An open trial of intensive cognitive-behavioral therapy for school refusal
Abstract
Cognitive-behavioral therapy (CBT) has been used to address the myriad of problems within cases presenting with school refusal. Although CBT for school refusal shows promise in increasing attendance, results to date have been mixed. Treatment studies on CBT for school refusal differ in regards to the dosage of CBT (i.e. session time and frequency) provided. The current study examined the use of intensive CBT, in which sessions lasting 1.5–2 hours were delivered on a daily basis. Altogether, 25 participants were enrolled in an intensive CBT school refusal program. Based upon their needs, individual treatment interventions were designed that incorporated standard CBT procedures, as well as interventions specific to the needs of a student/family. Treatment was delivered on a daily basis over 3 weeks. At pretreatment, all students were spending less than 90% of time in their assigned school/classes, with 88% not attending any school. At posttreatment, 60% of students were attending school at greater than 90% attendance. Intensive CBT for school refusal shows promise in increasing time spent in school. It allows clinicians the necessary time to address maintaining factors of school refusal within a short timeframe (daily). In addition, it allows extended time in session to build skills and also address any daily issues that arise. Further study is needed to directly compare intensive CBT to CBT on a weekly basis and to examine the student characteristics associated with response to treatment.
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The treatment packages are designed to be flexible enough to be adapted to a variety of cases and locations, and indeed have been across educational, mental health, and medical settings.
“The treatment packages are also designed to be flexible enough to be adapted to a variety of cases and locations, and indeed have been across educational, mental health, and medical settings (e.g., Tolin et al., 2009; Rohrig and Puliafico, 2018; Hannan et al., 2019; Thastum et al., 2019).”
From Reconciling Contemporary Approaches to School Attendance and School Absenteeism: Toward Promotion and Nimble Response, Global Policy Review and Implementation, and Future Adaptability (Part 1) (2019) · cites this paper as Hannan et al., 2019
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- Authors
- Hannan, S., Davis, E., Morrison, S., Gueorguieva, R., & Tolin, D. F.
- Affiliations
- The Institute of Living, Anxiety Disorders Center, Hartford, CT, USA
- Yale University (US)
- Corresponding author
- Hannan, Scott
- Venue
- Evidence-Based Practice in Child and Adolescent Mental Health
- Publisher
- Informa UK Limited
- Published
- 2019-01-02
- Volume
- 4
- Issue
- 1
- Pages
- 89-101
- ISSN
- 2379-4925 (ISSN-L)
- 2379-4933
- OpenAlex
- W2912480514
- Cited by
- 21
- References
- 34
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 2 · 2023: 4 · 2022: 6 · 2020: 1 · 2019: 2
- FWCI
- 6.07
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Evidence-Based Practice in Child and Adolescent Mental Health (publishedVersion)
- Topics
- Social Sciences › Education › Youth Substance Use and School Attendance
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- school refusal, school absenteeism, school attendance, child and adolescent mental health, treatment dosage
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