Taking the Scared Ou Out of t of School hool Strategies ies to - PowerPoint PPT Presentation

Taking the “Scared” Ou Out of t of School hool Strategies ies to Addres ess Anxiety ety- based d Absent nteeism eeism Teresa Miller, LLPC Forest Hills Public Schools, Grand Rapids Community College Donna Secor Pennington, LMSW MASSW, Western Michigan University

School hool Socia cial l Work k & & Att ttendanc dance The “roots” of school social work are closely tied with attendance concerns.  A 1917 Chicago Truancy Study identified a need for “school attendance officers” who understood “the social ills of the community, poverty and poor health and their effects on attendance.” By 1918, all states had compulsory attendance laws that contributed to the growth of the early visiting teacher movement. School social workers in Michigan were known as “visiting teachers” until 1966.

Def efining ning School hool Ref efusal sal  Child-motivated refusal to attend school, arriving late to school and/or difficulty remaining in school for the entire day.  May display unusual distress at school  Up to 28% of American school-aged children refuse school at some time.  “One of the most frustrating problems faced by educators and parents.”  The longer students are out of school, the poorer the prognosis.

Truancy: y: Unexcused cused absence ence from m school ool  Since NCLB (2002) – States must report attendance data to receive federal funding  Left to states to define truancy and decide how many days constitute truancy  Truancy: 3 unexcused absences (NY , NV)  Varied Penalties: Fines & jail for parents (MT) Juvenile detention long term residential care (AL)

School hool Attendance endance Polic icy in Mi Michig higan an  Michigan has not prioritized school attendance.  No state definition  Parent “may” face misdemeanor  Example: One “truant officer” to serve 19 Kent County school districts.  10/2012: Truancy tied to state financial assistance  10 or more unexcused absences per year

Curren ent t Trua uancy Legis gisla lation ion Sen enate ate Bi Bill lls s 1151 1 – 1154 4 Sen. n. Schuitma huitmaker SB 1151: Defines “truant” as 10 or more unexcused absences and “chronically absent” as missing 10% of school days for excused, unexcused or discipline. SB 1152: Involve truant officer to contact parent  Provision for identifying reasons, intervention, “attendance agreements” SB 1153: Requires increased reporting, including suspensions, truancy, chronic absence & disciplinary absence SB 1154: Possible court proceedings against student*

Emotion otionall ally-based based Scho hool ol Ref efusal sal May include:  Separation Anxiety  Social Phobia  Performance Anxiety  Specific Phobias  Familial Trauma  Depression

PTSD SD and d Urba ban n St Students dents  There is a growing concern regarding the need for differential diagnosis and the role of trauma in the “truancy” seen in poor urban school districts where many students are repeatedly exposed to violence and other trauma.  Muskegon Heights: Marquis Gresham http://www.wzzm13.com/story/news/local/muske gon/2014/04/23/hackley-hospital-er-on-lockdown- following-shooting/8069183/ ACES Too High

“Looking out the Window”

School hool Ref efusa usal: l: Student udent Char aract acteristics eristics  History of anxiety  May include fear of panic attacks, vomiting in school, being trapped  Often have early history of poor attendance  Comorbid depression is also common  History of psychiatric hospitalization  Relatively few friends  May have perfectionist tendencies  Concerns with physical appearance  Feel teased or bullied at school  Sense that they don’t fit in

Parent ent Characte acteristi istics  May have permissive or “inadequate” parenting style  Are dealing with issues of their own  Divorce, infidelity, illness, psychopathology, family dysfunction, domestic violence  Compensating for family difficulties  Separation anxiety  Codependent/enmeshed

Commo mmon n Beh ehaviors iors at Home  Anxiety, crying, depression, withdrawal, fatigue  Physical complaints such as headaches and stomachaches  “Intense Morning Misbehaviors”:  Tantrums, noncompliance, arguing, running away from home, suicide or other threats and aggression.

