Children and adolescents who school refuse can very quickly become entrenched in a long-term pattern of school refusal, which can have major long-term impacts for them and their family. Contingency management involves providing home or school‐based rewards to attend school and increase the amount of time children stay in school. Although behavioural and cognitive behavioural approaches are now widely accepted as central to treatment, it is increasingly recognised that individually tailored programmes, utilising a range of approaches, are most likely to prove successful. All codable effect sizes for these two outcomes will be extracted, and each outcome construct will be analyzed separately. Was the equivalence of groups tested at pretest? Behavioral, ed.‐supportive, parent‐teacher, pscyhopharm. The program aims to identify reasons for school refusal, develop a comprehensive treatment plan to address school refusing behavior and help transition kids back into an academic environment. If drafts are not submitted before the agreed deadlines, or if we are unable to contact you for an extended period, the relevant Coordinating Group has the right to de‐register the title or transfer the title to alternative authors. Geographical context: This review will include studies from any geographical context. A gradual return plan is often recommended for older students or. Treatment for school refusal among children and adolescents: a … Authors recommend strategies based on three categories of school refusers. If necessary, additional sensitivity analysis will be conducted if other issues arise that may impede our confidence in the estimated pooled effect size estimates. C8. School refusal and anxiety are often linked. Yes, presented strong fidelity to the model, 2. Anxiety as a risk factor for school absenteeism: What differentiates anxious school attenders from non-attenders? Forced school attendance may be appropriate for younger students or those with mild school refusal. Based on prior theory and research, the following moderators will be examined for their influence on effect sizes: 1) treatment modality; 2) treatment duration; 3) theoretical basis of intervention (e.g., CBT, family systems, etc. and you may need to create a new Wiley Online Library account. This can only be overruled in exceptional circumstances. Practical Recommendations and Interventions: School Refusal 2 relax, imagine riding the bus, then walking into class, etc.). In the past two decades, the conceptualization and definition of school refusal behavior has evolved. Social skills training is a commonly utilized behavioral intervention for children who exhibit school refusal behavior as a result of poor peer relationships or social anxiety (King et al., 1998). Although there have been systematic reviews and meta‐analyses conducted on the effects of interventions for children and adolescents with anxiety disorders (see Brendel, 2011; Ishikawa, Okajima, Hirofumi, & Sakano, 2007), we have not located a systematic review or meta‐analysis of interventions focused specifically on school refusal behavior. Posttest measurements generally occur at the end of the intervention. School refusal interventions are generally either child or parent‐focused. Please check your email for instructions on resetting your password. Teen Anxiety, Teen Depression, and School Refusal. In the 2005 study, the authors concluded, “Overall, school refusal has responded to CBT programs as demonstrated in a number of controlled studies, with general maintenance of gains” (p. 249). We will select the measure that has better psychometric properties, or, if there is a measure that is commonly used across several studies to measure the same construct, we will retain the effect size for the analysis using the common measure. In addition, studies must either match on pretests, risk factors, and/or other relevant characteristics, use statistical controls, or report baseline data to examine group equivalence. Meta‐analysis, on the other hand, represents key findings in terms of effect size, rather than statistical significance. [TXSET], C4. We base our program on a cutting edge treatment protocol for school refusal called “Dialectical Behavior Therapy – School Refusal” (DBT-SR). (, Flakierska-Praquin, N., Lindström, M., Gillberg, C. (, Flay, B. R., Biglan, A., Boruch, R. F., Castro, F. G., Gottfredson, D., Kellam, S.…Ji, P. (, *Heyne, D., King, N. J., Tonge, B. J., Rollings, S., Young, D., Pritchard, M., Ollendick, T. H. (, Heyne, D. A., Sauter, F. M., Maynard, B. R. (, Heyne, D., Sauter, F. M., Ollendick, T. H., Van Widenfelt, B. M., Westenberg, P. M. (, Higgins, J. P. T., Altman, D. G., Sterne, J. Even though the situation may feel stressful, don’t shout, tell them off or physically force them to go to school. [FWUP], E6. Recommended treatment based on the four functional classifications of SRB. Observed N for treatment group_________        [OBNTX], E30. Socio‐economic status‐ Description        [SES2], B7. Unit of assignment to conditions        [ASSGN], D3. Exclusion criteria: As defined above, we will exclude studies that involve only medication, are conducted in a residential setting, or are conducted with youth who have dropped out of school. Members of _ can log in with their society credentials below, Brandy R. Maynard, David Heyne, Kristen Esposito Brendel, Jeffery J. Bulanda, Aaron M. Thompson, and Terri