Evaluation & Interventions

When it comes to addressing school avoidance, evaluation and assessment is the first step. Interventions can then be applied to help students maintain regular attendance going forward.


Evaluation is the first step. The Center for School Engagement has experts that are available to examine a student’s needs. Every child is different, so the Center for School Engagement structures assessment based upon a student’s needs. The CSE is able to provide the following:

  • Academic review: File review and consultation with the school.
  • Diagnostic assessment: Is there a psychiatric diagnosis that is impacting the child’s school attendance (i.e. anxiety disorder, obsessive compulsive disorder, depressive disorder).
  • Examination of the function of school avoidant behavior. Does missing school/class provide the child an escape from negative emotions or social fears? Does missing school because they prefer to be spending time with trusted adults or doing fun things? The IOL can complete a functional analysis of school avoidant behavior that looks at four functions of school avoidance (Kearney & Silverman, 1999):
    • Avoidance of Negative Affect
    • Escape from Social Evaluation
    • Attention Getting Behavior
    • Pursuit of Tangible Reinforcement
  • Consultation with student’s current medical and mental health providers.
  • Assessment of motivation to return to school.


Credit recovery classroom:

  • For students that are behind on credits and need the right environment to catch up.
  • Small classroom setting.
  • Low stimulation.
  • Individualized academic instruction.
  • Opportunity for academic independence.
  • Clinical consultation (e.g., individual check-ins, seminars, family meetings) when needed.

Motivational enhancement consultation approach:

  • We respond to referrals from school districts or other agencies (e.g., DCF)
  • Assessing and utilizing the student’s motivation and desire to change.
  • Consultation with family and school to develop realistic re-entry plan.
  • Advocating for child’s needs for a successful school re-entry.
  • Facilitating communication between the school and family.
  • Regular meetings with student & family to assess progress, address any obstacles, and problem solve.
  • Serve as interface between student, parents, schools, and districts but remain neutral party in process.
  • Provide morning outreach services to assist and support to improve morning routine, remove family dynamics/conflict, and encourage independence of student in getting to school.

Cognitive Behavioral Therapy for School Refusal (CBT-SR)

Therapy is tailored to match the child’s specific needs and may involve:

  • Diagnostic evaluation
  • Functional analysis of behavior
  • Cognitive restructuring
  • Exposure based therapy
  • Emotion regulation skills
  • Social skills training
  • Parent management training
  • Consultation with school accommodations
    • Academic
    • Social
    • Emotional

CBT-SR through the Center for School Engagement 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.


Is this an inpatient, partial hospital, or residential program?
CBT-SR 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.

Is this service covered by my insurance plan?
Please be advised that insurance plans do not pay for this 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.

Is this this treatment is harder than regular weekly outpatient treatment?
Not necessarily. This 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, CBT-SR is more focused and possibly more effective, but is not necessarily more difficult than weekly treatment.

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