Denna studie syftar till att undersöka och analysera hur vårdnadshavare till barn medhemmasittarproblematik upplever samverkan mellan skola, socialtjänst och andra verksammaaktörer som berör ärendet, samt hur vårdnadshavarna upplever verksamheternas ansvar förderas barns problematik. Studiens mål är att förse en ökad förståelse för hur en sådansamverkan kan se ut och upplevs från vårdnadshavarnas perspektiv. För att utföra dennastudie hade vi en kvalitativ ansats och utförde sju semistrukturerade intervjuer medvårdnadshavare till barn med hemmasittarproblematik. Alla var utvalda efter ett målinriktaturval. Den teoretiska ansatsen för uppsatsen är systemteori. Resultatet visar att skola ochsocialtjänsten saknade kunskap och resurser för att hjälpa barn och unga medneuropsykiatriska funktionsnedsättningar. Studien har visat hur viktig kommunikation mellanbarn, vårdnadshavare och verksamheter är, samt att det finns en brist på samverkan mellanaktörer för att hjälpa hemmasittande barn. Dessutom upplevdes de sakna ansvar för barn medhemmasittarproblematik och vårdnadshavarna önskar fler insatser och mer samverkan. / The purpose of this study was to explore and analyze how guardians of children withproblematic school refusal behavior experienced the collaboration with schools, socialservices and other agencies in matters that concerned their children, as well as the guardian'sexperiences of the organization's responsibility in the matter. The study aims to be able toprovide an increased understanding of what such collaboration looked like and how it wasexperienced from the guardian’s perspective. To accomplish this study we had a qualitativeapproach and conducted seven semi structured interviews with guardians of children withproblematic school refusal behavior, all of which were chosen out of a goal-orientedselection. The chosen implemented theory for this thesis was system theory. The results ofthis study showed that schools and social services were lacking in knowledge and resourcesto help children and youth with neurodevelopmental disorders. Furthermore, they were alsolacking in responsibility for the children with problematic school refusal behavior and theguardians wished for further services with more cooperation. The thesis highlighted theimportance of communication between the child, guardians and organizations, as well as thelack of cooperation between agencies to help children with problematic school refusalbehavior.

This essay is about family therapists who, on behalf of social services, providesupport to children and adolescents with significant school absenteeism. Theinterviewees in the study describe their work with the target group, the reasonsthey believe contribute to school absenteeism, the methods and approaches theyuse in their work, as well as the challenges and opportunities they see in workingwith these young people. The study shows that family therapists assess the youthand their home and school situations in order to deeply understand how to proceedwith individual treatment. Often, neurodevelopmental diagnoses are part of theadolescents' profile of problems. Students with significant school absenteeism area group who would like to attend school but feel they cannot, for various reasons.Family therapists use a variety of approaches in treatment and wish for morecohesive method materials on how to approach social work with adolescents withsignificant school absenteeism.

The aim of this study was to examine how parents of children who refuse school experience the treatment they received from the school and from social services in regards to their situation, and what they believe that social services can improve in their work with these families. The study was conducted by qualitative phone interviews with six mothers of children with school refusal behavior. The main results show that the mothers were displeased with the help and treatment the school provided, but overall pleased with the help from social services although they also described room for improvements. The respondents also expressed that they had to struggle to receive help and had to make a lot of efforts themselves. Several suggestions for improvements for social services were mentioned, especially that more knowledge about school refusal and neuropsychiatric disabilities is needed in social services, and that collaboration between schools and social services should be improved. / Syftet med studien var att undersöka hur föräldrar med s.k. hemmasittande barn, det vill säga som varit frånvarande från skolan utan synbar orsak i minst tre veckor, upplever skolans och socialtjänstens agerande gentemot dem samt vad de anser att socialtjänsten eventuellt kan förbättra i arbetet med dessa familjer. Telefonintervjuer med sex mödrar till hemmasittare genomfördes. Resultaten visade på ett missnöje med skolans bemötande och hjälp medan man överlag var nöjda med socialtjänstens bemötande och hjälp även om de ansåg att det fanns utrymme för förbättringar. Ett annat starkt tema var att man ofta upplevde att deras barn inte togs på allvar utan föräldrarna fick kämpa för att få hjälp och lägga ner mycket arbete själva. Flera förbättringar för socialtjänstens arbete föreslogs, främst nämndes att mer kunskap om hemmasittare och neuropsykiatriska funktionsnedsättningar behövs samt att deras samverkan med skolan behöver förbättras.

