BOSTON— Many school-aged children are reluctant to say goodbye to summer. Who can blame them? It’s not easy to trade swimming, lazy days, camp activities, and late nights for homework and early morning bus rides. But for most kids an initial reluctance to return to the school routine is quickly overcome. For others, though, concern about returning to school runs much deeper and can take hold as school refusal.
With the school year well under way, children with this difficult problem may still plead to be excused from school, complain of illness, and run home if forced to go. The cause may be a fear of leaving home or a fear of school itself—perhaps of a critical teacher or bullies. The start of the school year is sometimes a trigger, though school refusal can also develop after a school vacation, a brief illness, an accident, or the death of a relative.
Refusal to go to school often stems from an anxiety disorder, according to Coping with Anxiety and Phobias, a newly revised special health report from Harvard Medical School. Up to 25% of 13- to 18-year-olds suffer from anxiety disorders, and school refusal is one of the most troubling symptoms of generalized anxiety, social anxiety, or separation anxiety in children.
Treatment of school refusal involves teasing out whether there is an underlying anxiety disorder and addressing that, often with cognitive behavior therapy, an SSRI antidepressant, or both. But as Coping with Anxiety and Phobias points out, other immediate action is needed too—perhaps having a therapist meet with school staff or parents or having a therapist or parent go to school with the child on the first day.
Coping with Anxiety and Phobias includes more information on recognizing and treating anxiety disorders in adults as well as children.
Also in this report:
- What causes anxiety
- The symptoms, causes, prevalence, and treatment of panic attack, panic disorder, specific phobia, social phobia, obsessive-compulsive disorder, post-traumatic stress disorder, acute stress disorder, and generalized anxiety disorder.
- The best treatments
- Mindfulness meditation, biofeedback, and other alternative approaches to treating anxiety
Coping with Anxiety and Phobias is available for $18 from Harvard Health Publications, the publishing division of Harvard Medical School. Order it online at http://www.health.harvard.edu/Anxiety2011 or by calling 877–649–9457 (toll-free).
