Your teenage daughter doesn’t want to go to school. She’s upset by the mere thought of it, she says; yet she seems to be performing well academically and, on investigation, bullying does not appear to be an issue.
But your child insists . . . she’ll have a panic attack if you make her go.
In the mid-to-late teens, the phenomenon of “school refusal” can be about a teenager feeling “unsettled” or “not socially confident”, says psychotherapist Stella O’Malley.
Many Irish secondary schools have had some experience with the issue of school refusal, says Michael O' Loughlin deputy principal at Presentation Secondary School in Clonmel. "Schools do huge work in trying to stay in contact with these students," he says.
It's a complex condition with no single underlying factor but clinicians can attribute it to everything from generalised anxiety disorder or social phobia to separation anxiety, according to Dr Sharon Houghton, clinical psychologist and lecturer on the University of Limerick doctoral programme in clinical psychology.
Avoiding school, Dr Houghton says, can help an anxious teenager avoid negative emotions associated with school, interaction with peers or teachers, or even tests, if they feel they might not be able to perform well. School refusal can also be a way of gaining attention or support from others, she says, and it can provide a way of getting time away from school, thus allowing the adolescent to engage in an activity like gaming.
What should worried parents do?
Author of Bully-Proof Kids and Cotton Wool Kids, O'Malley says parents have reported to her that when they tell a teenager he or she can stay home as a result of their anxiety about school, the child "immediately cheers up and becomes significantly less anxious".
The findings of a recent American study of school counsellors in a US school district showed that up to 10 per cent of absences at high-school level were attributed to anxiety.
The survey found that teenagers were missing school because their anxiety was interfering with their sleep, appetite and nutrition which can lead to headaches and stomach-aches. Panic attacks could contribute to students’ resistance to going to school, while the fear that they could have an attack at school heightened their anxiety.
However, O’Malley warns, allowing a teenager avoid something that makes them anxious is not the solution – long-term, it will only exacerbate the problem.
“Avoiding it is about short-term gain and long-term pain,” she says, adding that many parents and children fall into this trap. “Modern parents can be more reverential towards their children’s feelings than perhaps they should be,” she observes.
“While they’re trying to do the right thing and address a mental health issue they’re being led down a rabbit hole by their child’s extreme emotions.”
Mental health
She suspects many children and teenagers have misinterpreted modern messages about mental health to mean they should feel happy at all times – and that if they’re not happy, the thing that’s causing them distress should be avoided at all costs.
“I believe this is linked to an extraordinary rise in a lack of resilience. Back in the day, people were stoical and enduring but now, although we’re very thoughtful, compassionate and self-aware, our children and teenagers have lost their resilience.
“We’ve been so busy attending to mental health issues that we’ve forgotten to teach our children resilience,” she observes.
A fundamental aspect of well-being is the ability to tolerate stress and this has been inadvertently lost, explains O’Malley, who says this epitomises the term “snowflake generation”.
The snowflake generation is kind, thoughtful and compassionate, she says, but, these young people also have a tendency to be over-introspective, overly concerned with their emotions and manifest “a glaring lack of tolerance to stress or emotional difficulties”.
“We’ve been so open about mental health and suicide, and talk about it so much, that parenting children who are in emotional distress of any kind is very shaped by fear of suicide.
“Parents don’t know what to do now when coping with a child who is manifesting severe anxiety, they’re afraid to ‘push’ the child too far,” she says, adding that worried parents often “collude with the child’s belief that it is appropriate to avoid all emotional discomfort”.
“It is as if the parents and the children collude in the perceived enormity of the upset the child is experiencing,” says O’Malley. Many modern children have been taught to be “over sensitive” to their own feelings, she believes.
Parents may either support intervention to reduce the problem of school refusal or they may inadvertently maintain it, says Dr Houghton.
“There may be over-involvement with a child in terms of the child’s emotions,” she says, adding that if a parent is over-protective about a teenager it can fuel ongoing school refusal. “The teenager can pick up on this and it can perpetuate the problem. School refusal can be down to a very complex series of factors – everything from family dynamics to the individual child’s personality and their social milieu.”
