SCHOOL PHOBIA
Source: Dr Isaac M. Marks, Living with Fear: Understanding and Coping with Anxiety
Most children are reluctant to go to school at some stage; however, their distress is generally short-lived and clears up without treatment. Occasionally reluctance to go to school culminates in outright refusal. This can become a serious problem and is sometimes called school phobia.
Refusing school differs from truancy. Unlike truants, school phobic children bluntly refuse to go to school, do not show other delinquent behaviour, have no history of their parents being away from home, and have a fair standard of work and behaviour at school. They also have more physical symptoms of anxiety than truants, such as difficulties in eating and sleeping, abdominal pain, nausea, and vomiting.
School Phobic children may give no reason for refusing to go to school or they may express concern or worry about being bullied, being teased, or fear a teacher, or be self-conscious about their appearance. They may avoid undressing in front of other children or taking a public shower after games, or be anxious about doing badly at games or schoolwork. A few children fear that harm may befall their mother while they are at school. Other reasons given for not going to school include fears of fainting during school assembly or vomiting.
School phobic children express their fears not only directly but also in physical symptoms, especially in the morning when encouraged to leave home for school. They may complain of nausea, vomiting, headache, and diarrhea, pain in the tummy, throat, or leg, eating difficulties, sleep disturbance, and various fears. The complaints may make the parents nervous and lead to open or tacit agreement that the child should stay home. The complaints then usually subside, only to recur the next morning when it is time to return to school. Typically a child complains of nausea at breakfast and may vomit and resist all attempts at reassurance by his worried mother until she gives in and allows him to remain home. Then he feels better unless pressure to go to school is resumed.
School refusal is usually preceded by a gradually growing reluctance to attend. The child might be irritable, weep a lot, be restless and sleep badly, feel sick, and complain of tummy pain when it is time to go to school. Insistence that school be attended will produce fear, and the child may go pale, tremble, and sweat. The fear may begin suddenly on a Monday morning following a weekend, on the first day of a new term, or on the day of return to school following illness. A common trigger is a change to a new school. Less often, school refusal can begin after the death, departure, or illness of a parent.
Prolonged absence due to school phobia can lead to serious consequences that may continue into adulthood. The child may lose touch with friends, social skills wither, and education suffers. The habit of avoiding unpleasantness may grow, so that in later years that person will cope more poorly with the slings and arrows of outrageous fortune with which we all must learn to contend.
TREATMENT
When treating school phobia it is important to first check that the conditions at school are tolerable, that the child is not being bullied, and that unreasonable educational demands are not being made. If the situation at school seems satisfactory and the main problem is the child is scared of ‘normal’ circumstances, the most important point in treatment is firm insistence that he return to school and stay there however much he dislikes the idea.
Returning the child to school may require the co-operation of teachers, who need to understand the problem. When the child is sent protesting back to school, crying and yelling, it is common for parents to feel heartless especially in lieu of angry looks from other parents accusing them of outrageous cruelty. In most instances the child stops crying and settles into classroom activities quickly and the dramas of the morning are soon forgotten. It is important for parents to show interest in what children do at school and praise children for the work they are accomplishing, this can help a lot.
This article is an extract from Dr Isaac M. Marks book “Living with Fear: Understanding and Coping with Anxiety”. To order your own copy of this book or to speak to a psychologist about your child’s school phobia please contact Bulimba Psychology on 07 38991455 or via email info@bulimbapsychology.com.au
Continue Reading