The purpose of this study was to establish a functional analysis protocol for examining behavioral deficits, using social withdrawal as an exemplar. A review of the Journal of Applied Behavior Analysis over the past 10 years found that although the current behavior analytic literature contains extensive studies that functionally analyze behavioral excesses, there is a limited amount of studies that analyze deficits. The rationale behind this study was the notion that although behavioral deficits are rarely studied, the fact that the participant is capable of the behavior yet fails to engage in it leads to the idea that certain events are functionally maintaining this failure. The method used involved examining two male students identified as socially withdrawn. The approach for functionally analyzing their behavior(s) was based on the conditions described in Iwata et al. (1982/1994). Specifically this study had the following conditions attention, demand/escape, and unstructured play, otherwise known as the control condition. The procedures of this study were predicated on the hypothesis that behavioral deficits respond to social contingencies in a manner similar to many behavioral excesses. Based on the findings of this study, the deficit collectively referred to as "social withdrawal" was responsive to such contingencies. Specifically, social withdrawal appeared to be maintained by adult attention for both participants.

Le refus scolaire anxieux est un phénomène complexe et multiforme qui peut avoir des conséquences graves au niveau familial, professionnel et sur le fonctionnement psychique de l’adolescent. La reconnaissance précoce est importante car le pronostic dépend en partie de la rapidité de l’intervention. Cependant, le refus scolaire anxieux est un objet encore mal défini, ce qui entrave sa prise en charge et la reconnaissance du phénomène par l’ensemble des partenaires. A ce jour, il n’existe pas d’outil commun aux différents professionnels pour aider au repérage précoce. L’objectif général de cette recherche était de créer et de valider un auto-questionnaire de repérage du refus scolaire anxieux au collège. Trois études ont été menées successivement en utilisant une approche intégrative et une méthodologie mixte (qualitative pour l’étude 1 et quantitative pour les études 2 et 3). L’étude 1 a été l’occasion, à l’aide d’entretiens (N = 42), de recenser et d’organiser les différentes manifestations du refus scolaire anxieux au collège de façon à pouvoir créer ensuite les items du questionnaire. L’analyse de contenu a mis en évidence un modèle de description du refus scolaire en quatre grands thèmes. L’étude 2 (N = 22) a permis d’élaborer la version pilote du questionnaire (SChool REfusal EvaluatioN ; SCREEN). Cette étude portait sur les étapes de création et de sélection des items et sur la création de la structure du questionnaire. L’étude 3 (N = 584) a porté sur la validation de la SCREEN auprès de collégiens et de patients et la mise en évidence de scores seuils pour le repérage du refus scolaire anxieux. Les analyses factorielles indiquent que la SCREEN est composée de 18 items repartis en 4 facteurs. Une analyse en courbe ROC et une standardisation des résultats ont déterminé des scores seuils. Les résultats indiquent de bonnes qualités psychométriques de la SCREEN (sensibilité de .88 et spécificité de .89 ; alpha de Cronbach de .84). Le modèle issu de l’étude 1, ainsi que le questionnaire, peuvent être utilisés dans les établissements scolaires comme dans les services de soins, à des fins de recherche ou dans le cadre d’une pratique clinique. La SCREEN peut contribuer à l’orientation plus rapide des adolescents, aider au développement des études empiriques sur le refus scolaire anxieux et favoriser le travail de partenariat entre les différents acteurs. / Anxiety-based school refusal is a complex, ill-defined phenomenon related to several dimensions social, family, school, psychological…). This anxious absenteeism is a clinical reality with consequences on the adolescent’s family and professional perspectives and on his/her psychological functioning. As the prognosis depends to a large extent on early clinical care, early diagnosis is crucial. While a specific assessment is required, there is still no common tool that school professionals and health care professionals may use.The goal of this research was the creation and the validation of a self-reported screening tool for assessing school refusal.Three studies were carried out successively using an integrative approach and qualitative method (Study 1) or a quantitative method (Studies 2 and 3). The first study, with interviews (N = 42), aimed at a conceptual and operational definition of this construct. The content analysis revealed a descriptive model of school refusal comprising four different themes. The second study (N = 22) concerned the creation of the pilot version of the questionnaire (SChool REfusal EvaluatioN; SCREEN): generation of items, selection of items and creation of the questionnaire. The last study (n = 584) involved the validation of the SCREEN with a community sample of teenagers and a clinical sample. Analyses revealed a 4-factor model structure with 18 items. ROC analyses and standardization revealed a cut-off for screening school refusal. Results suggested that the tool has good psychometric properties (sensitivity .88; specificity .89; Cronbach’s alpha .84).The SCREEN and the descriptive model of school refusal can be helpful both at school and in health care services, for research and clinical practice. The SCREEN is useful for early clinical care, empirical studies, and for developing partnerships between school educators and health care professionals.

