Intensive interventions for emotionally based school avoidance: a scoping review of program structures and...

Area of Science:

• Child and Adolescent Psychiatry
• Educational Psychology
• Clinical Psychology

Background:

• Many children and adolescents with emotionally based school avoidance (EBSA) do not improve with standard outpatient care.
• More intensive interventions are needed, but knowledge on their structure, mechanisms, and indications is limited.

Purpose of the Study:

• To systematically map and synthesize literature on intensive interventions for EBSA.
• To identify target populations, intervention structures, therapeutic mechanisms, and implementation challenges.

Main Methods:

• Systematic search of databases and grey literature (2000-2026).
• Included 19 publications describing 17 samples across 13 programs.
• Data synthesis using a structured coding manual and narrative synthesis.

Main Results:

• Intensive interventions targeted adolescents with severe, chronic school non-attendance and comorbidities.
• Four program types identified: outpatient, alternative education, day hospital, inpatient.
• Key therapeutic levers included graded exposure, educational scaffolding, and multidisciplinary teams in transitional settings.

Conclusions:

• Intensive EBSA interventions restructure care to facilitate evidence-based treatments.
• A typology of models and therapeutic levers were identified, forming a basis for future research.
• Further research should specify target populations, intervention models, and mechanisms of change for EBSA.