Understanding Scolionophobia and How to Treat It

Scolionophobia, or fear of school, is a relatively common fear that can cause significant disruptions to students and their families. Not only does fear of school cause a lot of mental and physical stress, but it also results in missed school time and poorer academic performance.

Therefore, it’s important to identify cases of scolionophobia as early as possible. Once identified, there are a variety of measures that can be implemented to help students feel more at ease at school, while ultimately improving their daily functioning and overall well-being.

What Is Scolionophobia?

Scolionophobia is an intense fear of school, sometimes referred to more simply as “school phobia.” This is grouped more broadly into the term “school refusal”, which refers to when a child regularly refuses to go to school and/or has problems staying in school. Estimates suggest that this condition affects around 2 to 5% of children.^[1]

School phobia and school refusal aren’t documented mental disorders in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-TR-5), although they can fall under the “Specific phobia” diagnosis. School phobia is also often present when there are other mental disorders, especially various anxiety disorders.^[1]

Symptoms of Scolionophobia

Scolionophobia is associated with a wide variety of symptoms, including physical, mental, and behavioral symptoms.

For one, the fears that accompany school phobia may lead to various physical symptoms, such as:^[1]

• Nausea
• Headache
• Stomachache
• Back pain
• Palpitations
• Shakiness

A variety of mental and emotional symptoms often show up in school phobia too, including:^[2]

• Tantrums
• Anxiety
• Panic attacks
• Crying
• Screaming

Moreover, scolionophobia can lead to several key behavioral symptoms too, including:^[2][3]

• Being absent from school
• Hiding from parents
• Arriving late to school
• Leaving school early

Just like other phobias, the symptoms of school phobia are present during or around the time of the actual fear. Symptoms are often highest in the mornings before school, yet may completely dwindle when the child stays home from school. Many children only have symptoms during the school week and not on weekends, again pointing to the fears’ specific nature.^[1][2]

Causes and Risk Factors of Scolionophobia

There are multiple potential causes of scolionophobia, as well as a variety of risk factors that make it more likely to occur. As with most disorders, school phobia results from a combination of genetic, environmental, temperamental, and situational factors.

Individual and Family-Based Factors

Firstly, one of the risk factors for scolionophobia is pre-existing mental disorders, particularly anxiety and depression. Anxiety and depression can potentially lead to or exacerbate school phobia. Also possible is that individuals more prone to anxiety and depression are also more prone to school phobia, given that they share common symptoms of worry and rumination.^[2][3]

Children with school phobia are also shown to have a high sensitivity towards interpersonal relationships, high levels of emotional distress, and lower perceived self-efficacy (i.e. one’s belief in his/her ability to achieve certain goals).^[4]

Parenting styles and the general parent-child relationship may also play a role in developing a fear of school. Parents of children with school phobia are known to have their own psychological issues, which indicates a potential biological influence.^[2]

Beyond that, underresourced parents may lead to a child not being able to figure out how to deal with problems on their own effectively, which can lead to worry and fear when faced with stressful circumstances. Plus, students with fear of school have been shown to live in higher areas of poverty and violence, which is very stressful and can potentially worsen the problems.^[2]

Other family-based factors that seem to be causes or influences of school phobia include being overly dependent on one’s parents, which can lead to separation anxiety. General conflicts and communication challenges within the family, as well as overly rigid or demanding parenting styles, can play a role in the development of school phobia.^[3][4]

Environmental and Situational Factors

There are also a variety of factors stemming directly from the school itself that may cause scolionophobia. Some of the more prominent examples are bullying, perceiving teachers as mean or controlling, and feeling unsafe at school. Academic factors, such as learning disabilities or simply having a hard time with schoolwork, can also make students apprehensive about going to school.^[2][4]

Lastly, a few situational factors can contribute to a child becoming scared of school. For example, transitioning from one school to the next can increase the risk of school phobia. The highest incidence of school phobia is often around ages 5 to 6 and 10 to 11, which is right around the time of transitioning from home to elementary school, and from elementary to middle school, respectively.^[1]

In addition to changing levels, moving to another school (such as during the same school year) can also increase the risk of school phobia. Fear of school also may become heightened after periods of being sick, while on vacation, or other instances when the child has been away from school for a longer than normal time, likely leading to greater anxiety upon return.^[1]

Impact of Scolionophobia on Education and Social Development

Fear of school leads to a lot of missed school time, which negatively impacts students’ educational and social development, not to mention the overall negative impacts on general well-being.

One of the most obvious impacts of scolionophobia is poorer academic performance. If children miss significant periods of school time regularly, they become unable to complete homework, learn new concepts, and perform well. This can lead to low grades and, perhaps more importantly, a lack of knowledge development at a time when this is so important.^[2][3]

If this continues over time, school phobia may also lead to students dropping out of school completely. Given the influence education has on employment, income, and overall health, dropouts are more likely to make less money, experience unemployment, and engage in more criminal and risky behaviors.^[3][4]

Also, by failing to attend school regularly, students miss out on vital interactions needed to foster healthy social and emotional development. This can lead to social isolation, poorer mental health, and a decreased ability to handle socialization and interpersonal relationships in the future. This also generally leads to a greater dependence on other family members rather than developing self-efficacy and self-agency. Because of these issues, substance abuse and other unhealthy coping habits are more likely to occur as well.^[2][4]

Diagnosing Scolionophobia

Scoloionophobia in and of itself is not a clinical mental disorder, although it may fall under the “specific phobia” diagnosis. Nonetheless, it is still important to correctly diagnose school phobia to lead to the best treatment plan.

