Not attending school because of anxiety

[PinkGinAndTacos]

Does anyone have any experience in this field?

My daughter has now been absent from school for over 2 weeks. This has been an ongoing battle for her since year 4 or 5 in primary school and I have tried various professionals both NHS and private to help deal with the problem but we just get fobbed off/treatment hasn't worked.
She is now in year 7 and it has all become too much. We have talked and it seems to be an issue with actually going in but once she is there she is ok.
I don't feel that the school are doing much- they have made suggestions for what to do during lessons but that isn't the issue. she has terrible anxiety about just going in/entering the building- not during the lessons.
We have got her up and dressed on many occasions only for her to have a panic attack when we get to the gates. Some days she won't even get dressed. Some days she gets dressed but won't leave the house.
The school keep telling me to speak with the GP and the GP tells school should be dealing with it.

I don't know where to turn. What should they be doing in an ideal world? I didn't know if I should call the education welfare officer or attendance people at our council or if this would just be drawing attention to ourselves. I'm petrified they are going to fine me.
I have requested work for her to be getting on with whilst she is home.

The school have said there is nothing they can do unless she goes in- they can't put any interventions in place unless she is there. It seems crazy to me. She can't go because she is too anxious so they won't give her help.

I have called the school nurse and am waiting for a call back.
I've left a vm for another private therapist that the school recommended. (we've used 2 private therapists already)
I really don't know what else I can do. She says some days she wishes she was home schooled but others she just wants to be at school with her friends.

I'd say see a different GP.

Hello, I'm just about to rush out so can't write a long reply, but the Not Fine in School website and Facebook page are excellent resources.

notfineinschool.org.uk/

This may be nit picking language but when you say therapist, do you mean psychologist, or just therapist. If just therapist, I would push to get her under the care of a psychologist - NHS or private if you can afford. She needs the tools to deal with it herself. I hate to say it but I really don't think it's something the school can help with. I'm saying that as someone who has chronic anxiety which started in school. I didn't get help until I was an adult, by which time it was completely crippling in all aspects of my life and it is still extremely restricting. I haven't been able to travel anywhere further than the supermarket for years. I haven't left the town, visited family - they have to come to me, I struggle with work although I do hold down a full time job. For me it escalated from difficulties in school right up to self harm, withdrawal and complete isolation now (aged 30). I have finally got to the stage of getting help from a psychologist and I can see how together we may work out a way to make my life better. The reason I make that differentiation between psychologist and therapist is what they can do for you. I have also been to a therapist and that was far more talking it through but not really tackling the true, deep down reason for it. She helped me curb a spiral of self harm, but it wasn't going to stop my anxiety - and it wasn't that she was bad...it just wasn't her remit.
I hope that isn't all just nonsense...I was just thinking and typing so it's all a bit of a splurge of thoughts!

do you know what she is anxious about? have the therapists that you've seen used CBT?

I'm going through the same thing with my ds OP.

He's in year 8 now, but I've had this problem since year 7 and I've had to fight for the school to try and find a way forward. I have finally got the SENCO in school involved, they didn't offer I had to find out for myself. My ds feels overwhelmed by school and is now started a reduced timetable until February half term. It's 3 hours a day, not great, but I'll see how it goes.

I've found that the attendance officer at the school a pain, she's been round to the house to pick ds up and take him to school ( I put a stop to that, she completely missed the anxiety he was suffering, and I felt it was bullying) and I've been sent a final notice by the council about his attendance. They are asking for medical evidence but the doctor doesn't have to provide it.

Keep going OP. There are actions that the school can take, but they sometimes won't tell you what's available. Firstly though, I would have a meeting with the SENCO and hopefully find a way forward.

Good luck

She saw school nurse, who referred her to a paediatrician, who then referred her onto a clinical psychologist. No real treatment was offered with her. I felt like she was blaming it on me. She suggested things like sticker charts and spending quality time together. This was at a time when DD was beating me up on a daily basis and couldn't sleep, we would put her to bed at 7.30 and she would still be up at 1/2 am. I asked her to pass us back to the paediatrician so we could get melatonin but she wasn't keen so I bought it from a pharmacy in America and gave it to DD myself. She now sleeps for 11+ hours a night and has grown about a ft because she was so sleep deprived before. She is like a different child in that respect.

