Cognitive and Behavioral Therapy in School Refusal
- Conditions
- Child PsychiatryCognitive Behavioral TherapyAdolescentAnxious School Refusal
- Interventions
- Other: cognitive and behavioral therapy (CBT)
- Registration Number
- NCT04559633
- Lead Sponsor
- University Hospital, Montpellier
- Brief Summary
Anxious school refusal (ASR) is a common disorder which concerns more and more adolescents who are at worse completely absent from school. A specific ambulatory cognitive and behavioral therapy (CBT) program has been established to gradually reintegrate the child back into the school environment with a multidisciplinary team. Alongside school reintegration assessment, the child's overall ability to function and anxiety levels will be measured before and after the program with additional assessments made after a further 6 and 12 months have elapsed.
- Detailed Description
ASR concerns children and adolescents who feel anxiety about going to school. Some are totally absent, some just have difficulty remaining in school for the entire day, or go to school following behavioral problems such as morning tantrums or psychosomatic complaints. Anxiety disorders are the main diagnostic underlying this behavioral problem, with one or many anxiety disorders associated (i.e. separation anxiety disorder, panic disorder, social anxiety disorder, generalized anxiety disorder or specific phobia). ASR causes much distress to the child, the parents, and the school personnel and interferes with social and educational development. Children with severe or chronic school refusal appear to have a long-term risk of adult mental health issues (e.g. anxiety, depression). Studies about ASR are few, and nonexistent in France. ASR occurs in approximately 1% of all school-aged children, and 5% of all clinic-referred children, is equally common in both boys and girls but more frequent in adolescents. Recommendations for anxiety disorder treatment in youth is psychotherapy. CBT, especially exposure-based, is the intervention that is supported by numerous, randomized, controlled trials in this area. But concerning ASR, there are few studies.
A specific ambulatory therapeutic CBT program for totally absent from school adolescents is established within the children and adolescent psychiatric unit in the University Hospital of Montpellier, France. The unit has implemented CBT techniques to gradually reintegrate the child back into the school environment. This program will be implemented in 3 other child and adolescent psychiatry centers (Marseille, Béziers and Nîmes).
The main objective of this study is to evaluate the efficiency of a CBT program on the return back to school.
Secondary objectives are:
1. To evaluate the feasibility in implantation of this program
2. To describe the characteristics of adolescents
3. To assess the initial severity of mental disorders and the evolution of these disorders
4. To describe the evolution of patient anxiety
5. To describe the evolution of the overall functioning
6. To evaluate the efficiency on the return back to school at 6 and 12 month after intervention.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 66
Not provided
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description Anxious school refusal cognitive and behavioral therapy (CBT) Adolescents with anxious shool refusal will beneficiate of cognitive and behavioral therapy (CBT) in order to help them to return back to school
- Primary Outcome Measures
Name Time Method School continue reintegration 46 months The return back to school next year : school continue reintegration (number of hours the adolescent attended school \> 80% of the number of hours expected for each patient
- Secondary Outcome Measures
Name Time Method Presence of comorbidities 46 months Presence of comorbidities is evaluated by the questionnaire Mini-International Neuropsychiatric Interview for Children and Adolescents (MINI-S KID) completed with parents and the adolescent
Initial severity of mental disorders and the evolution of these disorders 46 months Mesure thanks to the Clinical Global Impression (CGI) scale.
Anxiety assessment 46 months Mesure thanks to the scales Multidimensional Anxiety Scale for Children (MASC)
Types of anxiety disorders according to the DSM 5 46 months The questionnaire Mini-International Neuropsychiatric Interview for Children and Adolescents (MINI-S KID) is completed with parents and the adolescent
Global functioning 46 months Mesure thanks to the scale Children's global Assessment (C GAS) Scale
School attendance time month by month 46 months
Trial Locations
- Locations (1)
Montpellier University Hospital
🇫🇷Montpellier, France