One teacher in a co-ed second-level school in the west of Ireland recalls some recent examples of school refusal: "We've had a number of pupils who refused to come to school. One pulled out of school, and prior to that his attendance had been very patchy. There seemed to be no evidence of bullying – we investigated the situation – and in the end, the student admitted he just didn't want to go to school.
“Another pupil didn’t want to come back to school after the summer holidays and although he did come back, he later dropped out. He said he’d no issue with the school and in fact, was getting on with his work,” says the teacher, who did not wish to be identified.
However, after some encouragement, the second student eventually returned to school full-time: “When we have students like this, we do all we can to help them ease their way back in, even if it means they only come in for two or three classes a day. It’s exceptionally stressful for parents.”
Social media
“I believe something is going on in the minds of modern 14-16 year-olds. It has something to do with the amount of time children are spending on social media,” he says, adding that some students appear to exist in a virtual world which has nothing to do with the real world.
“They can spend three hours a night on it. This is where they live; they think life is social media. I believe the amount of time they’re spending on social media has messed up their mental well-being.
“They’re being swallowed up by it. They don’t read books or talk to their parents. They lock themselves in a room with their phone and connect into the outside world without any major personal interaction. Parents are blind to it.”
Parents are “afraid of what could happen if they push too hard”, he says.
“Children today are not learning to be resilient,” he says, adding that the culture of constant praise for children can lead to problems.
“If they think everything they do is great, they don’t like taking criticism and when things don’t go well they just cannot cope because they’ve been told from day one that they’re marvellous.
“Life is not being allowed to teach them resilience so they cannot be criticised at all. Parents are wrapping children up in cotton wool. They don’t get the hard truths and you can see that coming through.”
School life can simply get too much for some teens, says O’ Loughlin: “The level of some students’ coping skills means they’re not able to cope with where they are in life.
“The busyness of school life is overwhelming for them,” he says, adding that in his experience it seems to be more of a problem in the Leaving Certificate year.
“You’d have perhaps one student who finds it hard to come in,” he says, pointing out that parents often understandably find it difficult to insist an 18 or 19-year-old attends school: “Sometimes your heart would go out to the parents as they’d do anything to get the young person back into school.”
In his experience, he says, school refusal can be caused by anxiety, stress, depression, or an inability to cope with life. Sometimes a bereavement or substance abuse is an underlying factor, he adds.
“The student would tell you that he or she is struggling to get into school,” he says, adding that while school refusals are, in his experience, “rare enough cases”, every school could expect to encounter one occasionally.
“The main thing is to try to keep in contact with the student. We encourage them to try to sit the Leaving Certificate, and support them as much as possible.”
Research on early school-leaving has underlined the negative dynamic that can set in when young people don't attend school, warns Moira Leydon, assistant general secretary for education and research at the Association of Secondary Teachers Ireland: "They become isolated from their peers and friends, leading to further disengagement and social withdrawal.
“Schools are highly conscious of this aspect of non-attendance and typically put in place interventions to support students they have identified as being at risk.”
[ TIPS FOR PARENTS: HOW TO SUPPORT YOUR CHILD TO GO BACK TO SCHOOLOpens in new window ]
– Reassure and encourage your child. Tell your child he or she will be fine once they get over the part about school he/she dreads.
– Work with your child to find ways to help them cope with the scary aspects of school.
– Tell them they are brave for going to school.
– Explain that their fears are brought on by thoughts that are not always true (“stinking thinking”). They are reacting to normal things in an extreme way.
– Encourage your child to find things they enjoy in the school day, such as chatting with friends, a favourite subject or class, PE, break time or home time.
– If your child does stay at home during school time, make life boring; no TV, laptops or DVDs.
– Don’t interact with your at-home child too much and try to keep to a school timetable – one-to-one attention from a parent can be rewarding.
– Continue with the normal routine. Ensure your child goes to bed and gets up at the same time every day, even on weekends, so he or she has some secure framework to live around.
