Anonymous wrote:Parent of a former school refusal kid who is now thriving (for the most part) in college.

1) Consider that his school environment is a root of the problem. Dig into this, if it can't be made better, sending him back to that environment is unhealthy.

2) This is a marathon not a sprint. Once you get off the path, you have a lot of freedom. If your kid is into it and will accompany you, it could be a great time to take a few months to get out and see museums and take advantage of where you are posted. This is not a long term solution, but if it lifts his spirits in the short term, could be helpful and buy you time to find his next school situation. I wouldn't worry about the academics - he can make things up when he is healthier and/or repeat a year of high school. This is not the end of the world.

3) The only way to treat anxiety is to face the thing you fear, so getting him back into school has to happen eventually. We chose Fusion because is was a completely different environment from my kid's school where he was bullied. Home schooling is avoiding the fear, and would only be a good short term thing.

4) If moving back to the US is the way to access the best therapy and school situation for your kid, absolutely do that. There are schools in the DMV that accept kids like your son - Nora comes to mind. We didn't take our kid's situation as seriously as we should have and ended up with residential treatment (serious $$) which maybe could have been avoided if we had not been in denial about how bad the anxiety was.

5) It is entirely possible that your kid can get therapy, change schools and still attend college and have a great life. Think if it this way: you are getting your kid coping strategies that he will use for the rest of his life. It might be a rocky or windy road, but it is entirely possible for you guys to get through this.

Hugs to you, OP.

This last is the most important message to convey to kids. I work with a lot of kids who are unhappy in MS and HS. HS particularly is such a specific set of requirements -- to take a bunch of subjects that you may have no interest in, with a bunch of people that you don't like, with teachers who are often not great, and all while sitting in a chair 90% of the day. I keep telling kids.... just get through this well enough to have some choices about college, and I don't mean choices in terms of how great the college is. I mean choices in what kind of life you want to explore -- East Coast? West Coast? South? City? Rural? etc. -- and find peeps that you like, which can be hard in HS unless you go to a very big HS.

We went through this last year it it led to suicidal ideation resulting in in patient and then pho/iop for remainder of school year.

They call it homebound here.

If you have not read her book I would suggest it.

https://www.withunderstandingcomescalm.com/

She also works with parents diectly

Do a public cyber or brick and click if your state allows them.

I didn’t see this thread earlier but I went through pretty extreme school refusal with my youngest and I have a couple thoughts. I would try hard to find a therapist/psychologist trained in school refusal. We did this virtually during the pandemic and it works fine, as most sessions will be with you, the parent, to figure out how to scaffold and support your child back to school. It also sounds like you really need more information about what happened and how significant the issue is. If there is one kid who is the whole problem, it may be possible for you to work toward getting back to school parts of the day where they would be separated from that person. If the issue is wide spread then you need a different approach. Just trying to send him back with out understanding the issues sends the signal you don’t care and won’t help fix a real problem. But just pulling him out sends the signal he can’t do school. So you need to walk the line carefully.

I agree coming back to the US may be the best thing, but I would have a plan towards returning to school in some capacity before I moved, particularly since he enjoys social aspects of school in the past.

Anonymous wrote:OP here- thanks everyone for the encouragement and good suggestions. I have a bunch of calls in to different places to get the details on all of our options (relocation etc)

I expect we will still be here for at least 6 weeks. In that time I hope to get DS into much more intensive therapy (multiple times per week).

For those who have been through this- how did you structure your days? Therapy will be 1st priority. And I plan to maintain our daily errand as a way to keep things from shrinking further until we get some professional guidance.

But I’m wondering about leaning into things that are interests (for DS that is geography, geology and cooking) and ways for him to be successful.

The last time we homeschooled we had playground trips and arts and crafts times etc. to add structure. I am having trouble imagining the teen version of this. Maybe we should relaunch our StarDew Valley farm.

I would be grateful for any ideas.

Ideally, his day should involve a significant time out of your home. He should get exercise and have a planned activity for the day. Your previous idea of museums is a great one. The therapy is the priority but unless you can get him into an IOP (where he spends the day at a program doing group therapy and other activities), it is unlikely that he will spend that much time in therapy per week. For depression/anxiety, it is about behavioral activation and being in the world, not in his room on his phone (isolating). Errands, field trips, exercise class/gym time - any of that is better than being at home with his thoughts. Work with him to make the schedule, if he will engage.