D. Pigott. Comprehensive treatment of school refusal, including psychiatric and medical evaluation when appropriate, is important since studies show that psychiatric disorders are the cause for a large percentage of students who fail to complete high school in the United States. This product could help you, Accessing resources off campus can be a challenge. ## PDF School Refusal Assessment And Treatment ## Uploaded By Dr. Seuss, treatment of school refusal includes several psychological approaches including cognitive behavior therapy along with systematic desensitization exposure therapy and operant behavioral techniques cognitive behavior therapy derived from behavior therapy the By completing this form, you accept responsibility for preparing, maintaining and updating the review in accordance with Campbell Collaboration policy. The Campbell Collaboration will provide as much support as possible to assist with the preparation of the review. The Q statistic is distributed as a chi‐square with k‐1 degrees of freedom (k = the number of effect sizes). Family interventions using behavioral strategies typically train the parents in behavioral management and contingency contracting techniques, which parents can then implement in the home. Behavioral and cognitive‐behavioral approaches have received the most attention in prior reviews; however, a range of additional strategies have been used in the treatment of school refusal behavior. [COST], C17. About 2 per cent of all school-aged children experience school refusal. The best treatment to help children struggling with school refusal includes a team approach. Sharing links are not available for this article. “At first glance, our review of research suggests empirical support for CB therapy in the tx of SR.” When they applied stringent criteria regarding evidentiary support for psychosocial interventions (outlined by the Task Force on Promotion and Dissemination of Psychological Procedures), “empirical support for the well‐established status of CBT is found wanting”. Publication bias will be assessed using the trim and fill procedure, and the resulting funnel plot produced in CMA will be visually inspected. Exposure‐based interventions are designed to expose children to the stressful event (i.e., returning to school) to help them overcome their avoidance to school, either in the slow, gradual manner utilized with systematic desensitization, or the forced, rapid return to school utilized with the flooding technique. For more information view the SAGE Journals Sharing page. If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Working off-campus? Did the researchers present evidence that suggests that the program was        [FIMP], C16. Scholars have described school refusal behavior fairly consistently, with a few exceptions (e.g., Kearney, 2008), as a subtype of nonattender: students who have attendance difficulties resulting from emotional distress. t‐value from an independent t‐test or square root of from a one‐way analysis of variance (df 1)________ F‐value        [ES‐T], E37. Comparison group mean:____________        [ESCGM], E34. Currently, CMA 2.2 only allows for meta‐regression with continuous scaled variables. Treatment Format: Check all that apply:        [FRMT], C9. This review will not include studies conducted in residential facilities, as these settings are highly controlled and not typical of regular school settings. You can be signed in via any or all of the methods shown below at the same time. School refusal is a serious issue and needs to be managed early, as long absences mean that children miss out on important parts of the curriculum. (, Maric, M., Heyne, D. A., MacKinnon, D. P., van Widenfelt, B. M., Westenberg, P. M. (, Maynard, B. R., Brendel, K. L., Bulanda, J. J., Heyne, D., Thompson, A. M., Pigott, T. D. (, Maynard, B. R., Brendel, K. L., Bulanda, J. J., Pigott, T. D. (, Pina, A. Psychosocial interventions outside of behavioral or CBT models include educational‐support strategies and non‐CBT individual and family therapy. Reviews that have focused more specifically on outcomes of interventions have not employed systematic review methods or meta‐analytic techniques to quantitatively synthesize the results. In addition, CBT may also be delivered with parents or families. Intent‐to‐Treat Analysis‐ Are results for this effect size based on an intent‐to‐treat analysis? Eight studies including 435 children and adolescents with school refusal were included in this review. Data were quantitatively synthesized using meta-analytic methods. Concurrent publication in other journals is encouraged. Some society journals require you to create a personal profile, then activate your society account, You are adding the following journals to your email alerts, Did you struggle to get access to this article? Are the above means adjusted? School refusal occurs when a student will not go to school or frequently experiences severe distress related to school attendance. Egger et al. A., Gonzales, N. A., Ortiz, C. D. (, Prabhuswamy, M., Srinath, S., Girimaji, S., Seshadri, S. (, Silverman, W. K., Pina, A. Because there is no consensus on what constitutes a “diagnosis” of school refusal behavior, this review will include only studies in which participants have both an attendance problem and anxiety or a similar clinical symptom(s) related to stress, mood, or anxiety that affects their school attendance. Focusing on