Diagnosing scolionophobia involves the assessment of various key symptoms, while also differentiating from other causes that may look similar, such as truancy or conduct disorder.

School refusal (which includes the phenomenon of school phobia) is typically identified by several operational criteria, which are:^[2]

• School attendance less than 80% in the classroom over the last two weeks.
• Presence of an anxiety disorder or anxiety-related symptoms.
• Parents’ full awareness of where the child is during absences.
• The lack of conduct disorder problems.
• Parents are motivating and encouraging the child to attend school.

Mental health professionals consider all of these criteria alongside the presence of the physical, mental, and behavioral symptoms mentioned above (e.g. headache, nausea, panic, tantrums, hiding, etc.) to accurately diagnose fear of school. They especially look to see if symptoms are condition-specific, in which the children only experience symptoms during or close to the time of school.

Treatment of Scolionophobia

There are a variety of evidence-based treatments that can help children manage and ultimately overcome school phobia. This includes exposure-based therapies, cognitive behavioral therapy (CBT), educational-support therapy, medication, and various interventions (such as parent-teacher interventions).

CBT and Exposure Therapy

CBT is one of the most widely used therapies for school phobia. In this treatment, students learn about their negative thoughts and behaviors regarding school phobia and then learn to address these and replace them with healthier alternatives. CBT helps to get to the root causes of a child’s anxiety and fear around school, which in turn leads to a more specific treatment.^[1][2]

Importantly, involving the parents in CBT is likely more effective than with just the child. This provides more perceived support for the child and can help parents engage in more appropriate and effective behaviors when dealing with the issues, ultimately creating healthier relational dynamics.^[2][4]

Exposure-based therapies, such as exposure response therapy (ERP), can also help with fear of school. ERP involves gradually exposing the child to their fears, while simultaneously helping them manage their anxiety and related symptoms through techniques, such as mindfulness and deep breathing.^[1][4]

The exposure is started at a level that causes very little anxiety, and then the child is gradually introduced to situations that cause greater anxiety. For example, a therapist may initially have a child simply imagine going to school, then driving by the school one day, then participating in school for an hour, and gradually increasing their presence in a school setting after that.

During this whole process, mental health professionals help the child adapt healthier response patterns and thoughts regarding the situation, ultimately leading to less anxiety and problematic behaviors over time.^[4]

School and Family Support Strategies

Educational support therapy can also help a child manage some of the school-related causes of school phobia. For example, children may undergo social skills training to help with interactions with peers, while also learning coping skills to deal with anxiety and other emotions that may come from homework and other school demands. Teachers and staff may also work with the parents to discuss the issues and become more aware of the actual problems, which can foster a healthier relationship between everyone involved.^[1][4]

Direct family interventions may also be useful, especially if scolionophobia is in part due to family conflicts and unhealthy relationships. Within family therapy, parents can learn how to more effectively manage and communicate with their child(ren), while adopting healthier parenting styles that lead to greater feelings of trust and self-efficacy.

Medications

Medications may also be useful for school phobia, especially in more severe cases. One class of drugs called selective serotonin reuptake inhibitors (SSRIs) are generally considered safe and effective for the management of childhood anxiety disorders, including for long-term use.^[1]

Supporting a Child with Scolionophobia

Offering support is crucial when dealing with a child who has a fear of school, yet parents and caregivers may often have confusion about the right way to go about it. They may struggle to maintain authority without causing any additional anxiety, stress, or conflicts that would likely only worsen the issues.

Therefore, it’s important to adopt a validating approach. Parents and caregivers should talk to the child about the problems they’ve noticed without sounding judgmental. From there, it’s helpful to ask the child questions to learn about the possible reasons for their behavior, such as bullying, exam anxiety, shyness, etc.

Parents should also work collaboratively with teachers because this can help make the transition from home to school easier. If a child knows that his/her parents and teachers are aware of the issues and are willing to help, this will likely lower anxiety and fear.

Beyond that, implementing periods of fun and relaxation can be helpful. If a child is stressed after a day of school, parents can implement fun and/or relaxing activities the child enjoys, such as coloring, playing music, watching their favorite TV show, or playing outside. Parents should also recognize and applaud children when they do attend school to reinforce positive behavior.

Can Scolionophobia Be Prevented?

There are several ways to help prevent scolionophobia or at least minimize the possibility of it developing. This is of course with the understanding that every situation is different.

Firstly, it’s important to address the issues as early as possible, including not only for school phobia but also for co-occurring issues, such as an anxiety disorder. Early intervention has been shown to prevent or minimize school phobia severity, so it’s best to act as soon as possible and get started on a treatment plan if needed.^[1][3][4]

Having healthy relationships also helps to prevent fear of school. It’s important for children to have positive perceptions of their parents and close bonds with parents and other family members. Tight-knit relationships with friends and teachers can also be preventative in developing school phobia.^[4]

High self-esteem and a high level of social functioning and social skills also are protective. While some children naturally have an easier time developing these than others, every child can ultimately improve these areas, so they should be worked on frequently.^[4]