There's a book on parenting children with anxiety called SPACE therapy. It will give you ideas of how to parent him without rescuing or enabling him: "I know this is hard, and I also know that you can do it."

OP here- thanks everyone for the encouragement and good suggestions. I have a bunch of calls in to different places to get the details on all of our options (relocation etc)

I expect we will still be here for at least 6 weeks. In that time I hope to get DS into much more intensive therapy (multiple times per week).

For those who have been through this- how did you structure your days? Therapy will be 1st priority. And I plan to maintain our daily errand as a way to keep things from shrinking further until we get some professional guidance.

But I’m wondering about leaning into things that are interests (for DS that is geography, geology and cooking) and ways for him to be successful.

The last time we homeschooled we had playground trips and arts and crafts times etc. to add structure. I am having trouble imagining the teen version of this. Maybe we should relaunch our StarDew Valley farm.

I would be grateful for any ideas.

OP, since you said NoVa could be a potential place to relocate in the US, the Center for Anxiety and Behavior Change includes school avoidance among the conditions treated. Offices in McClean VA and Rockville MD. Good luck.

https://changeanxiety.com/

Parent of a former school refusal kid who is now thriving (for the most part) in college.

1) Consider that his school environment is a root of the problem. Dig into this, if it can't be made better, sending him back to that environment is unhealthy.

2) This is a marathon not a sprint. Once you get off the path, you have a lot of freedom. If your kid is into it and will accompany you, it could be a great time to take a few months to get out and see museums and take advantage of where you are posted. This is not a long term solution, but if it lifts his spirits in the short term, could be helpful and buy you time to find his next school situation. I wouldn't worry about the academics - he can make things up when he is healthier and/or repeat a year of high school. This is not the end of the world.

3) The only way to treat anxiety is to face the thing you fear, so getting him back into school has to happen eventually. We chose Fusion because is was a completely different environment from my kid's school where he was bullied. Home schooling is avoiding the fear, and would only be a good short term thing.

4) If moving back to the US is the way to access the best therapy and school situation for your kid, absolutely do that. There are schools in the DMV that accept kids like your son - Nora comes to mind. We didn't take our kid's situation as seriously as we should have and ended up with residential treatment (serious $$) which maybe could have been avoided if we had not been in denial about how bad the anxiety was.

5) It is entirely possible that your kid can get therapy, change schools and still attend college and have a great life. Think if it this way: you are getting your kid coping strategies that he will use for the rest of his life. It might be a rocky or windy road, but it is entirely possible for you guys to get through this.

Hugs to you, OP.

I’m the posted who mentioned intensive therapy. For us, it included some time in residential treatment, then an IOP (an afternoon program). Exposure therapy was the primary component. We also followed with a DBT program because my DC also had behavioral struggles when overwhelmed. The PP who talked about DBT had good advice. We continue with family therapy and individual therapy twice a week. At the level of difficulty your DS is experiencing, it’s unlikely that 1 hour per week therapy is going to be enough.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:The biggest risk is not academics. It's that DS will never go back once they are out. Research school avoidance. The school doesn't care about the LT outcome.

Is there an alternative school in your area, as people talk about Fusion etc here?

+1.

+1.

With anxiety, especially severe anxiety, your world is always getting smaller. Each step you avoid feels better in the moment, but long term means the walls are now getting smaller regarding how much you can tolerate.

The trick is giving a lot of support plus scaffolding to push back on those walls, even a little bit, every day.

Yes, this is my worry. I’m trying really hard to find a therapist with experience with anxiety and exposure therapy but am not getting anywhere.

Does anyone have experience with Acceptance and Commitment Therapy or DBT for anxiety? Those are the skill sets of the people I am finding locally.

I don't know much about ACT, but DBT could be really helpful. It focuses a lot on strategies for emotion regulation and tolerating discomfort. You may also be able to find some DBT groups for teens, which might provide an element of social support.

I work in mental health and am trained in Acceptance and Commitment Therapy (ACT) and I'm familiar with DBT. ACT is an evidence-based treatment focused on learning how to tolerate strong negative emotions/thoughts instead of avoiding them (ACT incorporates exposure therapy into treatment). It works well for anxiety, and I'd probably send a kid with social anxiety to an ACT therapist over a DBT therapist. DBT is a great treatment, but it's aimed more at severe depression, self-harm, and severe emotion dysregulation. Though there's definitely a lot of overlap between the two treatments.

Thank you for these details. I do think exposure therapy is going to be an important part of this.