Various multimodal treatments employ interventions in addition to CBT, such as medication or inpatient treatment, to address the complexity of SR in adolescence.
There are five CBT manuals, which vary in their sensitivity to developmental issues.
Further, the review describes CBT manuals for SR and the extent to which they are developmentally sensitive. These developmental issues may potentiate and exacerbate an adolescent’s difficulty attending school, make it difficult for families to cope, and complicate practitioners’ efforts to provide effective treatment for SR. Such challenges include increased academic and social demands in the secondary-school environment, and increasing autonomy which may contribute to family conflict. It begins by considering the reasons for the higher referral and poorer treatment outcomes, including the higher level of absenteeism in adolescence, higher rates of concurrent social anxiety disorder and depressive disorder, and the developmental challenges inherent to adolescence. This paper provides an in-depth review of developmental issues associated with adolescent SR and treatment via cognitive-behavioral therapy (CBT). Referral rates appear to be higher among adolescents relative to children, and treatment appears to be less effective among adolescents. It is important to consider developmental issues when addressing school refusal (SR) in adolescence.