School refusal

(6 Posts)
NettleTea Sun 10-Nov-13 12:20:22

Simple question, complicated background.

DD is in year 8. Last year she had a poor attendance, some was medical, some we learned in retrospect was school avoidance/psychological pain causing physical symptoms, most usually stomach ache/feeling sick. Refusal shows as complete hysterics, screaming, shouting, hiding, hitting herself, refusing to get out of bed, get dressed, etc, taking out anger and frustration on her younger brother. DD loved primary, which was a very small rural school. She was happy and popular. Move to secondary has triggered this, although her overall need for 'control' has been ongoing for several years, and started with her hiding food/refusing food/hiding medication/ refusing to do treatment/nebulisers, etc.

School avoidance, due to extreme anxiety - other issues - non compliance with medication/treatment for CF, possibly to cause hospitalisation rather than go to school. DD has had CAMHs involvement in past - successfully at age 6 and 8 to deal with my abusive ex and her fear/mixed emotions, and unsuccesfully at 10 to deal with medical non compliance.

Recently we have a specialist psychiatrist involved - had an initial assesment during half term, but she is in London and we are a long way away, so she is liasing with school and with an impending hospital admission, she will probably get 6 sessions during her inpatient stay, but that is not probably until mid december.

As a result of her medical issues she has access to e-learning but the school have said that it is for 'medical' use only and NOT for when she is displaying anxiety.

It is also worth mentioning that DD can be very adept at persistance to get her own way - this has been demonstrated in many different parts of her life and the huge lengths (often to her own detriment) she will go to in order to control an outcome or situation means that taking things way way beyond normal behaviour is not unusual. Much of the time I am able to stand firm in my decisions and she can be twarted in attempts to undermine boundaries I have set, but there are occassions where she has got the better of me and as a result she will push and push in the hope that I will give up. This makes a situation like school refusal very difficult to deal with, because she hopes that I will cave in and so, once she has managed to get a day off, it makes it near impossible to get her up the following day. The underlying medical condition also makes it difficult to know whether the symptoms are based in pathology or psychology. When she was put on different medication she found out about the side effects and suddenly she had them all when presented with a need to go to school. At one point last year she got so hysterical about how ill she was that I took her to the hospital and she had to undergo every test known only to show she was perfectly healthy, in a physical sense.

The school have allowed her access to the pastoral care, she can go there daily, and she has built up a good relationship with the councillor, who goes with her between lessons. She has also this week been referred to the school advisory service. I spoke to the school this week and raised the prospect of CBT, but they didnt seem keen - felt she was too young (despite the fact that she is very mature and prefers to mix/converse with adults) The schools stance is that she needs to attend, and that absences escalate the situation. This is all very well but I have the problem of actually getting her to school.

I am beginning to dread the mornings. They have always been difficult as she has always dragged her feet in regards getting up and dressed, doing her nebulisers/physio and leaving on time. But now its almosty an impossibility. If I physically get her dressed when I turn round she has taken her clothes off again and got back into bed. I have had to give up on getting her to do her medication/physio as there literally isnt time and I have to get my son to school too. The mornings are just awful, screaming shouting, doors slamming. I simply dont know what to do and feel like I have come to a point where I just cannot cope with it at all.

I dont know if this is real. whether she is playing us all in a huge elaborate thing because she doesnt like school that much and what she really wants is a combination of me home schooling her and access to the e-learning, and she is going to act the part to the best of her ability until she gets what she wants, regardless of the consequences for everyone else. I feel it is destroying my family, and its certainly causing a huge amount of frustration and (I hate to admit) anger on my part because I have missed work, messed up a whole year of college work, missed my own medical appointments, and been made to feel like a fool when she is allowed to stay home and then later seems to be perfectly OK, with only passing reference to the 'agony' that she is in.

