Cuando los niños se niegan a ir a la escuela: Guía del terapeuta (Programas que funcionan)

What is 'When Children Refuse School'?

When Children Refuse School: Therapist Guide (Programs That Work) is a clinical manual designed for mental health professionals working with children and adolescents who have difficulties attending school. Written by Christopher A. Kearney and Anne Marie Albano, both renowned experts in child psychology, this guide is part of the prestigious Programs That Work series, known for offering evidence-based interventions.

The book provides a structured framework for assessing and treating school refusal, a problem that affects approximately 5-28% of young people at some point in their school lives. Unlike school absenteeism motivated by behavioral problems, school refusal is usually associated with anxiety, depression, or other emotional difficulties.

Who is this guide designed for?

This manual is primarily aimed at clinical psychologists, child psychiatrists, social workers, school counselors, and occupational therapists who work with children and adolescents. It can also be useful for graduate students in clinical psychology or child psychiatry seeking practical training in the treatment of school refusal.

The guide assumes that the reader has a basic understanding of cognitive-behavioral therapy (CBT) assessment and treatment, although it also includes detailed instructions for implementing each step of the treatment. Parents and educators may find the supplementary information helpful, although the main focus is clinical.

How does it address school refusal?

The book presents a multimodal approach that combines cognitive-behavioral techniques, social skills training, family interventions, and coordination with the school. The initial assessment includes semi-structured interviews, questionnaires, and attendance records to determine the type of school refusal (e.g., anticipatory anxiety, avoidance of social situations, or somatic complaints).

Treatment is organized into progressive phases: psychoeducation, gradual exposure, anxiety management, problem-solving, and relapse prevention. Each session includes objectives, necessary materials, step-by-step instructions, and examples of therapeutic dialogue. Special attention is paid to customizing the treatment according to the child's age, family context, and the severity of the problem.

Content and structure of the book

• Initial assessment: Chapters on interviews, questionnaires, and differential diagnosis.
• Psychoeducation: Explanation of the cognitive-behavioral model for parents and children.
• Gradual exposure: Detailed plans for reintroducing school attendance.
• Anxiety management: Relaxation techniques, cognitive restructuring, and coping skills.
• Family intervention: Strategies to reduce parental accommodation and foster autonomy.
• School coordination: Guidelines for collaborating with educational staff.
• Relapse prevention: Contingency planning and maintenance of achievements.

In addition, the book includes appendices with reproducible materials such as worksheets, attendance records, and assessment scales, which facilitates its direct application in clinical practice.

Frequently asked questions about the treatment of school refusal

How does school refusal differ from school absenteeism for other reasons?

School refusal is characterized by the child's difficulty in attending class due to anxiety, fear, or emotional distress, while other forms of absenteeism may be due to behavioral problems, opposition, or lack of interest. The guide helps therapists distinguish these profiles and adjust the intervention accordingly.

How long does treatment usually last?

The duration varies depending on the severity and individual response, but the proposed protocol is structured into approximately 12-16 weekly sessions, with periodic follow-ups. The emphasis is on achieving early re-entry into school to prevent the problem from worsening.

Is the guide useful for very young children or older adolescents?

Yes, the strategies are adapted to different ages (from preschool to late adolescence). Variations in language, materials, and parental involvement are offered according to the child's development.

This guide represents a valuable resource for any professional facing the challenging problem of school refusal. Its practical and evidence-based approach makes it an essential reference tool in daily clinical practice.