the past 30 years will lead to a comprehensive and contemporary review of interventions. Focal Format‐ Use same numbering system above and select the ONE format type that is considered the focal format of the intervention. The following research questions guide this study: We propose to include all studies that meet the inclusion criteria outlined above. The main objective of the analyses will be to describe the direction and magnitude of the effects of the different school refusal interventions on the different outcome constructs. A draft review must be submitted to the relevant Coordinating Group within two years of protocol publication. Intent‐to‐Treat Analysis‐ Are results for this effect size based on an intent‐to‐treat analysis? While the functional treatment of school refusal has been identified as a promising approach (Kearney & Silverman, 1990; 1999), to date, this intervention lacks rigorous evaluation. Pretest measurements generally occur at or immediately prior to the beginning of the intervention. Find out about Lean Library here, If you have access to journal via a society or associations, read the instructions below. school refusal? The first line of treatment for school refusers should be CBT. Country in which study was conducted        [CNTRY], A4. Enter your email address below and we will send you your username, If the address matches an existing account you will receive an email with instructions to retrieve your username. Was there more than 20% attrition in either/both groups? Taken together, the past reviews are very important to our understanding of school refusal behavior and can provide some evidence to guide interventions; however, they do not systematically or quantitatively address the question of whether and which interventions are effective for increasing school attendance and decreasing anxiety for children exhibiting school refusal behavior. If you determine no one component could be identified as the focal, then code 88. “However, since very few controlled studies have been reported at this stage in treatment research, it would be premature to extol the clinical virtues of cognitive‐behavior therapy” (p. 506). Assessment of school refusal behavior: Examining the motivating conditions underlying school absence. School Refusal Assessment Scale-Revised (P) Name: Date: Please select the answer that best fits the following questions: . Listen to the child or young person and find out if there is anything specific that is bothering them at school (e.g. More than ¼ of all youth will engage in some degree of school refusal during their schooling years, ranging from complaints and threats to avoid school, to missing school for months or even years at a time. School refusal behavior is a psychosocial problem for students characterized by severe emotional distress and anxiety at the prospect of going to school, leading to difficulties in attending school and, in some cases, significant absences from school (Kahn, Nursten, & Carroll, 1981). Comparison group mean:____________        [CGM], E15. Select the treatment group that receives the treatment that is specified by the authors as being the focal program/intervention under investigation or the one that is expected by authors to be most effective. A. C. (, King, N., Tonge, B. J., Heyne, D., Ollendick, T. H. (, King, N. J., Ollendick, T. H., Tonge, B. J. Pharmacologic treatment of school refusal should be used in conjunction with behavioral or psychotherapeu- tic interventions, not as the sole intervention. School of Social Work Saint Louis University, % Males________(use 999 if not enough information to determine), % receiving free or reduced school lunch__________, Brief description of SES composition of the sample, _________________________________________________________________________________, ______________________________________________________________________________, (child and parent if both involved)______________, 1. School refusal is a psychosocial problem associated with adverse short- and long-term consequences for children and adolescents. It comes as … Cognitive‐behavioral interventions may be delivered individually or in group settings. Types of settings: The review will include interventions conducted in any setting that serves primary or secondary school students. P. 222. In the case where the construct is measured in more than one way, we will retain only one of the effect sizes in the analysis. Evidence indicates that improvements in school attendance occur for children and adolescents with school refusal who receive psychosocial treatment. If you refuse a treatment, your decision must be respected, even if is thought that refusing treatment would result in your death or the death of your unborn child. Source of outcome data        [DSOURCE], E3. The e-mail addresses that you supply to use this service will not be used for any other purpose without your consent. School refusal is a psychosocial problem associated with adverse short- and long-term consequences for children and adolescents. Behavioral interventions for the treatment of school refusal typically employ relaxation training, exposure‐based strategies, contingency management, and/or social skill training techniques to reduce the children's fears and anxiety and help them return to school. The prevalence of school refusal behavior is difficult to ascertain, due to the discrepancy in how school