Cognitive-behavioral treatment of school-refusing children: a controlled evaluation

Area of Science:

• Child and Adolescent Psychiatry
• Clinical Psychology
• Educational Psychology

Background:

• School refusal is a significant problem affecting children's education and well-being.
• Cognitive-behavioral therapy (CBT) is a promising approach for addressing school refusal.
• Understanding the efficacy of structured CBT programs is crucial for clinical practice.

Purpose of the Study:

• To evaluate the efficacy of a 4-week cognitive-behavioral treatment (CBT) program for children experiencing school refusal.
• To assess improvements in school attendance, emotional distress, and behavioral problems.
• To determine the maintenance of therapeutic gains over time.

Main Methods:

• A randomized controlled trial involving 34 children (aged 5-15 years) with school refusal.
• Participants were assigned to either a CBT condition or a waiting-list control group.
• Treatment included individual CBT for the child and behavior management training for parents/teachers; outcomes measured included school attendance, self-reports, caregiver reports, and clinician ratings.

Main Results:

• Children receiving CBT showed significant improvements in school attendance compared to controls.
• Participants in the CBT group reported reduced fear, anxiety, and depression, and enhanced coping skills.
• Caregiver reports and clinician ratings also indicated significant improvements, with gains maintained at 3-month follow-up.

Conclusions:

• The 4-week cognitive-behavioral treatment program demonstrated efficacy and acceptability for treating school refusal in children.
• The findings support the use of CBT as a viable intervention for school-refusing children.
• Further research is needed to elucidate the specific contributions of child therapy versus parent/teacher training.