I paid for her to see a relaxation coach- my daughter was not interested and said it was rubbish. (in her defence it was quite wishy washy)
I also paid for her to see a counsellor, they did lots of art therapy together and talking. It helped a little bit but there were still days where DD was refusing to go to school.

The latest therapist I have contacted does CBT

DD doesn't know what she is anxious about.

the psychologist that she was under said she had "mild" anxiety which I found insulting.

DD gets very paranoid that people don't like her, that they are talking about her, looking at her, judging her. She gives herself labels like naughty which are completely untrue.
She wont go out for bike rides etc because she thinks people are looking at her.

I will ask for the SENCO to get involved.

I have arranged a coffee with a friend from a support group who has been through the same with her son and I am also going to visit my god mother who is a retired SENCO to get some advice.

I get that the school are limited in what they can do if she won't go in but doing nothing or providing little in the way of advice is incredibly frustrating. I feel like I am doing everything to help her. It's driving me mad a little bit. I am a single parent and have another child who gets ignored whilst I am trying to figure this all out. My job is at risk because of all the time I have had off/been late.
I don't expect them to wave a magic wand and fix it but surely they've
seen this before and know where to point me to get help?

I feel for you OP. My daughter is similar but in year 9. I work in a secondary school and level of anxiety and depression in teenage girls is through the roof. I think there is a child mental health crisis that is being ignored.

You daughter needs a referral to CAMHS or if you can afford it then take her to a private psychiatrist.

My DD sounds similar to yours and she has started to take Sertraline which has definitely helped a bit; she's looking to maybe start CBT with CAMHS.

Often when children are this anxious it is because they are on the autistic spectrum but not always - my dd isn't- but it's worth looking into.

The psychiatrist that we saw told us that most of her cases were due to school - related anxiety. I really think the school system is toxic to certain kinds of children - those who are sensitive or have SEN. Have you thought about home - schooling ? Would that be an option? It's something that we are seriously considering at the moment.

Yes they do. I've been fobbed off so many times by the school about what they could do I started to feel like I was going mad! They tried to exclude him ( shift the problem somewhere else) and I demanded to see the school goveners to make an official complaint, then I was sent to the SENCO.

Time to get tough OP, they're letting your dd down!

My friend has had to make the decision to homeschool her daughter due to anxiety, depression & awaiting an assessment for Autism. She had always been anxious about going to school from nursery age, but within 2 weeks of starting at secondary school she had become selectively mute & was having constant meltdowns & self harming. Her parents took the decision to deregister her & homeschool her. She is a bright girl who loves to learn but school just wasn't right for her.

I am like a ball being batted back and forth between the school and the GP.

I do wonder if she has PDA- pathological demand avoidance which is a form of autism I believe.
I can't really afford to go private but I don't feel like I have any other choice so will find the money from somewhere or put it on my credit card.

I will deffo ask about the SENCO. I am going to send another email tomorrow morning. I am sending them daily and documenting everything to keep proof of what I am doing and how little the school are doing. I have asked them to put everything in writing for this very reason. It's very slow getting anywhere with the school as they take days to respond to my emails. I totally get that they are stretched but this is having such a detrimental effect on my other child that I need help. He is also at the school so I feel they have a duty of care towards him as well.

This sounds far more deep rooted than a SENCO can manage OP.

I struggled with anxiety all my life until I paid for private therapy for 5 years in my 20s. NHS CBT and publicly funded therapy just doesnt cut it, there isnt the funding. CBT didn't touch me, it's a quick fix therapy to develop coping mechanisms for specific scenarios. Can you afford private assessment and therapy?

I have looked into home schooling/online learning but I am not sure where to start with it. I work FT and am on my own so don't really have much choice if I want to pay my bills. I also feel like this is any easy escape for the school/system and she will still have the anxiety in other aspects of her life which will remain untreated.
The school say they are putting forwards a CAMHS referral but it hasn't been submitted yet and I fear it will be rejected as they haven't really put in any interventions to help her get into school (they keep focussing on what they can do when she is there) and my GP already said if he put the CAMHS ref in they would reject it due to a lack of supporting evidence.

