Barlow's etiological model

Crying spells, aggressiveness, anger, disobedience, illnesses and repeated visits to the infirmary, strong agitation, clinging … are all behaviors that your child has during the school period? Do the vacations seem much calmer? Does your child seem to be refusing school or dropping out with little motivation during class?  Your child is actually in great emotional pain, it is difficult for him/her to stay in school and suffers from this obligation. A panic attack occurs at the mere thought of school. We then speak of school phobia. 

  1. What is a panic attack?
  2. What is school phobia?
  3. Who does school phobia affect?
  4. What is the reason for school phobia?
  5. School phobia and separation anxiety, two related concepts?
  6. What character traits can be found in a child with a school phobia?
  7. How do I know if my child has a school phobia?
  8. What are the short-term consequences for my child?
  9. What are the longer-term risks?
  10. When to take care of my child?
  11. How can I help my child with a school phobia?

What is a panic attack? 

A panic attack occurs when a child feels in danger and an intense fear overwhelms him or her. It is not always easy for the child to understand, or detect or even recognize his or her panic attack. This panic attack can manifest itself in different ways. They may sweat, have a stomach ache, hyperventilate, scream, cry, feel dizzy, nauseous, tachycardia, vomit, or tremble. 

It is interesting to note that a panic attack usually lasts about twenty minutes. Indeed, beyond 20 minutes, the danger no longer seems imminent and intense to the child, and he or she will begin to create a habituation of the situation. It is with this information that exposure therapies work. 

In order to avoid this panic attack, the child tends to avoid class, either through absenteeism, going out during class, or regularly going to the infirmary.

What is school phobia?

School phobia may also be called anxious school refusal. It is defined as “children or adolescents who, for irrational reasons, refuse to go to school and resist with very strong anxiety or panic reactions when forced to attend.” 

School phobia is therefore an excessive fear or strong irrational anxiety about not being good enough at school, being humiliated, criticized, mocked by classmates, being alone while being away from parents etc.

Who does school phobia affect? 

School phobia affects about 3% of young people of compulsory school age. Therefore, many child psychiatry appointments are made to palliate and understand this anxiety. Boys tend to be more affected by this disorder than girls, although there is not yet too great a difference.

In terms of age, school phobia can appear at any time during growth. It can appear in childhood or adolescence.

What is the reason for school phobia? 

However, certain periods in the young person’s life might tend to favor this anxiety. The transition from one grade to another or puberty may have been experienced in a particularly difficult manner. 

It is also possible that trauma has occurred. This trauma may have been experienced within the school itself (harassment, assault, racketeering etc.) and the child has a shocking experience there. But the trauma may not be related to his or her student life, but rather in his or her personal space (divorce, family conflict, death, friendship or love breakup etc.). 

A child may have a school phobia because his or her home environment is too protective. Indeed, if he is overprotected, the child has difficulty experiencing life away from home, and will imagine danger in the moments when he had to leave the family home or the parent. Generally speaking, if you are overprotective of your child, it is because you are particularly anxious yourself. You then transmit this hostility of environments to your child, who always imagines the worst in every situation. 

School phobia and separation anxiety, two related concepts?

School phobia is often characterized as separation anxiety by child psychiatrists. Separation anxiety is excessive anxiety when distance is created between parent and child.

In a completely normal way, between 6 months and 1 year, the child begins to understand that he is a being in his own right, and not an extension of his parents. It is therefore normal for him, that at this age, he is worried about a separation or a possible abandonment between you and him. When you leave the place where he is, he feels like you are gone, forever. A safe and secure setting, for all that, that is not overprotective, allows him to stabilize these anxieties and does not make them dysfunctional. 

It is possible that, at an early age, the separation from you (or his/her father/mother) was difficult and badly assimilated by the child. Later, anxiety may be triggered and that a day at school, away from you (or him/her) is really badly experienced by the child. This daily separation is considered a tear, a real trauma. 

There is no guilt to be had on your side, there are no perfect parents, only parents who are doing their best. But your child may need more reassurance that you love him, but also that he has the skills to stand on his own two feet, to successfully be independent. Show him that you trust him, and that you will love him unconditionally, no matter what decisions he makes.

What character traits can be found in a child with a school phobia?

Often, teachers will perceive the child with a school phobia as particularly shy. For this reason, it is not uncommon for the teacher to not realize the child’s dysfunctional behavior when it comes to schooling. They often view the child as introverted or as a school dropout. 

In reality, the child wants to get out, but is in too much suffering

Many children with school phobia have low self-esteem and are very sensitive. They also have little confidence in the academic system and the people who are associated with it (teachers, supervisors, peers, etc.). 

