I am working with a mother of a 15yo female engaging in quickly worsening school refusal. She has a long history of significant anxiety and as a result, has been incredibly socially isolated for the past two years. I have two consultation questions:
1. Mom could think of only two individuals at child's current school that could be at all called possible friends. We will work to recruit these two youth in implementing the SPACE school refusal plan with peers coming in the morning but if these youth's families are not willing to support, what is recommended? The only other two peers the youth identifies as being friends with in the past do not attend her same school. Is a friend from a different school viable? Seems like recruiting ppl from her own school she doesn't know at all could be quite challenging.
2. Prior to starting to work with me, the school had worked to reduce students school load to increase likelihood of her completing any school at all. Thus, she is only enrolled in two in person classes and is taking health online. Thus, expectation is she be at school daily from 9am-12pm. Currently, the appropriate level of expectation to work towards would be her going 2/5 days a week as she is currently going 0-1 days per week. How would ppl recommend then handling the rules around screens until expectation is met? Would it be basically screens are given if she attends school that day but are removed after that day until she attends 2 school days in the week? (E.g. If she goes Monday, gets them after school Monday until Tuesday morning. If doesn't go Tues, she has no access to screens until she attends school again?)
Thanks so much for all help!
I appreciate your summary and questions. I have found myself working with more school refusal cases, lately. And they are difficult!
I'll offer a couple of ideas -- and I will look forward to hearing more from others.
1) It would be great to have a friend show up at home, of course. But if they cannot, I wonder if there are others in the extended family or neighborhood who might be a viable option. I had a previous case (with a middle schooler) in which a grandparent took turns attending in the morning in order to facilitate school attendance (and reduce sometimes destructive explosions before school). I have another family with whom I am working now and we are considering the presence of aunts and uncles because the client is very close to them. (In both of these cases, friends were not an option for one reason or another)
2) Again, targeting accommodations during the day -- especially if the parents have to leave for work -- has been a challenge for me, too. But my approach has been to offer screen time in a manner that is consistent with whatever screen time the client would have if she/he/they WERE going to school. So, no access to any non-course-work screens during the school day. Regular rules for screen time outside of the school day -- especially for kids with social anxiety when I really want them to have access to peer interactions. I sort of try to avoid additional after-school-hours 'punishment' of taking away the screen time.
3) For my own cases :) I am curious if/how you have addressed the child's activity during school hours. Specifically, if the client sleeping while at home? What else is she doing? And, if the parents are not home and cannot always be home.....how have other targeted those sorts of accommodations??!!
Thanks and good luck!