School Refusal

School refusal is defined as refusal to attend classes or difficulty remaining in school for an entire day without a support person present. Children often refuse school due to strong feelings of anxiety, such as fears of separating from their parents or caregivers.

The School Refusal Program begins with an initial diagnostic evaluation, as well as a consultation with the child's school. During the evaluation and subsequent consultations, we seek to identify the function of school refusal in order to determine an appropriate treatment.

Treatment is tailored to match the child's specific needs, with the immediate goal of returning the child to school as quickly as possible. Depending on the child's concerns, treatment may involve gradual exposure to feared situations, skills training, anxiety management training, or helping parents with limit setting and rule enforcement. The treatment team will work closely with school personnel to assist them in providing an appropriate transition plan back to school for the child. By the beginning of the second week, it is expected that the child will begin to attend school at least part time.

The School Refusal Program at the Anxiety Disorders Center/Center for Cognitive Behavioral Therapy is an intensive treatment program that includes 15 sessions of CBT, delivered five days per week for three weeks. Each session lasts 1.5 to 2 hours. CBT is provided individually or with the child's parents or guardians.

Frequently Asked Questions

Q: Is this an inpatient, partial hospital, or residential program?
A: The Accelerated Cognitive Behavioral Therapy program at the Center for Cognitive Behavioral Therapy is a specialized intensive therapy program that does not fit into any of these categories. Clients do not stay overnight at The Institute of Living. Each visit lasts from 1.5-2 hours and clients are expected to spend additional time during the day completing homework exercises on their own. Those who live outside the Hartford area may choose to stay in a local hotel (our center can help those from out of town locate an appropriate hotel).

Q: Is this service covered by my insurance plan?
A: Please be advised that insurance plans do not pay for Accelerated Cognitive Behavioral Therapy (School Refusal Program) and our staff members are not contracted with any insurance companies to provide this service. We often contract with schools to provide this service.  A determination to fund an evaluation and treatment for school refusal is made by a PPT (Planning and Placement Team).  We are not part of that determination, other than providing information requested by the school.  Families can pay for the program is their district is not paying.

Q: Does “accelerated" or "intensive" cognitive behavioral therapy mean that this treatment is harder than regular treatment?
A: Not necessarily. The words “accelerated" or "intensive" cognitive behavioral therapy mean that treatment is delivered more frequently than the typical weekly schedule. This allows you to receive immediate feedback and support from your therapist about your exposure homework exercises. Therefore, Accelerated Cognitive Behavioral Therapy is more focused and possibly more effective, but is not necessarily more difficult than weekly treatment.

Q: What is the cost?
A: Costs for the Accelerated Cognitive Behavioral Therapy Program for School Refusal are $6,565 with a licensed psychologist and $3,675 with a postdoctoral fellow*. These costs do not include the initial evaluation. Most insurance plans will cover the cost of the initial evaluation. Please contact your insurance carrier for coverage verification. Out of pocket expense for the initial evaluation is $595.

*Postdoctoral fellows are clinicians that have their Ph.D., but are not licensed. The postdoctoral fellowship is a 2 year training program in which fellows receive specialized supervised training in Anxiety Disorders and Cognitive Behavioral Therapy prior to taking their licensing examination

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Anxiety Disorders Center