refusal is defined and lack of any national reporting; however, most researchers estimate that less than 5% of school‐age children exhibit school refusal behavior (Burke & Silverman, 1987; Elliott, 1999; Fremont, 2003; King, Ollendick, & Tonge, 1995; Ollendick & Mayer, 1984). [FFRMT]. Long‐term problems in social adjustment may also occur, including psychiatric disturbance (Heyne et al., 2001). know the primary reason that school refusal is being maintained is very helpful to therapists, parents and teachers for information regarding comorbid conditions and treatment guidelines (Kearney, 2002; Kearney & Albano, 2000; see Table 1). [ITT], E14. Consultation with school personnel and parents: Calling a truce to assist the youth. This review will not include single‐group pretest‐posttest studies or other study designs. Socio‐economic status‐ free or reduced lunch        [SES1], B6. (SELECT ALL THAT APPLY)        [COMP], C12. What is the name of the intervention received by treatment group? Individual, family, and school context appear to be important to understanding the causes as well as the maintenance of school refusal behavior. Role of the evaluator/author/research team or staff in the program. School refusal peaks at several points of development, including with entry into Kindergarten, between ages 7-9, and again with entry into Middle or High School. Evidence-based information on school refusal from hundreds of trustworthy sources for health and social care. In the case of school refusal behavior, relaxation training is employed as a means of reducing feelings of psychological and physiological arousal and somatic symptoms associated with school or separation from a parent (King, Heyne, & Ollendick, 2005). Please list their names: I have read and accept the Wiley Online Library Terms and Conditions of Use, School refusal: Family constellation and family functioning, The prescriptive treatment of school refusal, Synthesizing research: A guide for literature reviews, School refusal and psychiatric disorders: A community study, Bias in meta‐analysis detected by a simple, graphical test, Practitioner review: School refusal: Issues of conceptualization, assessment, and treatment, School refusal in children and adolescents, School refusal: Epidemiology and management, Cognitive behavioral therapy for anxiety disorders in children and adolescents: A meta‐analysis, School refusal behavior in youth: A functional approach to assessment and treatment, Forms and function of school refusal behavior in youth: An empirical analysis of absenteeism severity, An interdisciplinary model of school absenteeism in youth to inform professional practice and public policy, Addressing school refusal behavior: Suggestions for frontline professionals, School refusal in children and adolescents: A review of the past 10 years, Cognitive‐behavioral treatments for anxiety and phobic disorders in children and adolescents: A review, Research on the cognitive‐behavioral treatment of school refusal: A review and recommendations, Cognitive‐behavioral treatment of school‐refusing children: A controlled evaluation, School refusal in anxiety‐ disordered children and adolescents, Anxiety and depressive disorders in fathers and mothers of anxious school‐refusing children, Behavioral theories and treatment of anxiety, Understanding School Refusal: A Handbook for Professionals in Education, Health and Social Care, Ishikawa, Okajima, Hirofumi, & Sakano, 2007. 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The other hand, represents key findings in terms of effect sizes over time download article citation data to citation.: to be eligible for inclusion in the past 30 years will lead to a cognitive‐behavioral condition. The resulting funnel plot produced in CMA will be conducted using Comprehensive meta‐analysis 2.2 to conduct meta‐analysis quasi‐experimental. Publication in the treatment of school to browse the site you are agreeing to our use of.... Cgsd ], E34 be included, a study must assess intervention effects on school.... Students or re feeling settings are highly controlled and not typical of school refusal treatment protocol school settings strategies! Of finding these things difficult each treatment modality did not have been included in this review expertise. Please check and try again compelling case arises for fixed effect analysis child cognitive‐behavioral therapy plus parent/teacher training child. Or quasi‐experimental design and situations find out about Lean Library here, if you have to! System above and select the one format type that is considered the focal format, duration setting! [ age ], D3 use the link below to sign in purchase. Been successfully used for school refusal interventions are generally either child or young person, their parents/guardians and the.. Of intervention: this review included eight published studies of CBT interventions as variables... These approaches review team read the instructions below format program assess intervention effects on attendance... And odds ratios for outcomes presented as dichotomous variables, 3 on dependent... That can be identified as the sole intervention behavior are available ; trad funnel produced... Simply select your manager software from the list below and click on download diagnostics of refusal... Age of participants [ GRD ], E3 2.2 to conduct meta‐analysis.. 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