School attendance problems experienced by children are a concern across Canadian educational systems. Higher rates of attendance issues exist among children who experience emotional and behavioural difficulties, which places them at heightened risk for poor educational outcomes. Frequently explored in educational research are variables related to school attendance problems among the general child population, however, a shortage of literature exists that explores these elements among children with emotional and behavioral difficulties. To address this void, this mixed-methods study explored child and educational elements that surrounded the school attendance problems of a sample of children receiving mental health services at a community clinic. Together, analyses of data gathered from the CANS, SDQ, and client files indicated that dynamic and reciprocal relationships existed among children’s emotional, behavioural, social, and academic difficulties which contributed to their attendance and overall educational experiences. These results corroborate existing research related to school attendance problems, however, provide unique insights into the profiles of this particular population and how their needs can be better met to promote more positive school experiences.

The school is an important actor in creating good future opportunities for children and youths, but despite the school's duty, the school absence is common in the municipal school. The purpose of the study was to illustrate how schools in Halmstad municipality work to promote school attendance and how they work to prevent pupils from ending up in a school refusal problem in elementary school, grade 7-9. The relational perspective, sociocultural perspective and sense of coherence (SOC) has been applied as a theoretical basis to get an understanding of how schools handle the complex situation of absence. The study has used a hermeneutic basis where conclusions have been drawn from an abductive approach. With the qualitative design, empirical data has been collected through four semi-structured interviews. The empirical work has then been analyzed through a qualitative content analysis, which resulted in three main categories that account for how the schools relate to absenteeism and meet pupils with interventions and measures to deal with the problem. The analysis resulted in the categories: Organizational efforts and approaches, Pedagogical efforts and measures for participation and Prerequisites for presence through the social environment. In summary, all schools attempted to maintain preventive and promotional efforts based on an organizational, pedagogical and social level at an early stage, where relationships were seen as the prime condition for promoting presence and preventing absence.

The aim for the study is to identify high school students’ perceptions of absenteeism. More specific the aim is to investigate their perceptions of the situations before, during and after the time they were absent. The chosen method for the study is phenomenography which includes qualitative semi-structured interviews. Six students currently in secondary school with a background of absenteeism have been interviewed. The interviews have been analyzed with an eight-step approach. The result of the study presents young students perceptions of circumstances that lead to and sustain their school absence and their return to school attendance. The findings in the analysis show that the informants perceive mental illness as a circumstance with major impact on leading to and sustaining school absence among the students. The mental illness is related to the students’ perceptions of social circumstances in and/or outside school and unmet needs in relation to school success. The perceptions of the circumstances that lead to and sustain attendance were related to a better mental health. Mental health was affected positively mainly by the circumstances related to social relationships and by the adaptations in the learning environment. However, the informants did not perceive better mental health as a key circumstance as explicitly as mental illness.

