School non-attendance evidence

Department of Education, 2024

persistent absentees = attendance < 90%

severe absentees = attendance < 50%

Kearney, 2003

- Nonproblematic: Legit, agreed-upon absences (illness, religious holidays, family emergencies).

- Problematic: Unapproved or excessive absences tied to truancy, anxiety, or refusal.

- Key factor: Agreement between parents and school plus the duration/frequency of absences.

Havik & Ingul, 2021; Heyne et al., 2019

- forms of non-attendance:

School refusal (ESBA): Emotional distress, often anxiety-driven; child is reluctant or distressed about attending. Spectrum: reluctant attendance to full withdrawal.

Truancy: Absence without permission; often disaffected or oppositional.

School withdrawal: Parentally condoned absence.

Other: Exclusion, dropout, or other complex patterns

- Terminology varies:

"school phobia," "emotionally-based non-attendance," "school avoidance," etc.

Ingul et al., 2019

- Emotionally-Based School Avoidance (EBSA):

Associated with:

Anxiety and emotional regulation difficulties

Somatic complaints

Low self-efficacy

Gulliford & Miller, 2023

- Behaviourist techniques:

Classical conditioning: flooding, desensitisation

Operant conditioning: reinforcement, structured exposure

- Some evidence from small-scale studies and professional experience.

Gulliford & Miller, 2023

- therapeutic approaches:

Individual Psychotherapy:

Targets anxiety directly.

Can be slow and not effective for rapid return.

King & Bernstein, 2001 systematic review

- CBT had the strongest evidence for treating school refusal at the time of the review.

- Non-CBT approaches (e.g., psychodynamic therapy, non-directive counselling) lacked strong empirical support.

- Few controlled trials existed to confirm the effectiveness of non-CBT methods.

Carr, 2009

- Psychotherapeutic approaches:

Family therapy

- Evidence for family therapy in treating anxiety disorders is inconsistent.

Some studies show benefits when parents are actively involved.

Overall support is weaker than for disorders like conduct or eating disorders, highlighting the need for more research.

Heyne et al., 2005

CBT:

Focuses on how school experiences affect thoughts, feelings, and behaviours

King & Bernstein, 2001

- CBT combines cognitive restructuring with coping strategies

- Generally a helpful tool

Heyne, 2022

- CBT is not universally effective.

- ~60% show little improvement in attendance.

- Less effective for older children with entrenched patterns.

- Needs tailoring - therapy might focus too much on the child and not the context.

Tonge & Silverman, 2019

- Critiques of a Sole Mental Health Focus:

Timing issues: Early intervention lacks strong evidence.

Spontaneous resolution in some cases

Thambirajah et al., 2008

- Risk of the "vicious cycle":

Absence → Isolation → Academic pressure → More anxiety → More absence

Maeda & Heyne, 2019

Forced return can backfire or worsen distress

Kearney & Silverman, 1990

- Function = the purpose or motivation behind absence:

1. Avoid general anxiety or fear

2. Avoid social situations

3. Gain attention / manage separation anxiety

4. Pursue external rewards

Kearney, 2007

Multifunctionalism: Better at explaining absenteeism than form alone

Havik & Ingul, 2021

- Systemic Integrated Cognitive Approach:

Non-attendance = coping response when stress > coping ability

Includes school as stressor or amplifier (e.g., bullying, demands)

Hascher & Hadjar, 2018

- School Alienation:

Feeling disconnected from:

Teachers

Peers

Learning

Bronfenbrenner & Morris, 2007

- Bronfenbrenner & Morris (2007)'s Bioecological Model

- (Development = child + context + interaction)

Brewer-Borghuis et al, 2019

school factors:

Climate

Havik et al., 2014

School factors:

safety

Lauchlan, 2003

school factors:

bullying

academic pressure

social relationships

Archer et al., 2003

school factors:

supportive school facilities

Nuttall & Woods, 2013

school factors:

staff support

Lissack & Boyle, 2022

family factors:

parents feeling blamed

Fornander & Kearney, 2019

family factors:

dysfunction

Carless et al., 2015

family factors:

mental health

Stempel et al., 2017

family factors:

trauma

Berg, 1996

family factors:

older parents

being the youngest of several siblings

Chockalingham et al., 2022

family factors:

overprotection

Leduc et al., 2022

personal factors:

age

confidence

developmental needs

trauma

emotional skills

Kearney, 2008

- Multi-Systemic Intervention

- 5-Factor Model:

Intervene across:

1. Child

2. Family

3. Peer group

4. School

5. Community

Chu et al., 2019

- Preventive approaches are key.

- Whole-school development and early support > crisis-only reaction

Brouwer-Borguis et al., 2019

- When reintegration fails:

Smaller, calmer environments

Teacher support and embedded mental health services

Positive social support and low-stress schoolwork

Gradual return to mainstream school, possibly with adaptations