Therapist’s Overview
SCHOOL FEAR REDUCTION
GOALS OF THE EXERCISE
1. Utilize a systematic desensitization program to manage anxiety and gradually attend school for
longer periods of time.
2. Reduce anxiety and expression of fears prior to leaving home and after arriving at school.
3. Decrease the frequency and intensity of temper outbursts, regressive behaviors, somatic
complaints, and pleading before going to and after arriving at school.
ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST
USEFUL
• Separation Anxiety
• Social Phobia/Shyness
• Specific Phobia
SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT
This exercise is designed for the school-phobic child who is exhibiting very high levels of anxiety
and has already missed a substantial amount of time from school. Meet with the client, parents, and
school officials to develop a systematic desensitization plan that gradually allows the client to attend
school for longer periods of time. The client incrementally works his/her way back to attending
school on a full-time basis. The highly anxious and resistant client may begin attending school for 2
hours each day in the beginning phase of this program. (Note: This time can be adjusted depending
on the client’s level of anxiety and degree of pathology.) Once the client shows that he/she can attend
school without exhibiting a significant amount of emotional distress, then the length of the school
day is increased either in time (i.e., 45 minutes to 1 hour) or by the number of classes attended. Use a
reward system to reinforce the client for attending school for increasingly longer periods of time.
Expect more anxiety or resistance around the periods when the length of the school day increases.
Teach the client coping strategies (i.e., positive self-talk, thought substitution, relaxation techniques)
during the therapy sessions to help the client manage his/her anxiety and stress.
EXERCISE XXVIII.C
SCHOOL FEAR REDUCTION
PARENT/TEACHER INSTRUCTIONS
This systematic desensitization program is designed for the student who is experiencing a high level
of anxiety and has already missed a substantial amount of time from school because of anxiety and
fearfulness. In this program, the student is gradually expected to return to school on a full-time basis.
Before beginning the program, it is imperative that the student, parent(s), teacher(s), and therapist all
sit down together as a team to work out the specific details of this plan. The team will develop a
schedule that gradually increases the time the student is expected to be in school each day or week.
The student will spend increasingly longer periods of time at school as he/she becomes more
confident and self-assured. Use a reward system to reinforce the student for attending school without
exhibiting a lot of emotional distress.
1. The first order of business is for the team to come together to work out the specific details of
this plan. The student should be informed that the goal of this program is for him/her to
eventually attend school on a full-time basis. However, in recognition of a student’s high level
of anxiety and fearfulness, the team will structure the plan so that the student begins attending
school on a part-time basis. It is suggested that the student begin attending school under this
plan for a minimum of 2 hours. This time can be adjusted, depending on the student’s level of
anxiety and fearfulness. For example, a severely anxious child may start this program by
attending school for 1 1/2 hours per day; whereas a less anxious child may start the program by
attending school for 3 hours a day. The student is strongly encouraged to use the coping
strategies (i.e., positive self-talk, thought substitution, relaxation techniques) that he/she has
practiced in therapy sessions.
2. The length of the school day is increased in increments when the student shows that he/she can
attend school without exhibiting a significant amount of emotional distress. A significant
amount of emotional distress can be demonstrated in any of the following ways:
• Crying • Temper outbursts (yelling, screaming,
• Excessive pleading and whining swearing)
• Excessive clinging to parents before • Refusal to enter school building or
leaving home/after arriving at school classroom
• Numerous somatic complaints • Leaving classroom or school grounds
• Frequent verbalizations of unrealistic • Trembling and shaking
fears • Refusal to talk when appropriate
3. It is recommended that the student attend school 80% of the time (i.e., 4 out of 5 days, 8 out of
10 days) without showing a significant amount of emotional distress before increasing the
length of the school day. If the student successfully meets this criterion, then it is suggested that
the expected time spent at school be increased by 45 minutes to an hour. The steps of the
program are then repeated before moving on to the next level, where the student attends school
for an even longer period of time.
4. Use a reward system. The student should be reinforced for attending school for the expected
period of time without displaying significant distress. The student and other team members
should identify the specific reward(s) to reinforce him/her for attending school. Use the
following contract form as a means of formalizing the agreement with the student. Establish a
new contract for each phase of the program. Place the contract in the student’s notebook or post
it in his/her room as a reminder of the agreement. The team should consult with the student
about appropriate rewards that can be used to reinforce school attendance. A list of potential
rewards follows.
• Extra time to spend watching television or playing video games
• One-on-one time with child (e.g., attend a movie, exercise together, play a board game)
• Extended bedtime
• Extra time on telephone or computer
• Allow child to invite a friend over or go over to friend’s house after school or invite friend
to sleep over at house
• Outing to favorite fast-food restaurant
• Money
• Snacks
• Stickers or tokens that can be cashed in for a larger reward or privilege at a later date
SCHOOL ATTENDANCE CONTRACT
I, (Name of student) , agree to attend school for (Time) per day, in a calm,
cooperative manner, and without showing a significant amount of emotional distress. A significant
amount of emotional distress is defined as:
If (Name of student) attends school for the agreed upon period of time and without
resistance, then he/she will receive the following reward:
In witness of this contract, we have signed our names on this date
Signature of Student Signature of Parent
Signature of Parent Signature of Teacher or Therapist