Ce travail décrit les trajectoires des adolescents qui sont amenés à être suivis en psychiatrie parce qu'ils refusent d'aller à l'école en France. Il se propose ainsi d’employer une démarche sociologique de théorie ancrée (Grounded Theory) afin de répondre à une question de santé publique. En 1991, on estimait que les enfants et adolescents refusant d'aller à l'école représentaient 5% des consultations de pédopsychiatrie en France. Depuis 25 ans, il demeure pourtant difficile de quantifier ce phénomène et son évolution, notamment parce que le refus scolaire ne correspond à aucune catégorie de maladie mentale. L'enjeu sociétal et économique est toutefois considérable. Les associations de parents alertent sur le coût élevé de la déscolarisation, la 'phobie scolaire' rencontre un écho médiatique constant, et les jeunes qui achèvent leurs études sans obtenir de diplôme ont un taux de chômage supérieur à la moyenne pour leur tranche d'âge. De plus, une littérature psychiatrique internationale considérable sur le refus scolaire s’adosse à de nombreuses institutions de soin dédiées à la rescolarisation (consultations et hôpitaux de jours) et de manifestations professionnelles à ce sujet. Dans un contexte de contraintes budgétaires du sanitaire et de crise du système éducatif français, la gestion par le champ médical du refus scolaire pose question. Premièrement, une analyse socio-historique de la littérature médicale internationale entre 1941 et 2018 décrit comment le problème du « refus scolaire » s’est développé dans le discours scientifique selon les deux courants distincts de la phobie scolaire (school phobia) et du refus scolaire (school refusal) ; et tend actuellement à s’élargir vers une problématisation médicale de toute absence scolaire. La deuxième et la troisième partie de ce travail explorent les processus décisionnels qui sous-tendent la médicalisation du refus scolaire à l’échelle individuelle. En effet, le diagnostic psychiatrique intervient relativement tard, à l’issue d’une carrière débutée au sein de l’institution scolaire et de la famille. Comment un jeune en vient-il à être désigné par la catégorie de 'phobie scolaire'? Cette approche interactionniste se fonde sur plus de 100 entretiens réalisés auprès de familles et de professionnels de l’école et analyse le travail produit par le jeune et par les acteurs qui l’entourent. On décrit comment les professionnels de l’école repèrent et qualifient ses difficultés de fonctionnement scolaire. Quatre styles de gestion du problème émergent au sein de l’école, selon le degré d’extériorisation du problème hors du champ scolaire, l’usage des pratiques de care et les modes relationnels avec les autres acteurs. Une analyse dite des « carrières » retrace la trajectoire d’adolescents déscolarisés, de l'école à l'hôpital, en partant du récit des jeunes et de leurs parents. Si les enquêtés présentent le refus scolaire comme une prise de décision brutale, celle-ci vient interrompre un processus de longue durée notamment caractérisé par un épuisement lié au travail de représentation de soi en société. Après la décision de refus scolaire, sont analysés le récit de la transformation de soi, le remaniement des relations aux autres (parents, camarades, enseignants, soignants), la déconstruction et la construction de certaines modalités de socialisation. / School refusal is an increasingly common motive for consultation in child psychiatry. According to the psychiatrists, situations leading to school refusal are extremely diverse, from anxiety feelings in the classroom to truancy, and may lead children to miss school occasionally or to give up their studies. This sociological study, uses the grounded theory to describe the career of teenagers who receive psychiatric care in France because they refuse to go to school. More than 100 in-depth interviews with teenagers, parents and school professionals allow to describe their careers from the school to the psychiatric care. First, we provide a socio-history of the medicalization of school absenteeism through the construction of medical categories (school phobia, school refusal, school attendance problems), based on a review of the international psychiatric literature from 1941 to 2018. Second, teachers discourse on school refusal, their daily management of student who refuse school and their involvement in the medicalization of the absenteeism of some pupils is analyzed. Four styles of management are described among school professionals. Third, the narratives of teenagers and of their parents are analyzed. If school refusal appears as an immediate shift, it answers to a process of long duration. For some students, struggling to attend school from day to day required a consuming work: the presentation of self in public places and emotional work towards peers. After refusing school, students ‘illness’ narratives describe their career in deconstructing and reconstructing their socialization and self.

Fler och fler elever har svårt med att gå i skolan. Problematisk skolfrånvaro påverkar eleven, familjen, skolan och till sist samhället. Skolsköterskans profession utgör en essentiell del för att bemöta och stödja elever genom att uppmärksamma riskfaktorer för ökad frånvaro i skolan och med detta främja elevers hälsa. Syftet med studien är att belysa riskfaktorer kopplat till problematisk skolfrånvaro hos elever i åldrarna 13-18 år. För att få en översikt av forskningsläget genomfördes en systematisk integrativ litteraturöversikt. Litteratursökningen gjordes i databaserna Cinahl och PubMed. Resultatet blev 15 artiklar som beskriver olika riskfaktorer som presenteras i tre kategorier och nio subkategorier. De tre kategorierna blev ”Skolvärldens relationer”, ”Hemmet som plats för trygghet eller utsatthet” och ”Balansera hälsa och ohälsa”. Orsakerna till problematisk skolfrånvaro är komplexa med flertal variationer av riskfaktorer. Som skolsköterska är det en nödvändighet att förstå riskfaktorer som är kopplade till elevens problematiska skolfrånvaro för att arbeta hälsofrämjande. Vid mötet med eleven behöver skolsköterskan förstå elevens livsrytm för att främja hälsa och välbefinnande i en vårdande relation. / More and more pupils are finding it difficult to go to school. Problematic school absence affects the student, the family, the school and ultimately society. The profession of school nurse is an essential part of responding to and supporting pupils by identifying risk factors for increased school absenteeism and thereby promoting pupils' health. The aim of this study is to highlight on risk factors for increased school absence in students aged 13-18 years. A systematic integrative literature review was conducted to provide an overview of the state of research. The literature search was conducted in the Cinahl and PubMed databases. The result was 15 articles describing different risk factors presented in three categories and nine subcategories. The three categories were "School world relations", "The home as a place of safety or vulnerability" and "Balancing health and ill health". As a school nurse, understanding the risk factors associated with a student's problematic school absence is a necessity to work in a health-promoting way. When meeting with the student, the school nurse needs to understand the student's rhythm of life to promote health and well-being in a caring relationship.