An interventional study of cognitive and behavioral therapy (CBT) in Child Psychiatry, Adolescent and Anxious School Refusal, sponsored by University Hospital, Montpellier. Completed at 1 site in France. Open to participants aged 10 Years to 16 Years. Per ClinicalTrials.gov, last updated 2024-07-18.
Sponsored by University Hospital, Montpellier · Not applicable, Interventional, and Treatment
Anxious school refusal (ASR) is a common disorder which concerns more and more adolescents who are at worse completely absent from school. A specific ambulatory cognitive and behavioral therapy (CBT) program has been established to gradually reintegrate the child back into the school environment with a multidisciplinary team. Alongside school reintegration assessment, the child's overall ability to function and anxiety levels will be measured before and after the program with additional assessments made after a further 6 and 12 months have elapsed.
ASR concerns children and adolescents who feel anxiety about going to school. Some are totally absent, some just have difficulty remaining in school for the entire day, or go to school following behavioral problems such as morning tantrums or psychosomatic complaints. Anxiety disorders are the main diagnostic underlying this behavioral problem, with one or many anxiety disorders associated (i.e. separation anxiety disorder, panic disorder, social anxiety disorder, generalized anxiety disorder or specific phobia). ASR causes much distress to the child, the parents, and the school personnel and interferes with social and educational development. Children with severe or chronic school refusal appear to have a long-term risk of adult mental health issues (e.g. anxiety, depression). Studies about ASR are few, and nonexistent in France. ASR occurs in approximately 1% of all school-aged children, and 5% of all clinic-referred children, is equally common in both boys and girls but more frequent in adolescents. Recommendations for anxiety disorder treatment in youth is psychotherapy. CBT, especially exposure-based, is the intervention that is supported by numerous, randomized, controlled trials in this area. But concerning ASR, there are few studies.
A specific ambulatory therapeutic CBT program for totally absent from school adolescents is established within the children and adolescent psychiatric unit in the University Hospital of Montpellier, France. The unit has implemented CBT techniques to gradually reintegrate the child back into the school environment. This program will be implemented in 3 other child and adolescent psychiatry centers (Marseille, Béziers and Nîmes).
The main objective of this study is to evaluate the efficiency of a CBT program on the return back to school.
Secondary objectives are:
5,065 studies on the registry are indexed under Anxiety Disorders; 1,408 are open to participants now.
This study's enrollment of 66 is below the median of 80 across 4,339 interventional studies indexed under Anxiety Disorders.
Browse Anxiety Disorders studies →University Hospital, Montpellier is the lead sponsor of 1,261 studies on the registry; 226 are open to participants now.
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Exclusion criteria:
Adolescents with anxious shool refusal will beneficiate of cognitive and behavioral therapy (CBT) in order to help them to return back to school
Other: cognitive and behavioral therapy (CBT)
The CBT program is delivered by a multidisciplinary team with 4 half day hospitalization that includes individual, group CBT and education time (2 hours per day delivered by the teacher). Participants have homework to do in their own time at home. CBT is a manualized program with anxiety psychoeducation, stress management, cognitive restructuration, problem solving techniques, progressive exposure, assertiveness exercises and self-esteem work.
School continue reintegration
The return back to school next year : school continue reintegration (number of hours the adolescent attended school \> 80% of the number of hours expected for each patient
Time frame: 46 months
Types of anxiety disorders according to the DSM 5
The questionnaire Mini-International Neuropsychiatric Interview for Children and Adolescents (MINI-S KID) is completed with parents and the adolescent
Time frame: 46 months
Presence of comorbidities
Presence of comorbidities is evaluated by the questionnaire Mini-International Neuropsychiatric Interview for Children and Adolescents (MINI-S KID) completed with parents and the adolescent
Time frame: 46 months
Initial severity of mental disorders and the evolution of these disorders
Mesure thanks to the Clinical Global Impression (CGI) scale.
Time frame: 46 months
Anxiety assessment
Mesure thanks to the Anxiety and Phobia Behavioural (ECAP) Scale
Time frame: 46 months
Anxiety assessment
Mesure thanks to the scales Revisited Children's Manifest Anxiety scale (RCMAS)
Time frame: 46 months
Anxiety assessment
Mesure thanks to the scales Multidimensional Anxiety Scale for Children (MASC)
Time frame: 46 months
Global functioning
Mesure thanks to the scale Children's global Assessment (C GAS) Scale
Time frame: 46 months
School attendance time month by month
Time frame: 46 months
Plan to share: No
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This study is completed, as verified in May 2024. You cannot join it, but the record below documents what was studied.
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