School hool History/Beh tory/Behaviors viors  Youths with lengthy/multiple absences  These can begin with an illness or holiday  Students who skip classes during the day  Students chronically late to school  May be “hiding” in the building, on school grounds in bathrooms, etc.  Assessment Scales

Goals als of School hool Refusa usal Behavior ior To avoid school-related situations that cause  substantial distress To escape painful social and/or evaluative  school-related situations, To pursue attention from significant others,  and To pursue tangible rewards outside of school.  (Assessment/Identification of goals is needed)

Is Is it rea eally y anxie iety/emotio ty/emotional? al?  Does not have as many symptoms when she isn't in school, including weekends and holidays .  Does not have a fever, vomiting, or diarrhea.  Although, these can be fabricated/exaggerated/self- induced…  Has no obvious physical signs of illness when you visit your physician. For example, he or she may have joint pain, but no joint swelling or limited movement of the joint.  Often have other fears, phobias, or symptoms of anxiety, such as clingy behavior, excessive worrying or nightmares.

Short-term term Conse sequen quences ces  Child stress  Declining academic status  Social alienation  Family conflict/disruption  Increased risk of legal trouble  Child maltreatment/lack of supervision  Financial expense

Long ng-term erm Conse nsequences quences  Increasing depression  Being left behind/left out by peer group  Prompt treatment of school refusal is key to shorten the course of the disorder.  Without treatment, as many as 40-50% of these youths are at risk for not graduating high school due to the intensity and chronicity of their anxiety.

Adult Outcomes Research  Twenty Year Longitudinal Study  Depression  Young people with social anxiety were almost 3 times as likely to develop depression later in life  Psychiatric treatment  Received more psychiatric treatment than the general population  Alcohol, drug use  More frequent use of alcohol and marijuana.  Different life choices  Make “fear - fueled choices” with long -term effects, including electing a less rigorous or challenging career

Current ent Res esea earch ch on Trea eatment tment Effecti ectiven eness ess (Ma Mayn ynar ard d et et. al. 2015) 5)  Meta-analysis of effect of psychsocial treatment, primarily CBT or CBT plus medication. (8 total studies)  “Robust” finding of positive impact on school attendance  No short-term impact on anxiety  Having close friends in school was associated with improved attendance

Compr mprehens ehensive e Program Collaborative Team Approach  Parent/s  Counselor/Social Worker  Teachers  Administrators  Section 504 Plans/IEPs  Outside Mental Health Providers

Provide vide Psych ch-educatio education n to Paren ents ts  Missing school reinforces and increases anxiety rather than alleviating it.  Keep your child in school all day, every day  Do not give in to crying, pleading, threats.  Be firm in your conviction that your child will be safe in school – that staff will help.  Encourage your student to use supports available in school.

Counselor/Social Worker’s Role  Providing Safety  Escape strategies – a break, to talk, retreat  Media center passes, safe places  Schedule carefully  Teacher characteristics, class make-up, friends, subject areas of interest  Get them involved in school  Sporting events, clubs, theater, helping in media center .

Coun unse selo lor/ r/ SS SSW Interv erventio entions ns  CBT techniques  Relaxation training  Desensitization  Kearney treatment plans  Based on “goals” of school refusal

Kear arne ney: y: Anx nxiety ety Mo Mode del

Anxiety and Avoidance Hierarchy

Feelings lings Thermometer mometer

School hool Refus usal al Suppor port t Group up Challenges Group Composition* Learn they are not alone Relationships/Sense of Belonging Share experiences/coping

Counselor/Social Worker’s Role  Social Media  Social interaction with peers whether home or at school, friends encouraging attendance (Facebook page)  Texting  Encouragement to come to school (staff or other students)  Coordination with Teachers and Administrators  Communication and understanding that this is an anxiety issue, help to coordinate “make - up work conversation,” discipline consequences, etc  Online Learning – REALLY?  Ala Carte Learning