The School phobia The didascaleophobia Is the irrational and persistent fear of school. This type of disorder is very similar to other types of childhood anxieties, which can arise from other variants such as a child's fear of separating from their parents.
This fear of everything school has therapeutic treatment and its causes and diagnosis are relatively easy to detect and evaluate.
Surely you have seen many children crying, screaming, clinging tightly to their parents, etc. at the beginning of the return to school or even if you are father / mother will have happened to you sometime.
In principle you should not worry about this type of behavior if it has only happened on a couple of occasions, since they are usually normal in almost all children. However, the problem would come once these kinds of behaviors happen recurrently and persistently with a marked level of anxiety and emotional distress.
Next, I will explain in detail what this phobia consists of, what its symptoms are, precipitating factors and possible treatments.
Characteristics of school phobia
The term"school phobia"was first used in 1941 to identify all those children who did not attend school because of the high level of anxiety And emotional distress that caused them. As we have discussed above, it is also known as school rejection or didascaleophobia.
Just thinking that you have to go to school, becomes something literally scary for those who suffer.
According to the American Academy of Child and Adolescent Psychiatry (AACAP) , Usually occurs in children of preschool age of 5-7 years who usually suffer Separation anxiety And in children aged 11-14 due to the transition from primary to secondary school.
In this transition the level of difficulty of school work begins to increase, in addition to the changes associated with puberty and adolescence and of course, to those Hormones Which are in full boil.
Possibly this phrase that Hartwell-Walker wrote in an article perfectly represents the phobia of going to school:
"The school is a place where they can not succeed, where they feel bad about themselves, where they constantly live up to the expectations of adults. Day after day, year after year, they are thrown into the situation they most fear. And day after day, year after year, fear is reinforced."
Symptoms of school phobia
The most obvious sign that we are facing a case of school phobia is the refusal to attend school. But not all those who refuse to go to school suffer from this psychological condition, since they must also have a specific symptomatology.
Regarding the beginning of the phobia, this can be:
- Gradual, with little intense protests about school attendance that eventually leads to a total denial.
- Brusca, who may be preceded by illness, vacation or a change of school, which may result Quite stressful .
Among the most prominent symptoms we have:
-A high level of anxiety Which can lead to real crisis of anguish at the prospect of having to go to school. It manifests itself in the form of paleness, crying, somatic complaints, nausea, vomiting, diarrhea, dizziness, palpitations, dry mouth, excessive sweating or even panic attacks .
This is often quite painful for parents as they are unable to help their children alleviate such symptoms.
-On the other hand can be given Depressive symptoms , Although they are less frequent, such as: sadness, Anhedonia , Or feelings of insecurity.
These symptoms tend to be more intense in the morning, hours before they have to attend school.
- Flu-like symptoms : As school time approaches, some children suffer from Headaches , stomach ache.
- Sleep Problems : Many of the children who suffer from school phobia, have Difficulty falling asleep , Even being able to have nightmares About going to school.
-Inappropriate behaviors : As can be the typical tantrums, feel fear, or literally stick to the arms of their mother / father.
Cognitive symptoms : Fear of everything related to the school without knowing very well to specify what and irrational thinking about their fear of going to school.
Causes
Among the precipitating factors that may contribute to the fear of going to school are:
-The family problems : a Death of a loved one , a divorce Or other stressful events such as school change, can trigger a school phobia.
- Academic problems : In poor students or where expectations and assessment are seen as very high, can lead to a rejection of school.
-Problems with other students : For example being harassed and humiliated by other students, can lead to a general inability to go to school. We must make sure that the child is not going through a bullying .
- Problems with appearance or physical defects .
Differential diagnosis
Two entities must be taken into account:
- Voluntary absenteeism , Also known as"doing steers": it differs from the school phobia in that in this case the child does not present any symptoms of anxiety and malaise clinically significant.
These children often have traits and Non-social behaviors .
- Other Anxiety Disorders : It can sometimes be difficult to make the differential diagnosis, since both anxiety disorder and school phobia can occur simultaneously.
It is important to take into account separation anxiety disorder, as it can be confused with the fear of going to school. In this case the fear would also be in the simple idea of separating of its figure of attachment. In fact, even when they are at home they do not separate from that figure.
Regarding the age of onset is usually less than in the school phobia.
Finally, it is also necessary to detect if there is any type of Serious learning disorders Or cognitive delays.
Treatment
Counseling to parents
The first objective to be achieved is for the child to return to school as soon as possible, since only in this way, both the symptoms of anxiety and depression may disappear.
For this, it is imperative to properly advise the parents on how to carry out the whole process. It is recommended that both parents accompany their child to school, so that little by little the child will stop resisting going.
It would also be advisable to teach parents some of the behavior modification techniques to carry them out in their natural environment.
Child Collaboration
It is imperative that the child is receptive. Through individual sessions in which it may be possible to be him, he must decide how his return to school will be and thus develop his capacity for self-efficacy.
Behavior modification techniques
Among the most used techniques we have the relaxation , the Exposure to phobic stimuli , the Cognitive restructuring Of irrational and catastrophic thoughts, use of problem solving techniques, self-instruction and self-reinforcement.
Family therapy
It can be used to help family matters that may be affecting the child.
Pharmacotherapy
In coping with phobia, it may be useful to use Anxiolytics , Provided the above techniques have not been effective. If it is used, it should be for the shortest possible time, as it would become accustomed to it and therefore the symptoms would be reinforced negatively.
In October 2003 The Food and Drug Administration of the United States , Issued a notice stating that children receiving treatment with Selective reuptake inhibitors from Serotonin (SSRIs) or Antidepressants , They may be at greater risk of suicide, so they should weigh well before prescribing these drugs.
Forecast
Bernstein reported a positive prognosis for all children receiving treatment, citing studies indicating that more than 8 out of 10 previously-phobic children were in school one year after they underwent therapy.
The Cognitive-behavioral therapy Seems to be the cause of producing these results so successful.
Among the underlying conditions that may affect the recovery of phobia from school is the Tourette syndrome , ADHD , depression , Bipolar disorder Or other anxiety disorders Y Phobias .
Tips for Parents
To conclude, I leave some advice on how to act in a case of school phobia:
1- Parents should be advised by a mental health professional.
2 - Keep your children in school, as missing would reinforce anxiety behavior instead of avoiding it.
3- Talk with your child about your fears and fears as this will help reduce them.
4- It requires patience, tolerance and understanding from parents and teachers.
5- Any little progress or effort that the child makes in returning to school should be reinforced.
6 - Expose your child to school gradually, so you will gradually realize that your irrational fear of going to school will disappear.
7- Give special attention to the positive aspects of going to school: to be with friends, to learn interesting things, to play at recess, and so on.
8- Have a meeting with your teacher to explain the process your child should take.
9- Choose a good self-help book that the therapist has recommended.
10- Encourage your child to make the hobbies that he likes, so that he can help him to trust him.
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References
- American Academy of Child and Adolescent Psychiatry. 3615 Wisconsin Avenue, NW, Washington, DC 20016 3007.
- Kearney CA, Albano AM. The functional profiles of school refusal behavior. Diagnostic aspects. Behav Modif. 2004; 28 (1): 147-61.
- Lewis M: Child and adolescent psychiatry. Lippincott, Williams & Wilkins. 2002. Uveg C, Aschenbrand SG, Kendall PC. Separation anxiety disorder, panic disorder, and school refusal. Child Adolesc Psychiatr Clin N Am. 2005; 14 (4): 773-95.