Prompt

Parents of a 12-year-old with separation/social anxiety and 6 weeks of near-complete school non-attendance want a plain-language explanation of why this is not 'just laziness', how graded return and exposure CBT work, why open-ended home schooling is unhelpful, when an SSRI such as sertraline might be considered (including simple CAMS combination rationale and Melvin caution), and how you monitor for activation and suicidal thoughts.

Station brief

Format. Communication station, approximately 7–10 minutes active time after reading. You are the psychiatry registrar in the CAMHS clinic. ^[6]

Candidate instructions. Explain school refusal as a treatable behaviour linked to anxiety (not bad parenting or laziness), outline exposure-based CBT and graded return-to-school, discuss reducing accommodation without blame, cover when an SSRI might be added and safety monitoring, check understanding, and respond to the request for indefinite home schooling. The examiner plays a parent. ^[1]^[2]^[5]

References6Show

[1]Kearney CA, Albano AM. The functional profiles of school refusal behavior. Diagnostic aspects Behav Modif, 2004.PMID 14710711
[2]Walkup JT, Albano AM, Piacentini J, et al. Cognitive behavioral therapy, sertraline, or a combination in childhood anxiety N Engl J Med, 2008.PMID 18974308
[3]Melvin GA, Dudley AL, Gordon MS, et al. Augmenting Cognitive Behavior Therapy for School Refusal with Fluoxetine: A Randomized Controlled Trial Child Psychiatry Hum Dev, 2017.PMID 27485100
[4]Bridge JA, Iyengar S, Salary CB, et al. Clinical response and risk for reported suicidal ideation and suicide attempts in pediatric antidepressant treatment: a meta-analysis of randomized controlled trials JAMA, 2007.PMID 17440145
[5]Heyne D, King NJ, Tonge BJ, et al. Evaluation of child therapy and caregiver training in the treatment of school refusal J Am Acad Child Adolesc Psychiatry, 2002.PMID 12049443
[6]Walter HJ, Bukstein OG, Abright AR, et al. Clinical Practice Guideline for the Assessment and Treatment of Children and Adolescents With Anxiety Disorders J Am Acad Child Adolesc Psychiatry, 2020.PMID 32439401

Station brief

Format. Communication station, approximately 7–10 minutes active time after reading. You are the psychiatry registrar in the CAMHS clinic. ^[6]

References6Show

[1]Kearney CA, Albano AM. The functional profiles of school refusal behavior. Diagnostic aspects Behav Modif, 2004.PMID 14710711
[2]Walkup JT, Albano AM, Piacentini J, et al. Cognitive behavioral therapy, sertraline, or a combination in childhood anxiety N Engl J Med, 2008.PMID 18974308
[3]Melvin GA, Dudley AL, Gordon MS, et al. Augmenting Cognitive Behavior Therapy for School Refusal with Fluoxetine: A Randomized Controlled Trial Child Psychiatry Hum Dev, 2017.PMID 27485100
[4]Bridge JA, Iyengar S, Salary CB, et al. Clinical response and risk for reported suicidal ideation and suicide attempts in pediatric antidepressant treatment: a meta-analysis of randomized controlled trials JAMA, 2007.PMID 17440145
[5]Heyne D, King NJ, Tonge BJ, et al. Evaluation of child therapy and caregiver training in the treatment of school refusal J Am Acad Child Adolesc Psychiatry, 2002.PMID 12049443
[6]Walter HJ, Bukstein OG, Abright AR, et al. Clinical Practice Guideline for the Assessment and Treatment of Children and Adolescents With Anxiety Disorders J Am Acad Child Adolesc Psychiatry, 2020.PMID 32439401

Explain school refusal plan and possible SSRI to parents — CASC communication station

Station brief

Explain school refusal plan and possible SSRI to parents — CASC communication station

Station brief