Evaluation of child therapy and caregiver training in the treatment of school refusal.
OBJECTIVE
To evaluate the relative efficacy of (1) child therapy, (2) parent/teacher training, and (3) the combination of child therapy and parent/teacher training in the treatment of anxiety-based school refusal.


METHODS
Sixty-one school-refusing children (aged 7-14 years) from throughout Melbourne, Australia, were randomized to a child therapy program, a parent and teacher training program, or a combination of the two. Children were assessed before and after treatment, and at 4.5-month follow-up, by means of attendance records, self-report of emotional distress and self-efficacy, parent and teacher reports of emotional distress, and clinician ratings of overall functioning.


RESULTS
Statistically and clinically significant pretreatment-posttreatment change occurred for each group. Immediately posttreatment, child therapy appeared to be the least effective in increasing attendance. By follow-up, the attendance and adjustment of those in the child therapy group equalled that of children whose parents and teachers were involved in treatment, whether on their own (parent/teacher training) or together with their children (combined child therapy and parent/teacher training).


CONCLUSIONS
Contrary to expectations, combined child therapy and parent/teacher training did not produce better outcomes at posttreatment or follow-up.
Heyne
David
D
Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Victoria, Australia. daheyne@unimelb.edu.au
King
Neville J
NJ
Tonge
Bruce J
BJ
Rollings
Stephanie
S
Young
Dawn
D
Pritchard
Melinda
M
Ollendick
Thomas H
TH
D000293:Adolescent; D017028:Caregivers / Q000193:education* / Q000523:psychology; D002648:Child; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D003887:Desensitization, Psychologic; D005260:Female; D006801:Humans; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D010698:Phobic Disorders / Q000523:psychology / Q000628:therapy*