School Absenteeism - Requirements for a Successful Therapeutic Approach

Abstract

School absenteeism constitutes a severe and increasingly evident problem, which progressively concerns pediatrics as the first point of contact. It affects 2-5% of all children and adolescents who are subject to compulsory education [3]. School absenteeism is associated with an elevated risk of school dropout, drug abuse, unemployment, chronic psychiatric disease and delinquency [2, 3, 10]. To date, there is a lack of effective treatment options for chronic school absenteeism. 67 psychiatric patients (aged 7-17 years) with chronic school absenteeism between 3 months and 2 years (median: 8 months) were treated in a multi-modal therapy setting in a psychiatric day-unit specialized in school absenteeism. 93% of the patients had a history of unsuccessful attempts at therapeutic treatment. 55 out of 67 patients (82%) reported continued school attendance to a regular school 6 months after discharge from the day-unit. An integrated therapy concept is essential for successful treatment of school absenteeism. This incorporates (1) intensive and interconnected psychiatric treatment of patients and - if necessary - their parents within and outside of the schooling context with long-term interdisciplinary support and continuity of therapists, (2) efficient observational learning in small groups with similarly affected patients embedded in a (multi-)family therapy context, (3) an affiliated reliable and psychologically trained "pickup and return service", which, if need be, "hauls patients out of bed" in the morning, and (4) close cooperation with the patients' original schooling institutions.