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School avoidance/phobia/refusal

(7 Posts)
NettleTea Sun 10-Nov-13 12:19:47

Simple question, complicated background.

DD is in year 8. Last year she had a poor attendance, some was medical, some we learned in retrospect was school avoidance/psychological pain causing physical symptoms, most usually stomach ache/feeling sick. Refusal shows as complete hysterics, screaming, shouting, hiding, hitting herself, refusing to get out of bed, get dressed, etc, taking out anger and frustration on her younger brother. DD loved primary, which was a very small rural school. She was happy and popular. Move to secondary has triggered this, although her overall need for 'control' has been ongoing for several years, and started with her hiding food/refusing food/hiding medication/ refusing to do treatment/nebulisers, etc.

School avoidance, due to extreme anxiety - other issues - non compliance with medication/treatment for CF, possibly to cause hospitalisation rather than go to school. DD has had CAMHs involvement in past - successfully at age 6 and 8 to deal with my abusive ex and her fear/mixed emotions, and unsuccesfully at 10 to deal with medical non compliance.

Recently we have a specialist psychiatrist involved - had an initial assesment during half term, but she is in London and we are a long way away, so she is liasing with school and with an impending hospital admission, she will probably get 6 sessions during her inpatient stay, but that is not probably until mid december.

As a result of her medical issues she has access to e-learning but the school have said that it is for 'medical' use only and NOT for when she is displaying anxiety.

It is also worth mentioning that DD can be very adept at persistance to get her own way - this has been demonstrated in many different parts of her life and the huge lengths (often to her own detriment) she will go to in order to control an outcome or situation means that taking things way way beyond normal behaviour is not unusual. Much of the time I am able to stand firm in my decisions and she can be twarted in attempts to undermine boundaries I have set, but there are occassions where she has got the better of me and as a result she will push and push in the hope that I will give up. This makes a situation like school refusal very difficult to deal with, because she hopes that I will cave in and so, once she has managed to get a day off, it makes it near impossible to get her up the following day. The underlying medical condition also makes it difficult to know whether the symptoms are based in pathology or psychology. When she was put on different medication she found out about the side effects and suddenly she had them all when presented with a need to go to school. At one point last year she got so hysterical about how ill she was that I took her to the hospital and she had to undergo every test known only to show she was perfectly healthy, in a physical sense.

The school have allowed her access to the pastoral care, she can go there daily, and she has built up a good relationship with the councillor, who goes with her between lessons. She has also this week been referred to the school advisory service. I spoke to the school this week and raised the prospect of CBT, but they didnt seem keen - felt she was too young (despite the fact that she is very mature and prefers to mix/converse with adults) The schools stance is that she needs to attend, and that absences escalate the situation. This is all very well but I have the problem of actually getting her to school.

I am beginning to dread the mornings. They have always been difficult as she has always dragged her feet in regards getting up and dressed, doing her nebulisers/physio and leaving on time. But now its almosty an impossibility. If I physically get her dressed when I turn round she has taken her clothes off again and got back into bed. I have had to give up on getting her to do her medication/physio as there literally isnt time and I have to get my son to school too. The mornings are just awful, screaming shouting, doors slamming. I simply dont know what to do and feel like I have come to a point where I just cannot cope with it at all.

I dont know if this is real. whether she is playing us all in a huge elaborate thing because she doesnt like school that much and what she really wants is a combination of me home schooling her and access to the e-learning, and she is going to act the part to the best of her ability until she gets what she wants, regardless of the consequences for everyone else. I feel it is destroying my family, and its certainly causing a huge amount of frustration and (I hate to admit) anger on my part because I have missed work, messed up a whole year of college work, missed my own medical appointments, and been made to feel like a fool when she is allowed to stay home and then later seems to be perfectly OK, with only passing reference to the 'agony' that she is in.

This school year she has not missed any days due to stomach ache/anxiety related stuff although she was in hospital for 2 weeks. She seemed to be getting better. She was getting involved in stuff and seemed happier, and then last week (after discussing it with the CF psycologist during half term) it all seems to have cranked up a bit. I dont know why, there doesnt seem to be a reason. She is not being bullied. She is doing very well in class. She is making some new friends. Maybe the school councillor tried to pull back a bit - she seemed mighty put out that she was dealing with another child at one point, maybe she realised that this was it, and she was going to have to be going to school, but she has started having stomach ache again. And Friday she really refused and there was nothing I could do. She did 3 online live lessons, and she loved them, so now thats all she wants to do... All weekend she has been mentioning this 'painful stomach' and last night she freaked out because I said she would be going to school on Monday. This morning she seems OK, she is playing happily with friends now in the lounge - a cursory mention of the stomach ache so far, but I know by 6pm she will be back in full swing.

