Authors (including presenting author) :
Lai SM(1),Lok EYC(1), Lai YC(1),Lam HY(1),Yau HK(1),Lau YO(1),Tsui LI(1),Lam SK(1)
Affiliation :
(1) Department of Child and Adolescent Psychiatry, Castle Peak Hospital
Introduction :
School refusal behaviour is not a DSM diagnosis, but such complicated behaviour is not uncommonly seen in the Child and Adolescent Psychiatry. Early identification and interventions including psychoeducation, behaviour strategies, parental involvement and systematic desensitization and exposure to school have been proved effective for treatment improvement on school refusal behaviours (Kawsar, Yilanli & Marwaha, 2022; Kearney, 2021; Kearney, Lemos & Silverman, 2004). In order to provide the best quality interventions and support to the students with school refusal behaviours and their relatives, the new titled project was commenced in Child and Adolescent Psychiatric nurse clinic in NTWC.
Objectives :
1.To develop the standardized supportive program for student with school refusal behaviour
2.To re-introduce the students to school
Methodology :
The service need was discussed with doctors, supervisor and nurses in 12/2022. Working group was form and literatures about the best interventions on school refusal behaviour were reviewed. The findings were shared in academic meeting on 07/02/2023 and then the standardized supportive program with 12 sessions and 3 booster sessions was developed. The pilot run of the program in nurse clinic was endorsed in the Child and Adolescent management meeting on 11/08/2023 and had been implemented since 09/2023.
Result & Outcome :
As at 31/12/2024, 48 cases (Male:38%, Female:63%; average age: 13.8; primary school student: 17%, secondary school student: 83%) were recruited. Their psychiatric diagnosis includes mood disorders, autism, attention deficit hyperactivity disorder, anxiety disorders, mental retardation, Tourette’s syndrome, personality difficulties, substance abuse and eating disorder. 54% of them with psychiatric comorbidity. 8 cases (17%) just attended the first session only and pending for next follow-up. 16 cases (33%) defaulted the follow-up, and 4 cases (8%) declined the service. Overall, 20 cases (42%) could continue study with improving school attendance from less than 2 days to 4-5 days per week after joining 3 sessions in average of the program; 89% of cases continue to study in original school and 11% of cases change to another educational institute.
As the service demand continues to be high, staff training workshop for nurses working in nurse clinic is recommended to enhance their competence in supporting students with school refusal behaviours.