. He or she will most likely tell you to stop taking the child to school until he or she finds out what is causing the fear. Remember that the key to success is early intervention; The longer this behavior continues, the more difficult it will be to eradicate.
What will the psychologist do?
Treatment will depend on the causes. Many children may have started avoiding school for one reason but now prefer to stay home for another reason, such as access to video games or lack of academic pressure.
In general, most psychologists highlight the importance of returning the child to school, although some prefer that the return occur gradually. Therefore, systematic desensitization is one of the preferred techniques. Exposure to phobic stimuli can be done in imagination or in vivo and constitutes the most effective psychological treatment to deal with the avoidance behaviors that appear in specific phobias.
Relaxation, modeling techniques, reinforced practice, emotional enactments, rational emotive therapy are also used and, in the most severe cases, psychopharmacological treatments are used.
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