Education and Counseling for Individuals Affected by Oppositional Defiant Disorder and ADHD

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School Refusal

I will admit to being an over indulgent parent (initial score of 75), however, after viewing your first week of sessions, I would like to know if you address my particular situation of an overly dramatic teenage girl who repeatedly "makes" herself too ill to attend high school? She cajoles, manipulates, and at a time of day when we all need to get to work, and have little time for such events. Nine times out of ten she wins. This characteristic needs to be modified in order to get her on a more goal-oriented track toward success in her career and future relationships.

Thank you for your e-book. It applies a logic system to solving this persuasive teenage dilemma in the US :)




Hi E.,

Re: I would like to know if you address my particular situation of an overly dramatic teenage girl who repeatedly "makes" herself too ill to attend high school?

You’ll find a strategy to resolve this issue in Session #3. However, I would caution you to work the program as intended (one week at a time). If you leap to Session #3 without laying down the groundwork in Sessions #1 and #2, you will run the risk of failing with this program. Having said this, I’ll elaborate a bit regarding your daughter’s anxiety about school.

Parents can do several things to help their child who refuses to attend school:

· Firmly getting the child to school regularly and on time will help (see “When You Want Something From Your Kid” – Session #3). Not prolonging the goodbyes can help as well. Sometimes it works best if someone else can take the child to school after the parent or caregiver says goodbye at home.

· It truly helps to believe that the child will get over this problem; discuss this with the child (the parent or caregiver needs to convince himself or herself of this before trying to convince the child).

· Listening to the child's actual concerns and fears of going to school is important. Some of the reasons for refusing to attend school may include another child at school who is a bully, problems on the bus or carpool ride to school, or fears of inability to keep up with the other students in the classroom; these issues can be addressed if they are known. On the other hand, making too big a deal of school refusal may promote the child's behavior to continue.

· Supportive counseling is often made available at school in these circumstances so as to minimize reinforcement of school avoidant behaviors and to prevent secondary gain from school refusal and should be encouraged for any student who wishes to have it. If the child simply refuses to go to school, some parents have found that decreasing the reward for staying home helps, for example, do not allow video games or television, or find out what work is being done in the school and provide similar education at home, when possible. This is especially if the "illness" seems to disappear once the child is allowed to stay at home.

· The parent or caregiver should reassure the child that he or she will be there upon the child's return from school; this should be repeated over and over, if necessary. Let the child know that the parent or caregiver will be doing "boring stuff" at home during the school day. Always be on time to pick the child up from school if you provide transportation rather than a school bus.

· Whenever events occur that could tend to cause students to miss school (for example, traumatic events such as terrorism, school shootings, or other traumas) all attempts should be made to help students return promptly to school and to help them to feel safe at school.

In addition to parental intervention, teachers and school staff should help the student identify and recognize the triggers for school refusal.

Many children with school refusal have an earlier history of separation anxiety, social anxiety, or depression. Undiagnosed learning disabilities or reading disorders may also play a significant role in the development of school refusal.

Signs of a psychiatric disorder called separation anxiety disorder can include the following:

· Excessive reluctance to be alone at any time
· Excessive worry about losing a parent; excessive worry that a parent might be harmed
· Persistent refusal to go to sleep without a parent or other caretaker present
· Repeated complaints of physical symptoms whenever the child is about to leave a significant parental figure
· School refusal

These behaviors must begin before the child is aged 18 years, must last for 4 weeks or longer, and must cause serious problems with academic, social, or other functioning in order to be called a disorder.

Some commonly cited reasons for refusal to attend school include the following:

· A death in the family of a friend of the child
· A parent being ill
· Being bullied by another child
· Feeling lost (especially in a new school)
· Jealousy over a new brother or sister at home
· Moving from one house to another during the first years of elementary school
· Not getting along with a teacher or classmates
· Not having friends
· Parents separating, having marital problems, or having frequent arguments
· Parents worrying about the child in some way (e.g., poor health)

Helpful tools to confirm the diagnosis of an anxiety disorder and the level of impairment include the following:

· Children's Global Rating Scale
· The Child Behavior Checklist (CBCL)
· The Children's Manifest Anxiety Scale

I hope this helps,


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