School refusal anxiety teenager

[Mumpe]

Can anyone help? I feel sick with worry. My 14 year old has barely attended school since last October, and her anxiety is now starting to limit going out of the house at all. We had to come home early from a recent weekend away because she was in such a state. When she’s at home she’s absolutely fine. We are paying for private counselling, which is yet to have any observable impact. School have put loads in place, including full time access to a quiet room with an ELSA. But I feel as if despite all this she is spiralling down so quickly. GP not interested. CAMHS won’t take referral. Please can people share stories of hope? I need to know she (and we) can get through this. She’s a bright girl. She’s been referred for ASD assessment but I don’t think that’s the issue (I’m a SENCo so have a bit of knowledge behind me). How do school ref users get back in once the behaviour is entrenched. She doesn’t want to deregulated. My hubby and I both work (me full time, him part) so home school wouldn’t really work anyway. I need positive vibes and hope PLEASE!!!

Would it be horrific to put her in your school? I realise there may be blurring of boundaries, but wouldn't that maybe help?

I'm afraid i don't think there are any easy solutions for anxiety.
I think, difficult as it is, you need to not put pressure on her. You can try and encourage her to take advantage of the accommodations school has made for her- spending her day in the quiet room and doing the work her peers will be doing in the classroom.
Anxiety is not logical- but you should try to validate her fears rather than dismiss them. Can she articulate what is hard for her about school. Believe her. She needs to trust you.
Both my DCs have /had school anxiety. It kind of came and went in waves over the years. My 15 yr old is on beta blockers but they don't seem to help.

Hi. We are in the same situation with our 12 year old daughter. Has had school phobia/anxiety for 2 years, since lockdown. Started in year 5, now in year 8. It improved a bit in year 7 but now it's worse than ever. Has barely been into school since January. Can't get help from CAMHs or GP and she also refuses to talk about her feelings. She has dyslexia and very low self esteem. When she does go to school she seems happy there and has a good group of friends. It just doesn't make sense what's going on in her head and I don't know how to help her. Sorry I know you wanted positive stories ☹️ I just wanted you to know you aren't alone, but you probably already know that.

Do you know what she is worried about?

There are quite a few who have been through this on the Children's Mental Health board.

My DD collapsed completely at the start of the pandemic 3 years ago, she was in y10 then and she never returned for y11. Germ related anxiety, and depression.

DD was prescribed Propranolol by the GP. It's a beta blocker and calms the physical symptoms. Later we paid for a Consultant Psychiatrist.

What is she anxious about?

My suggestions.
Consider whether the counsellor is qualified enough.
Make going for a walk every day non negotiable if you can.
What is her 'best time' of day? Can she go in for one/two lessons a day at her 'best time'.
Can school send home work and would she do it?

ASD is often late diagnosed in girls and can be linked with anxiety too due to all the masking.

Don't refer to it as school refusal if she wants to go in but can't face it. She's ill.

I’m so sorry you’re going through this, OP.

Can I ask whereabouts in the country you are? I work at an alternative provision where we support young people such as your DD. We’ve tended to be predominantly a post-16 provision, but we’re seeing more and more younger students being referred with the symptoms you’ve described. The aim for our younger students is to work with them therapeutically so we can support them back into their mainstream setting, while older ones are taken through either academic or vocational qualifications with our own staff. It might be worth finding out if there’s anything like that where you are.

Does she have an EHCP? Do you know why CAMHS won’t take a referral?

My son hasn't been in school for 5 months and was having trouble attending for a full day for months prior to that. Same as you, local GP won't help because he's a child and rejected by CAHMS several times. We eventually went to a private doctor who diagnosed ADHD and anxiety. We have taken all pressure off of going to school which has helped, although we are very lucky that school is supportive. Is there anything your child is particularly interested in? My son has started volunteering at a local farm which he loves. Didn't think we'd see him doing this as he barely leaves the house. There are some excellent Facebook groups which offer support and help, called not fine in school and another one called parenting mental health. Sorry you are going through this. X

There is a really great fb group called Not fine in school . Lots of advice and support available.
So hard for you all and understandable to be so worried . I would concentrate on her MH, she can always get qualifications later .

Second this so supportive and non judgmental like Mumsmet can be sometimes.

My dd has a late diagnosis of
Asd and adhd. I would never have guessed as a child.

