Social Psychiatry, Vol. 47 No. 2, 2019.
Case report
https://doi.org/10.24869/spsih.2019.214
School Phobia - When Fear Keeps Children Away From School
Ljubica Paradžik
; Psychiatric Hospital for Children and Adolescents, Zagreb, Croatia
Iva Zečević
; Psychiatric Hospital for Children and Adolescents, Zagreb, Croatia
Ana Kordić
; Psychiatric Hospital for Children and Adolescents, Zagreb, Croatia
Vlatka Boričević Maršanić
; Psychiatric Hospital for Children and Adolescents, Zagreb, Croatia, Josip Juraj Strossmayer University of Osijek Medical School, Osijek, Croatia
Nela Ercegović
; Psychiatric Hospital for Children and Adolescents, Zagreb, Croatia, Josip Juraj Strossmayer University of Osijek Medical School, Osijek, Croatia
Ljiljana Karapetrić Bolfan
; Psychiatric Hospital for Children and Adolescents, Zagreb, Croatia, Josip Juraj Strossmayer University of Osijek Medical School, Osijek, Croatia
Davorka Šarić
; Psychiatric Hospital for Children and Adolescents, Zagreb, Croatia, Josip Juraj Strossmayer University of Osijek Medical School, Osijek, Croatia
Abstract
School phobia is not a separate diagnosis, but a clinical entity that includes anxiety and avoidance behaviour related to either going to or staying in school, which may appear at any time during education. In most cases it is a manifestation of separation or social anxiety, although refusal to attend school may also be related to other emotional disorders in children and adolescents, such as generalized anxiety disorder, panic disorder or depression. Besides disrupting the normal
functioning of a family, school phobia has serious negative consequences on a child’s education and social relations, and as such may be a very complicated childhood disorder. In differential diagnosis it is important to differentiate school phobia from truancy, antisocial behaviour (stealing, lying, etc.) and engaging in fun activities. Early treatment is important in order to minimize the child’s falling behind in school, losing contact with other children and getting extra attention
from parents by staying at home. Treatment requires a multidisciplinary approach that includes the cooperation of a psychiatrist and/or psychologist, parents, school staff, a physician and social services in case of long-term absence from school or dysfunctional family surroundings. A multimodal treatment approach combining various techniques is required: the psychoeducation of parents, individual psychotherapy (psychoanalytic or cognitive-behavioural), group therapy
and family psychotherapy depending on the severity and causes of the disorder. In severe cases that do not respond to psychotherapy, antidepressant and anxiolytic medications can be prescribed. This paper presents recent findings on school phobia and treatment with cognitive-behavioural therapy, and one clinical case.
Keywords
School phobia; Separation anxiety; Social anxiety; Cognitive-behavioral therapy
Hrčak ID:
221997
URI
Publication date:
3.7.2019.
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