DOES YOUR CHILD SUFFER FROM SCHOOL PHOBIA?

Nowadays, the majority of consultations in child psychiatry concern problems related to schooling. Already in first grade, 25% of children present difficulties. The competitive spirit of parents towards their children grows with time, especially in France where academic success is an important value. Your expectations become even higher when they are teenagers. This increases their fear of failure. They know that you are worried about their success and about how society will view your family. In addition, schools are more rigorous about the frequency of evaluations. School is becoming more and more important in your life and that of your child, but also in today’s society. Your child may suffer from school phobia.

phobie scolaire

1. Schooling, a current topic of interest to all parents

Nowadays, the majority of consultations in child psychiatry concern problems related to schooling. You are, consciously or not, involved, in a more or less accentuated way, in the school institution. But little by little, parents, in a general way, feel fully and more involved in the schooling of their children. It is true that, for many children and adolescents, school seems complicated. Already in the first grade, 25% of children have difficulties. The competitive spirit of parents towards their children grows with time, especially in France where academic success is an important value. Your expectations become even higher when they are teenagers. This increases their fear of failure. They know that you are worried about their success and about how society will view your family. In addition, schools are more rigorous about the frequency of evaluations. School is becoming more and more important in your life and in your child’s life, but also in today’s society. The world is changing rapidly with this institution, and can be a source of anxiety for young people to whom the interest is not always well explained. 

 

2. What is the definition of school phobia? 

Your child does not want to go to school anymore, and you consider him/her to be refusing schooling (due to lack of interest or motivation). However, this school refusal is considered a phobia when it “concerns children or adolescents who, for irrational reasons, refuse to go to school and resist with very strong anxiety or panic reactions when we try to force them to go. This is why we can also call it “anxious school refusal”. But today, we consider that school phobia is part of the family of specific phobias.

School phobia is not uncommon and it is being identified more and more. However, it is not new and has certainly existed since school was made compulsory. For a long time, it was considered as juvenile delinquency, where children were playing hooky. But very soon, researchers realized that the absence of children from school was due to their strong anxiety in school situations. Your separation from your child during a school day was particularly hard on him. Rejecting school could allow him to get your attention and thus have a proof of your parental love, which he feels (rightly or wrongly) in pain. This is why it is often associated with separation anxiety, which is excessive anxiety about the distance between you and your child. 

To summarize, school phobia can be considered as an excessive fear, an irrational anxiety in front of different events such as being less gifted than one of one’s classmates, being criticized or mocked during oral presentations, being humiliated, taking exams, etc., or sometimes, for no apparent reason. It is regularly associated with separation anxiety, generalized anxiety, or post-traumatic stress disorder. 

3. What is the origin in the child?

It is difficult to give a single reason for your child’s school phobia. 

It is possible that his school phobia originates from the family environment in which he grew up. If you are particularly anxious by nature, if your couple has recurring difficulties and conflicts, if you overprotect him or her or give him or her the feeling that you are letting him or her live, etc. It is also possible that you (or your spouse) are hyper-emotional, and therefore, that he/she does not really understand what you may be feeling, which leads him/her to think that the environment is hostile when he/she is away from you. 

In addition, your child may be particularly vigilant about school anxiety if you are very anxious about social situations or if you perceive them in a negative way. You may sometimes talk about certain situations that may have intimidated you. In this way, you unconsciously transmit your anxieties to your child. But, at the same time, wanting to overprotect your child from certain situations is not necessarily beneficial. In fact, feeling vulnerable can help your child develop. The risk here would be to put your child in a situation of emotional dependence that would make it difficult for him to separate from you and to live his own experience at school. 

School phobia can also be found depending on the personality and characteristics of your child. It is not uncommon to find school phobic children with low self-esteem, little confidence in the academic system, hypersensitivity (especially to the risks of academic failure, etc.).

The school environment may also be a source of suffering for your child, such as bullying or teasing. Your child’s fear of returning to school may also be heightened by certain remarks made by teachers, by comments made by some of his peers, by conflicts within your family or with his friends.

Your child may behave in a way that seems functional for a while. In fact, he or she may have been able to cope with the situation. But, one day, an event in your child’s life (or in your family) may upset this balance. This can be a stressful event (evaluations, starting 6th grade…), or a death, a divorce, a break-up with a friend or lover…

4. What are the symptoms and characteristics of school phobia?

Unlike many other phobias where anxiety is known to manifest itself strongly, school phobia is not easily visible. Not being aware of it delays treatment. It is not uncommon for anxiety to appear in a very pronounced way in younger children. However, if your child is older or a teenager, it may be more hidden. You may have interpreted his or her behavior as a refusal or dropping out of school. You may have realized that your child is complaining a lot about school but for no reason that you think is valid. Or you may simply find that he or she shows little motivation for school. His teachers may simply consider that he is shy by nature and therefore does not participate much for this reason. However, there are symptoms that can be a warning.

Staying in school is particularly difficult for your child and causes him/her great emotional distress

School phobia leads to intense anxiety about school (middle school, high school or college for the older ones) and a consequent emotional upheaval. A panic attack is then born at the simple idea of having to go to the school, on arrival, when entering the classroom, during weekends in anticipation, etc. 