This school year she has not missed any days due to stomach ache/anxiety related stuff although she was in hospital for 2 weeks. She seemed to be getting better. She was getting involved in stuff and seemed happier, and then last week (after discussing it with the CF psycologist during half term) it all seems to have cranked up a bit. I dont know why, there doesnt seem to be a reason. She is not being bullied. She is doing very well in class. She is making some new friends. Maybe the school councillor tried to pull back a bit - she seemed mighty put out that she was dealing with another child at one point, maybe she realised that this was it, and she was going to have to be going to school, but she has started having stomach ache again. And Friday she really refused and there was nothing I could do. She did 3 online live lessons, and she loved them, so now thats all she wants to do... All weekend she has been mentioning this 'painful stomach' and last night she freaked out because I said she would be going to school on Monday. This morning she seems OK, she is playing happily with friends now in the lounge - a cursory mention of the stomach ache so far, but I know by 6pm she will be back in full swing.

I dont know what to do tomorrow. I need help. Tomorrow I KNOW is going to be impossible. I need advice. I am contemplating taking her to my mum's and getting her to take her in, to give me a chance to ask for some outside help to see if they will come to the house and physically take her in - is this even something?? Or am I ignoring a serious issue. I am in a real situation with a child who has a history of crying wolf and is very very smart and I am desperate.

Serious question - does she actually have to be educated in school? Are you in a position to home educate?

I am not an expert in this at all but I wonder if the focus was taken off going to school for a bit that might help? She gets a lot out of refusing to go to school - your attention, the counsellors attention etc. If that's added to the fact that she feels unwell and anxious and is perhaps now old enough to understand the significance of her illness better but perhaps not old enough to deal with the worries she may have. It feels a bit like a pressure cooker situation.

I wonder if the best way to take the heat out of it is to park the school issue for a while.

I do think you need some specialist help with this too.

Loopyloulu Sun 10-Nov-13 17:24:32

Replied on the Relationship forum.

schoolnurse Mon 11-Nov-13 07:22:31

What a terrible situation you're in I feel really sorry for you. I'm unsure how helpful your school are being from reading your post. I personally think you going to have to back off until she sees the psychiatrist in December let's face it it's not that far off. This is a very complicated situation it's not just about school refusing but you've got the CF as well she obviously non compliant with the treatment which is going to be detrimental long term. I think your going to have to let her stay away from school until she's had help.
In the meantime can the psychiatrist your waiting to see contact the school and get them to agree to the on line lessons until she's been seen the level of anxiety you describe is a "medical issue" and your struggles with her every morning to try and get her to school are stopping you from carrying essential medical treatment, or can your GP/your consultant at the CF clinic get involved and write a letter to the school explaining why she needs on line lessons for the moment?
CBT really does work and she is old enough by the way but in the circumstances it may be better to wait and have one person treating her.

NettleTea Mon 11-Nov-13 10:22:10

Mum came round this morning and there was no way she was going in. No pretence about tummy ache. No screaming or shouting, just a clear and calm refusal to contemplate going to school.
In the end I told her she needed to do her nebs and get dressed and be online for lessons at 9. No problem. All done. And now she is doing physio properly though with a fair amount of winge.
I texted the school and said she was not well and was doing.e-learning, and would be for the foreseeable future until she had been in hospital.
Have phoned her London main unit and said that as she isnt going to be going to school perhaps they can get her in asap, as she obviously isnt going to be doing her dance show at school. They are onto that now trying to find a space for her.
School have rung. I explained about her going to London. I explained that she was refusing to go in, and was actually not doing her physio/medication so that she got ill and didnt go to school. She said that we need to concentrate on her health and that they are happy for her to access the e-learning. She will ring me in a couple of days to see if we have a date for admission. They have wifi at London so she can go to the school room and do the e-learning there in between medical sessions. She like the e-learning.

this thread is also on relationships, where is is far more active, so will probably be posting on that one, but really appreciate the advice and support

bigdonna Tue 12-Nov-13 07:59:20

hi, just a thought i have a now ds16 who started refusing school at 9yrs ,anyway i finally got him into areferral unit for vunerable children he suffered with anxiety then he was assessed as having aspergers and adhd the school he went to was very small the other children had physical or mental issues ie ms. it was a brilliant unit and my ds son actually enjoyed going!!!see if there is anything offered in your area like this .hope you get something sorted soon

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