My experience of this is usually that children rarely make it back in to mainstream schooling. Usually alternative provision is needed (need to apply for EHCP first as she's clearly got significant needs which aren't being supported by the schools offer) and the different, much smaller, more supportive environment with enabling services to begin with can get some degree of access back to education.

I have one. It’s now called ‘Emotional Behaviour School Avoidance’ EBSA.

School are meant to be helping you to get her to return. My dd 16 was a late diagnosis of ASD. The majority of EBSA is related to ASD.

She is entitled to an education. Contact your LEA. Would the school do a part time timetable?

Have you applied for an EHCNA? If not you should. An EHCNA can include assessments from e.g. OT, SALT, psychiatrist &/or clinical psychologist without sitting on the normal waiting lists. And if the LA agree to issue an EHCP it can include therapies DC wouldn’t otherwise receive without the need to sit on waiting lists.

As well as this the LA must provide alternative education. This should have begun once it became clear DD would miss 15 days. If that isn’t in place email the Director of Children’s Services.

Does she have an EHCP? If not then get the process started. This will give access to alternative schools that are used to dealing with this.

Yes to this. I am moving to my daughters school. Similar issues though thankfully not regularly school refusing but has refused on several individual occasions. I am going to be working at her school from after Easter. Obviously I was lucky there was a job but moving her to my current school was a thought. I didn't because 1. She's doing her exams this year and 2. She has a strong friendship group who are wholly sympathetic. But being in the same school as her I think will be a game changer. She is heavily reliant on me atm. It's so difficult when you're working.

What are her anxieties related to OP, is she aware of what it is herself?

She's Year 9 and I teach at an Infant School, so not an option.

TitaniasAss nothing that she can identify/articulate at the moment. It's a bit of an anxiety loop now-she is worried she might/will feel anxious at school so avoids going in just in case.

We are in Derbyshire....there's very little Alternative Provision nearby.

There might not be a formal AP that is within travelling distance &/or suitable, but the LA must still provide provision to those unable to attend school, this doesn’t have to be and sometimes isn’t via an AP.

And an EHCP can provide even more bespoke provision.

Can school offer her part time to lessons she enjoys, or least dislikes, as a starting point? Will she use the quiet room for mornings only to get her back in? Does she have one teacher she likes and trusts who would be willing to mentor her and provide a safe space at the back of their classroom if other lessons/ break times get too much? At my previous school, lessons were being put on Teams so students could access them outside lessons. Does her school offer this or anything similar?

Is she willing to read books and complete online maths at home, as a compromise, if she point blank refuses school?

You have my sympathy- so difficult when a teen refuses school x

I think an important thing is for her to know that if she tries school she can leave at any point if she needs to. Giving her an 'out' might give her permission to try.

My DD's school had a timetable 1,2,break,3,4,lunch,5

So could she go in at break and stay for lesson 3, maybe 4 and only then decide whether to stay for lunch & 5.

Tutoring in the house and enablers to help build rapport and leave the house to do other activities is all AP.
Sadly I think it's unrealistic with these children to expect they will somehow return to the place they struggled so much with after such a long time out. Imagine what everyone else would say to you as a teenager.

You probably need to see a different GP and really push for a referral, even if your child is on the end of a long waiting list. If you can possibly get her to a private paediatrician or psychiatrist, it may well be worth doing.

Your daughter should be entitled to education via home tuition (possibly online as well as in person) provided by the local authority under section 19 Education Act 1996. However, you will need independent evidence that she is unable to attend for medical reasons - the government guidance says that, initially at least, LAs should be prepared to accept GP evidence. You may well find that accessing home tuition will help to alleviate your daughter's anxiety, by virtue of the fact that it helps to get her back into the education routine and she will be less worried about what she is missing. You could then perhaps start drawing up a programme for gradual reintegration with support. It may make sense to aim this at moving into a different school or college.

The LA have a statutory duty to provide education to students unable to attend due to illness. Stop calling it school refusal and instead use the more appropriate "anxiety based school avoidance" or similar.

Get in touch with the LA and ask what their provision is for these students and how you can access it.

Does your dd's counsellor have the qualifications to deliver CBT? - it can be very effective for anxiety.

Also have a look at the "autistic girls network" and NASENs stuff on autism.

I saw your comment about being a Senco, please don't be insulted; I teach students like your DD from a LAs worth of schools and I've only met 1 senco with what I would describe as good knowledge of mental health and additional needs in teenagers.