What is EBSA and how does it impact children and young people?

By Dr Hannah Wilson, consultant clinical psychologist and head of clinical governance and clinical psychology lead, Kooth

Emotionally Based School Avoidance, or EBSA for short, refers to young people who struggle to attend school because of a range of emotional factors. These can include struggling with issues like low mood, anxiety and loneliness.

The impact of EBSA can range from the young person experiencing an occasional reluctance to attend school, to complete non-attendance. It can start suddenly or develop gradually over time.

It’s really important to highlight that EBSA is not about young people being “defiant” or “lazy” - it’s a complex issue with no one single cause. EBSA can be influenced by factors at school and at home, as well as by individual differences in personality and coping styles between young people. 

The reasons for avoiding school may shift and change over time.  For example, a young person feeling anxious about friendships might avoid school in the first instance to help them manage their anxious emotions and reduce their exposure to scary things.

Although they might feel some relief in the short term, the very act of avoiding school can lead to a reduction in the young person’s social circle. It can also mean there are fewer opportunities for them to learn that they can cope with difficult feelings. They may also find they’re falling behind in class or that they’ve missed key events or information. All of these things may make it harder to return and so a vicious cycle begins, where further avoidance only reinforces the feeling of anxiety around going back to school.

Unfortunately Covid -19 created a “perfect storm” for EBSA, with increased exposure to risk factors for young people at school, at home and on an individual level, coupled with a reduction in the available access to support for their emotional difficulties. We know that early intervention is key and new interventions need to be accessible to this group of young people, who may sometimes be beyond the reach of traditional face-to-face services.   

What helps young people struggling with EBSA?

It’s important for support for EBSA to first focus on understanding the good reasons why the child or young person feels anxious about attending school. These will likely be different for everyone and understanding the young person’s unique experience helps us know how to best support them.

Young people can be supported to learn about their feelings, including the impact that anxiety can have on our minds and bodies. They need support to understand the unintended consequences of avoiding anything that makes us anxious, which can be an understandable response but often leaves us feeling worse in the long run. A ‘graded exposure’ approach can help the young person take small steps towards their goal, learning to manage the anxiety that comes with each step.

Anxiety coping strategies are helpful for many people, including relaxation techniques, using a “worry monster” or imagining a safe space. Journalling and talking to trusted adults can also help young people to work through anxious thoughts without getting caught in internal cycles of overthinking. 

Finally, if there are practical steps that might support the young person to get back into school, it’s important to work with school and families to agree what options might be available. The young person can develop a plan for how they would cope if anxiety strikes during the school day. This might include things like who to go to for support and strategies that they can try, helping them to feel better prepared to cope.  

How can Kooth help young people struggling with EBSA?

Kooth is well placed to offer support to children and young people struggling with EBSA.  Because Kooth is an entirely digital, text-based offer, it is accessible from home without the demands of talking face to face with a professional, which can often feel daunting for many young people with anxiety.  

Kooth is also available 24 hours a day, providing access to helpful resources and therapeutic tools, like the journal, forums and therapeutic activities. Our practitioner-led chat sessions and message support take place at convenient times too, between 12-10pm during the week and 6-10pm at weekends. This means there’s no need for young people to miss school to attend sessions; they can access these whenever it’s most convenient for them.  

Finally, we offer a range of support options, giving young people the flexibility to choose the right kind of help for them. They can choose from self-directed support or work with our skilled team of practitioners, where chats are individually tailored to their needs. This means that Kooth can meet the range of emotional needs that young people with EBSA might struggle with.

It can be really difficult for teachers and parents when a young person feels unable to go to school. It’s understandable that this can bring up feelings of frustration, especially as a parent, when it feels like other children are not experiencing the same struggles. 

It can help to remember that it’s not that they won’t go to school, but that they feel they can’t (yet!). 

Stay curious about their experience and confident in their ability to learn new skills to manage their emotions.  After all, not all learning happens in the classroom.