Practitioner Review: Signposts for Enhancing Cognitive-Behavioral Therapy for School Refusal in Adolescence

Area of Science:

• Psychology
• Child and Adolescent Psychiatry
• Educational Psychology

Background:

• Adolescent development significantly impacts school refusal (SR) presentation and treatment.
• Current cognitive-behavioral therapy (CBT) manuals and multimodal treatments for adolescent SR have limited success, failing to help 33-66% of cases.
• Existing treatments often inadequately address developmental complexities inherent in adolescent SR.

Purpose of the Study:

• To review literature-based suggestions for improving treatments for adolescent school refusal.
• To identify key adaptations that can enhance the efficacy of existing SR interventions.
• To provide practical guidance for clinicians treating adolescents with school refusal.

Main Methods:

• Literature review of suggestions for improving adolescent school refusal treatment.
• Identification and synthesis of seven key themes or 'signposts' from existing research.
• Focus on adaptations relevant to adolescent developmental stages and challenges.

Main Results:

• Seven signposts for enhancing adolescent SR treatment emerged: increased session frequency, focus on social anxiety/functioning, attention to depression, improved emotion regulation strategies, parental involvement, enhanced parent-adolescent communication, and use of alternative educational settings.
• These adaptations aim to create a more comprehensive and developmentally appropriate treatment approach.
• The review synthesizes existing recommendations rather than presenting new empirical data.

Conclusions:

• Current treatments for adolescent school refusal (SR) can be improved by incorporating specific adaptations.
• These adaptations address developmental factors, comorbidities, and systemic issues often overlooked in standard protocols.
• Further research is necessary to validate the effectiveness of these proposed treatment enhancements for adolescent SR.