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What can I do if my child refuses to go to school after physical schooling resume in September?

As announced by the Education Bureau, physical schooling will be resumed gradually on 23rd September. For many students, resuming physical schooling may be exciting news because they can see their friends again and enjoy all the interesting learning and extracurricular activities at school. For some students, it may be difficult for them to attend school at the beginning of the school year after a very long break due to adjustment issues. Usually for most of them, this difficulty will remit gradually within the first two weeks. However, for a limited number of students, resuming schooling may provoke their high level of anxiety. As a result of their general or social anxiety and emotional distress, these students refuse schooling in order to avoid experiencing their debilitating anxiety. School refusal becomes a chronic problem if the students refuse to go to school for a prolonged period of time, for example, more than two weeks.

For those students who refuse schooling in order to avoid stimulus provoking their anxiety, we need to help them to develop coping strategies to deal with their anxiety and reinforce them to substitute their avoidance behaviour with more adaptive strategies for schooling. It is important to educate the child who refuses schooling about the nature and process of one’s anxiety. When the child has increased understanding of his or her anxiety, we can help him or her to learn to observe one’s own anxiety reactions. For instance, the child may learn to observe his or her palpitations, sweating and tightness in chest when he or she wakes up in the morning thinking about going to school.

Gradually, we can teach the child to identify situations in which these anxiety reactions are provoked and skills to cope with these anxiety reactions. For example, when the child wakes up in the morning, he or she experiences physical sensations associated with anxiety, such as palpitations, butterflies in stomach and nausea. We can help the child to identify his or her thoughts associated with these sensations, such as, “I don’t want to go to school”; “My teacher will yell at me”; “My classmates will laugh at me”, etc. We also help him or her to identify one’s behaviour when experiencing these sensations, such as, lying in bed and crying. The emphasis is to help the child to understand the role of these physical sensations of anxiety, how these sensations exacerbated due to one’s tendency to avoid experiencing them, and the resulting avoidance behaviour, the school refusal.

In psychotherapy for these children, a hierarchy of gradually exposing to schooling will be developed. Usually, the child is helped to gradually expose to schooling starting from the level that provoked lower level of anxiety. For instance, the child may go to the entrance of the school without going inside for the first week of resume schooling. Relaxation exercises or mindfulness-based exercises will also be taught to the child to help them to cope with their anxiety during the exposure. The child will also be helped to understand the anxiety reactions are just manifestation of their anxiety and will subside if they learn how to manage them. It is also important to help the child to cope with their worrying thoughts with more adaptive thinking.

In fact, there are many underlying reasons for a child to refuse going to school other than to avoid situations for provoking their anxiety. Parents may need to find out what are the underlying causes for their children’s school refusal with the help of a professional. School refusal is one of the most common problems for students in primary and secondary schools. It is very important for parents to take appropriate and immediate actions to find out the causes and seek timely professional help.

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