Home-Based Occupational Therapy for Emotion-Related School Attendance Challenges: Two Case Studies

Emotion-related school attendance challenges (ER-SAC) refer to school attendance difficulties rooted in emotional issues. This report examined the support process and outcomes of home-based occupational therapy in two junior high school students experiencing long-term absenteeism and social withdrawal. Both students exhibited emotional difficulties, including anxiety, interpersonal tension, and impulsivity, that disrupted daily routines, impaired self-care, and led to social avoidance. Occupational therapists initiated home visits by building trust, then gradually introduced strategies to restructure daily routines, verbalize emotions, enhance self-understanding, and set interest-based goals. Both cases demonstrated improvements in interpersonal relationships, leisure activities, and coping skills. In Case 1, vocational exploration and growing introspection fostered future aspirations. In Case 2, reduced impulsivity and mistrust improved social skills, enabling desired participation in club and sports activities. Both students progressed from "blockage and isolation" to "social connection and active participation". Home-based occupational therapy appears effective for life restructuring and social reintegration in students with ER-SAC. The support model offers practical guidance for similar student cases, emphasizing the need for flexible, individualized plans considering emotional, cognitive, and social characteristics over uniform interventions.