[LUM#5] When school is scary

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

The very idea of going to class makes them literally sick, to the point that they sometimes end up dropping out of school. To help these children suffering from "anxious school refusal," the Montpellier University Hospital offers a unique treatment program.

After a weekend feeling great, your child finds themselves feeling terrible when it's time to go back to school. Headaches, stomach aches, nausea. While this "I don't want to go" syndrome seems fairly common, it can become a serious problem for some children, to the point where they no longer feel able to pick up their school bag and go to class. This fear of school can even lead to them dropping out, leaving parents feeling helpless. " This is known as 'anxious school refusal,'"explains Dr. Hélène Denis ( Anxious School Refusal, in Enfance et psy, 2005). At Montpellier University Hospital, the child psychiatrist has developed a unique approach to treating these children and gently but surely getting them back on the path to school.

"We are not dealing with bad students or children who don't want to go to school," says Hélène Denis. " On the contrary , most of them are hard-working students who want to do well and really want to go back to class."And if they can't, it's because they are overwhelmed by anxiety .The majority of young patients treated at the university hospital's child and adolescent psychology department are between 11 and 16 years old, "the age at which major anxiety disorders tend to appear."

Performance stress

What scares these children? "Anxiety can take many forms," replies the child psychiatrist. Some suffer from separation anxiety and find it difficult to be away from their parents, even if it's just to go to school. Many also admit to being afraid of being judged by those around them and skip school to avoid facing the gaze of others. "We are also seeing more and more children who suffer from performance anxiety and put a lot of pressure on themselves in terms of their academic results," explains Hélène Denis, who points out that many of her young patients come from private schools where the pressure to perform is often greater.

Specialists estimate that anxiety disorders affect 5 to 28% of children and adolescents during their school years. This figure has been rising in recent years. For the child psychiatrist, "this is indicative of a society that is in trouble and becoming a source of anxiety. From a very early age, we send children the message that they have to work hard to get a job. What pressure! Parents themselves are often under pressure and stressed, which doesn't help matters."Finally, the specialist points the finger at the teaching methods used in middle schools today: educational methods designed for everyone, but which are not necessarily suitable for everyone. "Some children don't fit in, which exacerbates their anxiety."

Cognitive and behavioral therapy

For children whose anxiety prevents them from going to school, Hélène Denis and her colleagues have developed a specific program. "When children can no longer attend class, their schooling takes place in the hospital, where they receive lessons from a certified teacher." At the same time, the nursing staff works with them on specific cognitive and behavioral therapy. "The goal is to help them understand how anxiety works and teach them techniques to better manage it." Relaxation, breathing exercises, and role-playing are some of the methods used to help them gradually overcome their fears so they can better cope with and overcome them.

Regain confidence

Although these therapies are still rarely used in child psychiatry, the method has proven its worth. In 10 years, Hélène Denis's department has treated around 50 children, all of whom returned to full-time schooling the following year. "The return to school is gradual, after 2 to 6 months of therapy. We work closely with the school to facilitate the transition,"she explains. The transition is a smooth one: the student is accompanied by a nurse from the unit, returns to the class of their choice, sits where they want, and is assured that they will not be asked to speak in class. They gradually reintegrate fully into their class.

"The students don't even repeat the year because the classes taught within the service have enabled them to keep up with their studies and, in the case of ninth graders, even pass their exams,"explains the child psychiatrist. The young people continue to be monitored in consultation for a whole year to build their self-confidence. "Little by little, they are regaining a normal relationship with school, and that's what success is all about," says Hélène Denis happily.

Keywords: LUM#5, LUM Magazine, Research, Health