Behaviour therapy in school phobia: A case study

Abstract

School phobia is defined as maladapted patterns of anxiety behaviours related to school situations. It is considered one of the most disabling anxiety disorders during childhood and adolescence. In this article a case study of a 15 years-old adolescent, diagnosed with school phobia is presented. The identified antecedent stimuli were aversive social situations, as being the target of jokes and threats by her peers during school situations such as recess, and anticipatory behaviours like gearing up for school, getting out of home, and/or taking the bus. Deficits in social skills and self-esteem were also found as mediating factors. Problembehaviours were high anxiety, passive and active avoiding behaviours, and negative thoughts. The treatment focused on enhancing coping skills involved in school situations, and improving the repertory of social behaviours. The techniques used were therapeutic contract, social skill training, in-vivo exposure, self-instructions and contingency management. When the treatment ended, the patient was attending her classes and her social competence level had improved. Treatment gains were maintained at follow-up session.