[LUM#5] When school is scary

[LUM Magazine] - Published on April 18, 2017 in Science-Society

The very idea of going to class literally makes them sick, to the point where they sometimes end up deserting the school benches. To help these children suffering from "anxious school refusal", the Montpellier University Hospital is offering a unique approach.

After a weekend in top form, your child finds himself all wobbly when it's time to head back to school. Headache, stomachache, vomiting. While this "I don't want to go" syndrome may seem fairly classic, it can take on alarming proportions in some children, to the point where they no longer feel up to putting on their schoolbag to go to class. Fear of school can even lead to dropping out, leaving parents at a loss. " This is known as 'anxious school refusal '", explains Dr. Hélène Denis ( "Le refus scolaire anxieux", in Enfance et psy, 2005). At the Montpellier University Hospital, the child psychiatrist has developed a unique approach to treating these children and getting them slowly but surely back on the road to school.

We're not dealing with bad pupils or children who don't want to go to school," explains Hélène Denis. On the contrary, most of them are hard-working students who want to do well and really want to go back to school . And if they can't, it's because they're overwhelmed by anxiety. Most of the young patients treated by the CHU's Child and Adolescent Psychological Medicine Service are between 11 and 16 years of age, "the age of onset of major anxiety disorders ".

Performance stress

What scares these children? " Anxiety can take many forms," answers the child psychiatrist. Some suffer from separation anxiety, finding it hard to get away from their parents, if only to go to school. Many also admit to being afraid of being judged by those around them, and shun school to avoid facing the gaze of others. " We're also seeing more and more children with performance anxiety, who put a lot of pressure on themselves in terms of their school results," explains Hélène Denis, who points out that many of her little patients come from private secondary schools, where the pressure to succeed is often greater.

Specialists estimate that school-related anxiety disorders affect between 5% and 28% of children and adolescents during their school years. This figure has been rising in recent years. For the child psychiatrist, "it's indicative of a society that's going badly and becoming a source of anxiety. Very early on, we send a message to children that they have to work to get a job - what pressure! Parents themselves are often under pressure and stress, which doesn't help matters . Lastly, the specialist points the finger at the teaching methods used in today's secondary schools: teaching methods that are intended for everyone, but which don't necessarily suit everyone. " Some children just don't fit in, and it exacerbates their anxiety.

Cognitive and behavioral therapy

For children whose anxiety prevents them from attending school, Hélène Denis and her colleagues have developed a specific program. " When children are no longer able to go to school, they are taught by an accredited teacher at the hospital. At the same time, the nursing staff work with them on specific cognitive-behavioral therapy. " The aim is to help them understand how anxiety works, and to teach them techniques to manage it more effectively. Relaxation, breathing exercises and role-playing are just some of the methods used to help them gradually tame their anxieties, so they can better cope with and overcome them.

Regain your confidence

Although these therapies are still not widely used in child psychiatry, the method has proved its worth. In 10 years, Hélène Denis' department has treated some 50 children, all of whom returned to full-time schooling the following year. " The return to school takes place gradually, after 2 to 6 months of therapy. We work closely with the school to facilitate the return ," she explains. The student is accompanied by a nurse from the unit, and returns to the class of his or her choice, in the place of his or her choice and with the assurance that he or she will not be tested orally. They are gradually reintegrated into their class.

" Pupils don't even have to repeat a year, because the courses provided by the department have enabled them to keep up with their studies and, in the case of the third-year students, even to pass their school-leaving certificate ," explains the child psychiatrist. The youngsters continue to receive counseling for a whole year, to consolidate their self-confidence. " Little by little, they're getting back into a normal relationship with school, and that's what success is all about," says Hélène Denis with satisfaction.

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