AreasWorry and anxietyThe cost of avoiding

Twenty minutesAny ordinary dayCBTWorry and anxiety

Getting a child back through the gates is not the same as helping them. Ask what the school day is asking of them that they cannot face yet, and put your effort there.

Attendance is easy to count, which is why plans get built around it. A plan that only presses for attendance leaves the frightening thing exactly where it was, so whatever compliance you win tends to collapse within a fortnight. Spend the first while finding out what the fear is made of: a person, a subject, a corridor, a test, or simply being away from home.

Qur’an and Sunnah

God does not change the condition of a people unless they change what is in themselves (Quran 13:11). The change that lasts is the one that reaches what sits underneath.

لَهُۥ مُعَقِّبَٰتࣱ مِّنۢ بَيۡنِ يَدَيۡهِ وَمِنۡ خَلۡفِهِۦ يَحۡفَظُونَهُۥ مِنۡ أَمۡرِ ٱللَّهِۗ إِنَّ ٱللَّهَ لَا يُغَيِّرُ مَا بِقَوۡمٍ حَتَّىٰ يُغَيِّرُواْ مَا بِأَنفُسِهِمۡۗ وَإِذَآ أَرَادَ ٱللَّهُ بِقَوۡمࣲ سُوٓءࣰ ا فَلَا مَرَدَّ لَهُۥۚ وَمَا لَهُم مِّن دُونِهِۦ مِن وَالٍ

each person has guardian angels before him and behind, watching over him by God’s command. God does not change the condition of a people [for the worse] unless they change what is in themselves, but if He wills harm on a people, no one can ward it off–– apart from Him, they have no protector

Qur’an 13:11read it in the library

Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.

What the research says

In a randomised trial comparing acceptance based behaviour therapy with applied relaxation for generalised anxiety disorder, improvement in symptoms and quality of life was mediated by reductions in experiential avoidance, the habit of turning away from unwanted inner experience. Those were adults with a diagnosis rather than children refusing school, and a mediation analysis suggests a route rather than proving one. It still points the same way: what moved was the avoiding itself, not the surface behaviour.

Eustis EH, Hayes-Skelton SA, Roemer L, Orsillo SM. (2016). Reductions in experiential avoidance as a mediator of change in symptom outcome and quality of life in acceptance-based behavior therapy and applied relaxation for generalized anxiety disorder.. Behaviour research and therapy doi

Strength of evidence: one line of research. A single study, or a theoretical account.

Why it works

Pushing on the surface behaviour leaves the thing being avoided untouched, so nothing shifts underneath.

When not to

If a child is being bullied or hurt at school, the first job is making the place safe, not working on their fear of it.

This one is still a draft. It is waiting on a scholar and a clinician to read it before it is published.

Near this one

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