OhMeows did you see a psychiatrist or psychologist? what kind of therapy did you have?

As you suspect SEN (autism/PDA), I would request an EHCP assessment via your local council. You can request an assessment yourself, you don't need the school to do it for you. However, the school will be asked supply evidence of need/support provided as part of the decision whether to assess. The criteria for assessment is very basic though - The only criteria you have to meet for an EHCP assessment is (i) that you suspect the child has special needs, and (ii) that you suspect that the child needs extra support in school.

www.ipsea.org.uk/ehc-needs-assessments

I've had it all, rubbish CBT, a school and university counsellor, and a psychologist. Eventually it was 5 years of 2hr weekly private gestalt talk therapy combined with trying multiple different medications - settling on venlafaxine which was absolutely life changing for me.

Im a different person now. As a child and teen I was terrified of everything, culminating in panic attack disorder and agoraphobia as I avoided more and more things. Life is great now, but I spent a lot of my teens thinking I was broken somehow. Everything made me anxious.

Could you possibly look into private therapists that specialise in anxiety and can provide weekly sessions? The best I got from school and NHS was 6 weekly courses of 40 minute CBT, which was worse than useless.

I do wonder if she has PDA- pathological demand avoidance which is a form of autism I believe.

We have a child in our school with PDA. It’s pretty rare and is characterised by very specific symptoms, but you’re right, it is a form of autism. We have had to send some of our teachers on a training course to support the child. It’s hard to say without knowing the child, but maybe ODD (oppositional defiance disorder) is more likely than autism. But anxiety seems the most likely.

Do speak to your Inclusion Officer (sometimes called Education Welfare Officer) - they are there to support you and have seen this sort of thing many times before. They won’t fine you if you’re engaging with them and other support services. She may need to start back again slowly and on a reduced timetable, but the school would have to agree.

Schools are limited in what they can do - any interventions Such as school counselling or ELSA would obviously need your child to be in school to access them. They can signpost to services, but it sounds like you have already done that yourself.

You need to see both your GP & the SENCO as your GP needs to do the referral to neuro disability & part of the assessment process involves a speech & language therapist going in to school to do observations & a speech & language assessment plus a report from SENCO, the EHCP process isn't straightforward & education authorities do everything they can to avoid having to fund places in specialist schools.

Could the school allow you in early? Perhaps going in without everyone else around may be easier?

Sounds really hard

Whilst pp have given you really good advice, I would still escalate the problem with the school. Taking days to reply to emails just isn't good enough, especially as it's affecting your mental health too. Go to the principal of the school, someone needs to put a bomb up them!!

I do think it’s difficult to put interventions in place, because a child needs to be in school to access them. You say that it isn’t the lessons that are a problem and that she enjoys seeing her friends once in school.

With children who have such difficulties, it might be suggested that they go into school for part of the day; perhaps until break time or lunch time for example and then increase the time gradually. I’m not sure that would help your daughter, but perhaps going in early to a designated place could alleviate the problem a bit. I used to open my department for children who couldn’t manage the bustle of mornings or break times. Maybe she could take a friend with her.

I’ve seen this work with a child before and it isn’t a difficult thing to organise.

We are in a similarish situation and not yet got over the threshold - but here are some things we are trying (with guidance from thd school) so build up slowly. Day 1 just get up at the right time and say this is the time you would go to school, then next is uniform. Just putting it in with no expectation to go in, then just going to school but not going in, then going but literally just sitting in the foyer for 10 mins.
Does the school have some sort of inclusion room she can build up to going to a lesson there and can withdraw to if she gets overwhelmed.

I know the school say they cant do anything unless she is there - i think there are things. Someone could come to your house and chat to her about things not related to school.
They could organise the LA outreach team to work with her at home. Yes it cost money but the LA do have a duty here.
They could arrange an out of hours time for her to walk around the building with you.
They could phone for a chat or just to explain what was covered in class
They could ask some of her friends to drop some work round and do it with her
They could let her attend a school activity not on site like a sports match
They just need to believee its a genuine mental health issue and not laziness/trying it on.

And yes going in early is another hood suggestion