It is not always easy for your child to put his anxieties into words, and to understand them. This is why he/she may express this fear through crying, irritability, anger, clutching, etc. You may also have noticed that he/she often complains of headaches, sweating, feelings of dizziness, intestinal or muscular disorders or exacerbated agitation. He or she may also manifest anxiety through difficulty breathing, nausea or vomiting. You may also find that lately your child has become increasingly disobedient and aggressive towards others or himself. Sometimes he or she hurts himself or herself. 

In addition, your child is increasingly absent from class (this is normal, since it allows him to avoid the anxiety-inducing situation). He sometimes goes so far as to be absent for more than half of his lessons. 

This situation puts your child in great academic and emotional difficulty. But not only. The whole family is going through a difficult period, in which doubts, uneasiness and conflicts arise. 

5. What are the consequences for the child’s life?

The consequences can be multiple in the long term from an academic, social or family point of view, leading to great emotional suffering for you and your child. 

Your child or teenager may become disengaged from his or her schooling or adopt a certain rigidity with regard to schooling. He or she may have a higher rate of absenteeism. This can lead to difficulties in their social and emotional development. This disengagement can lead to school dropout with all the underlying difficulties that accompany it. These complications may include social isolation, the onset or increase of anxiety disorders or depression, de-socialization, friendship and emotional breakdowns, and other psychiatric disorders. If your child is an adolescent, he or she may even develop personality disorders in the long term.

Moreover, this phobia can also have consequences on your family life. It can create conflicts for the whole family, for your siblings and for your partner. You may also have to reorganize your family’s functioning, such as taking a part-time job in order to be able to look after your child because he or she does not want to go to school, for example.

All of these difficulties combined may create additional complications for your youngster to find a job. 

6. How to manage school phobia?

If no care is taken, your child may suffer from conflicts within the school (with teachers, management, classmates …), within your parental relationship, but also to experience a deterioration of his relationships with his peers. Later on, he/she may have serious psychological or psychiatric problems. There are several solutions.

In the treatment of school phobia, it is important to consider all the underlying elements that may have induced the anxiety. This is why it is important to start as early as possible. It is estimated that the phobia should be treated within 10 months of the first symptoms. In this way, the risks of your child dropping out of school and social isolation are reduced.

In addition, it is important that the follow-up be done on an individual basis to best adapt to your child’s specific problems and to his unique discomfort with school. 

The goal is to get your child back to school without difficulty and to reduce the complications that this may have caused.

Cognitive-behavioral therapy is the most effective therapy in the treatment of school phobias for a quick return to school while taking into account the possible reasons for its appearance. Your child will be exposed to a school environment, in which he/she is normally in real life. This technique allows your child to become accustomed to situations that are anxiety-provoking. The exposure will allow the possibility of accompanying the therapy with a relaxation session. This exposure and background work will allow the child to change his interpretation of the anxiety-provoking school environment

7. What is the School Refusal Assessment Scale-Revised? 

School phobia being too often considered as a simple lack of motivation of the child, the researcher and psychologist Kearney created the “School Refusal Assessment Scale-Revised“. It is a scale that evaluates the level of severity of the child’s anxiety about the school environment and can explore the reasons for avoiding school. 

Through this questionnaire, you will be able to get an idea of your child’s level of anxiety about school environments (or not anticipating them). Answering in a completely honest and natural way, with your child, would be the best. Your answers are not recorded or consulted. The sole purpose of this test is to help you understand the anxiety your child may be feeling and to help you decide what to do. 

8. What are the prevalences of school phobia?

It is difficult to estimate the frequency of this disorder at the present time. On the other hand, it is considered that this phobia is constantly increasing and is one of the main reasons for child psychiatric consultation. It is estimated that 5% of the school-age population suffers from school phobia, and that it affects mostly boys.

There is no fixed age of onset. On the other hand, certain periods of life or school career can be more favourable to the evolution of this anxiety. The beginning of secondary school as well as adolescence seem to be part of it. Indeed, the inner conflicts during the development of your child during puberty sometimes interfere with the school process. In addition, they feel misunderstood by their teachers and sometimes by you.

9. Virtual Reality Exposure Therapy for school phobia?

Virtual Reality Exposure Therapies (VRET) are part of the cognitive-behavioral approach and are particularly appreciated by children and adolescents because of their innovative and modern aspect. Moreover, VRTs have been widely proven in the treatment of school phobias.

Exposure, in cognitive-behavioral therapies, allows for work on different aspects, whether they be of substance (anxious feelings for example), or of form, such as the avoidance of anxiety-provoking environments.

The therapies by exposure to virtual reality make it possible to appropriate the physiological sensations of panic, and thus to reduce its frequency. Indeed, virtual reality allows for habituation to the situation, just as cognitive-behavioral therapy would do with in-vivo exposure (i.e. in reality).

It allows to create an environment similar to reality, while being easy to access.  The exposure is completely safe since the therapist has direct access to what he/she is proposing to your child, and can interact at any time so that he/she can manage his/her difficulties more easily and not feel abandoned.

Your child will progress according to his own timetable and will be followed in his progress while being exposed to situations that he would not have thought were surmountable.

In this way, he will be able to find his way back to school (middle school, high school or university) and leave behind him the obstacles that prevented him from moving forward serenely.