I dont know what to do tomorrow. I need help. Tomorrow I KNOW is going to be impossible. I need advice. I am contemplating taking her to my mum's and getting her to take her in, to give me a chance to ask for some outside help to see if they will come to the house and physically take her in - is this even something?? Or am I ignoring a serious issue. I am in a real situation with a child who has a history of crying wolf and is very very smart and I am desperate.

trish5000 Sun 10-Nov-13 16:23:52

Have found this on the unanswered messages, so I will give this a go.

fwiw, I dont think she has a physical problem. She has had test in the past which have come to nothing, and she is somewhat fine today.

Not sure someone would come to your house or not. I suggest you ask people that are involved with her currently.

i couldnt think what cf is.

What do you think she likes at home. or perhaps the question is, what doesnt she like at her newish school?

Mumorandom Tue 12-Nov-13 14:24:23

Hi NettleTea

Compiled a long waffly post to you then lost it. Summary is:

- my DD (also y8) has severe anxiety which manifests in very controlling behaviours. Supporting her appropriately is so demanding of emotional energy that at times I feel that have nothing left for anything or anyone else.
- Not an expert, but does read like your DD is experiencing genuine anxiety. Hope psychiatrist will help but what about going back to CAMHS for longer-term support? Would your DD contemplate that after the last time? IME school counsellor did not have expertise to unpick DD's complex issues.
- DD was assessed for autism as some behaviours suggestive of being on the spectrum. She was below thresholds but still not sure this not relevant to DD at some level. Think she masks her social difficulties - probably a cause of anxiety in itself. Not saying your DD possibly on spectrum but maybe something to think about, even just to rule out.
- have you tried posting on SN CHILDREN board - lots of people on there with experience of handling school refusal, working with schools, getting the right support, anxiety and lots more. I have learnt a lot just by frequent lurking.
- school might need to be reminded that mental ill health is as real as physical illnesses. (I think that the new SEN code of practice is going to include mental health for the first time, hope I've read this right).

Hmm...seem to have made summary longer than original! Will post before lose again. Hope your Monday was ok in the end. Sorry did not see or reply sooner.

Mumorandom Tue 12-Nov-13 14:25:22

"She was below thresholds but still not sure this not relevant to DD at some level."

Ie MY DD, not yours!

Mumorandom Tue 12-Nov-13 14:27:55

Oh yes, also meant to say that DD moods and behaviour all widely varying at moment. Being 12/13 of course = hormones, mood swings, lack of logical thought, all kinds of brain chemistry going on etc

NettleTea Wed 13-Nov-13 00:39:43

Thanks for the help.
DD is now about to be admitted to hospital in London for 2+ weeks. We have stepped back from school atm and are concentrating on her health / MH and I basically told the school that although she refused point blank to go to school, she is happily accessing the e-learning and will continue to do so until everything is back on track.
Being in London will enable her to work with the specialist psychologist in the CF unit, who will work towards looking at a longer term strategy with her, before presenting that to the school at the end of her admission. She will continue the e-learning during her inpatient stay.
The psychologist confirmed what I felt - her anxiety is quite possibly transferred onto school as it is easier to cope with than the bigger picture, and with that in mind she should not be treated the same as your 'average' school refuser, so forced attendance may well exasperate the situation until she has done a fair amount of psychological work. She would recommend the e-learning route initially, moving forward to a graduated re-introduction when its felt the time is appropriate.
She is hoping to find someone to work with her locally, but is coming up with blanks as many of the services she thinks will be suitable wont take kids under 16. Its looking like monthly trips to London. Plus remote conferance calls /skype and CBT.

NettleTea Sun 23-Mar-14 21:39:23

Quite a long time since I last posted.

My DD never went back to school.

The psychologist assessed her as having extreme social anxiety, and moderate separation anxiety. While in hospital DD saw her several times, and then we had possibly 4 sessions where we travelled up. The psychologist then went on maternity leave and referred us locally to CAMHS - she has had 1 assesment, one follow up assessment and will have one further assesment before they decide on a course of action. What has also been raised is ADHD, and she is being referred to the educational psychologist too.

She had been attending a small unit in our town to get some one to one help with work sent home from the school, but after a disasterous PEP meeting with the school, where the LEA suggested (prior to any treatment for the anxiety) that she should come and spend a morning a week back in school, she has refused to go there. So we are left with her doing online lessons, and very little else. She recently has been playing silly buggers with those, but she got very short shrift with me for that and think she realised she had taken it all a bit too far,

What the future will hold with her education I dont know. She needs to go back to the small unit in order for them to be able to assess her for the ADHD, and she understands that and seems as if we might have a compromise there. I feel she is unlikely to return to her original school, but cannot say that or we lose the e-learning. Its all very tricky.

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