These children are often quite stressed by nature, having high expectations of themselves in terms of their academic success. The parent may put a lot of pressure on the child regarding grades or direction. For example, it is not uncommon to encounter parents who expect their child to go to a science major, to get into a prestigious school, to have at least a 16/20 average, etc.

How do I know if my child has a school phobia?

There are many phobias that are clearly expressed, but school phobia does not necessarily manifest itself strongly, and can develop very gradually. It is quite possible to miss school phobia. Nevertheless, the earlier the phobia is managed, the more likely the child is to have lower consequences in the long run. 

In adolescents, the onset may be hidden, and one may not realize that there is a real underlying problem or, may be equated with “teenage crisis”. 

Teachers can be your first point of contact for understanding what is going on at school. They will be able to describe to you his or her attitude in class, but also his or her relationships with classmates. Communicating with your child about what is happening at school is primordial. You can get in touch with the various people at the school who are in contact with him/her (supervisor, school nurse, principal etc.). 

If you have any doubts about your child’s attitude, or level of anxiety about school, it is important to go consult your doctor, child psychiatrist, psychologist etc. It may be that a trusted health professional can understand your child, and detect a possible school phobia.

With the information you’ve read on different sites, or different questionnaires you’ve taken, you may find some things that seem similar to what you think your child is like. You can find some scales assessing your child’s school phobia. Don’t hesitate to share all of your feelings and thoughts with the various professionals connected with your child. They will be able to guide you as best as possible on the steps to take, or reassure you about your feelings.

What are the short-term consequences for my child?

In the short term, you will feel like you don’t always recognize your child. He or she may lose his or her zest for life, be quite apathetic, refuse to do certain activities that he or she loves, or engage in behaviors that you find strange.

He may also experience depression that can lead to depression. He becomes sad, experiences some physical pain, and increasingly devalues himself. He may feel a sense of emptiness or dpowerlessness. His mood is changeable, and he becomes easily irritable. He may be aggressive with you or his peers; or, conversely, he may become withdrawn. 

Gradually, therefore, he may become dissocialized and feel lonely and rejected by his friends. You may have, in fact, already noticed that he no longer sees his friends too much, that he no longer goes out with them, or that he is no longer invited to birthday parties.

Conflicts may also arise within your family. At first, you may feel that your child is not making an effort in school and is at risk of dropping out. This anxiety puts extra pressure on him and creates quarrels. They can also occur with siblings. You may give the impression to your other children that they give more importance to your phobic child, and the others may feel neglected. This can then create jealousy and fights between children. 

What are the longer-term risks?

In the longer term, the risks are, initially, a school dropout. Your child feels so anxious about going to class, the playground, taking an exam, etc. that he will often be sick, or not go to his school. His absenteeism rate increases considerably. He will therefore miss lessons and tests. The less he goes to class, the less he manages to follow the subject, and he will feel behind and will not want to go anymore. So he enters a vicious circle that hurts his schooling. 

The depression he may have experienced, may turn into severe depression. It will be able a total demotivation, a loss of vitality, until going towards suicidal desires.

Gradually, there will be an increase in anxiety disorders or even other psychiatric disorders. Your child may also develop some personality disorders. He or she may therefore have behavioral disorders, adopting hetero-aggressive behaviors (aggressive toward others) or self-aggressive behaviors (aggressive toward himself with mutilatory behaviors, for example). 

When to take care of my child?

It is never too late to take care of your child if they are experiencing a school phobia. On the other hand, if treatment is done early, there will be fewer long-term risks that have set in. 

It has been shown that for proper management, it should be done within 10 months of the first symptoms.

It is never too late, however, and for the well-being of the child or adolescent. 

How can I help my child with a school phobia?

The main objective is to get the child back to school as quickly as possible and to avoid any longer term consequences. It is therefore recommended to focus on cognitive behavioral therapies (CBT). It has been proven to be the most effective therapy in the treatment of school phobia. 

In this way, the child will both have the tools to regain his schooling, but understand why he has his anxieties. The exhibitions that are proposed within this therapy (whether virtual or real) will allow him to apprehend his anxieties, and to learn how to manage them to regain his serenity.  

It is important that, initially, the care is individual to best adapt to the child’s issues, who will be able to fully express his or her discomfort.

The child should be able to have entire confidence in his or her therapist (psychiatrist or psychologist). Reassure him or her then that he or she will be able to express himself or herself honestly to him or her without information being shared. They may not be able to talk about their difficulties with you, but a therapist will help them put their suffering into words. 

 

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