1Two weeks away is the point to stop waiting and ask for help. A year away is beyond what one appointment a week can carry.
Short absences often sort themselves out. Once a fortnight has gone, the pattern has usually begun to set, and the amount of practice needed to undo it grows with every week after that. If it has been many months, ask about something more intensive than a weekly session, because the arithmetic is unforgiving: coming back takes repeated goes at the frightening thing, and an hour on a Tuesday does not supply enough of them.
Islamic evidence
We shall be sure to guide to Our ways those who strive hard for Our cause: God is with those who do good (Quran 29:69). Asking for more help is part of striving, not an admission that you failed.
“But We shall be sure to guide to Our ways those who strive hard for Our cause: God is with those who do good”
Qur'an 29:69
Psychological evidence
A meta-analysis of 75 childhood anxiety trials found that treatments weighted towards exposure, meaning actually approaching the feared thing, did better than those weighted towards anxiety management. It pools trials that differ a good deal from each other, so the comparison is broad rather than precise. It is still a fair basis for asking how much real practice a proposed plan will contain.
Whiteside SPH, Sim LA, Morrow AS, Farah WH, Hilliker DR, Murad MH, Wang Z. (2020). Clinical child and family psychology review · doi
Review detail
Why it works. The longer something has been avoided, the more practice at approaching it is needed to catch up.
Feedback
none yet2Somewhere between five and ten children in every hundred struggle to get to school at some point, and one or two of those need real help with it. Your family is not a strange case.
It feels rare because nobody mentions it at the school gate. In a school of a thousand that is a dozen or more children needing active support at any one time, which is reason to ask for a proper system rather than a personal favour. It turns up in boys and girls in roughly equal numbers, and rather more in big schools and big cities.
Islamic evidence
They were so shaken that even their messenger and the believers with him cried, 'When will God's help arrive?' Truly, God's help is near (Quran 2:214). Being badly shaken has never put anyone outside the ordinary run of people.
“Do you suppose that you will enter the Garden without first having suffered like those before you? They were afflicted by misfortune and hardship, and they were so shaken that even [their] messenger and the believers with him cried, ‘When will God’s help…”
Qur'an 2:214
Psychological evidence
In a community clinic study of 197 anxious young people, dropping out of treatment was frequent and to some degree predictable from the start. It describes one clinic and does not explain why people left. It is still worth knowing that leaving early is the usual way this kind of help fails, so it is worth planning at the outset for how you will stay in it.
Gonzalez A, Weersing VR, Warnick EM, Scahill LD, Woolston JL. (2011). Administration and policy in mental health · doi
Review detail
Why it works. Shame makes a common problem feel unique, and a problem that feels unique is much harder to ask for help with.
Feedback
none yet3Avoiding something makes today easier and tomorrow harder. Say that plainly, to yourself and to whoever is in it with you.
Without that sentence, asking someone to face a frightening thing looks like cruelty, and every conversation about it goes badly. With it, the choice comes into view: a hard hour now, or a fear that quietly grows while you wait. It helps to be specific about the price, so it becomes a real account of what these months of staying away have cost rather than a vague warning.
Islamic evidence
The death you run away from will come to meet you (Quran 62:8). Running is named here as something that does not remove what is being run from.
“so say, ‘The death you run away from will come to meet you and you will be returned to the One who knows the unseen as well as the seen: He will tell you everything you have done.’”
Qur'an 62:8
Psychological evidence
In a randomised experiment, 30 people asked to carry out health related precautions for a week ended up more worried about their health than those who were not. It is a small study with volunteers rather than patients, so hold the size of the effect lightly. What it shows well is the shape of the thing: the protective behaviour did not settle the fear, it fed it.
Olatunji BO, Etzel EN, Tomarken AJ, Ciesielski BG, Deacon B. (2011). Behaviour research and therapy · doi
Review detail
Why it works. Each escape buys relief now and pays for it with a bigger fear later.
Feedback
none yet4Anxiety is the most common mental health difficulty of childhood, with something like a third of young people meeting the threshold at some point and a smaller group badly held back by it. Both halves of that are worth saying.
The first half is for the shame: this is ordinary, and keeping it secret is its own kind of avoiding. The second half is so that nobody hears everyone gets anxious and decides your child needs nothing. Say them together, especially to relatives who mean well and to schools that have heard it all before.
Islamic evidence
My servants who have harmed yourselves by your own excess, do not despair of God's mercy. God forgives all sins (Quran 39:53). If shame is what keeps a family quiet, this is addressed precisely to shame.
“Say, ‘[God says], My servants who have harmed yourselves by your own excess, do not despair of God’s mercy. God forgives all sins: He is truly the Most Forgiving, the Most Merciful”
Qur'an 39:53
Psychological evidence
A meta-analysis of 39 randomised trials with 1,821 patients found acceptance and commitment therapy helped across a range of mental and physical health problems, while a later cumulative analysis focused on anxiety and depression found the evidence building steadily but with modest effect sizes. Put side by side they support a plain claim rather than a large one: treatment of this sort helps a good many people, moderately. That is enough reason to go looking for it, and not a promise about any one child.
A-Tjak JG, Davis ML, Morina N, Powers MB, Smits JA, Emmelkamp PM. (2015). Psychotherapy and psychosomatics · doi
Hacker T, Stone P, MacBeth A. (2016). Journal of affective disorders · doi
Review detail
Why it works. Knowing a difficulty is common makes it speakable, and knowing it can be serious keeps it from being waved away.
Feedback
none yet5The target is getting through the door, not feeling calm about it. Calm tends to arrive afterwards, and mostly for people who went.
It is tempting to wait for a good week, a settled mood, a morning that feels different. Waiting hands the decision to the anxiety, and the anxiety will never vote for going. Keep everyone pointed at the same plain endpoint, being in the building, and treat every other improvement as a welcome extra rather than a condition that has to come first.
Islamic evidence
Take action! God will see your actions (Quran 9:105). The instruction points at the doing, and it is the doing that is seen, not how confident anyone felt while doing it.
“Say [Prophet], ‘Take action! God will see your actions- as will His Messenger and the believers- and then you will be returned to Him who knows what is seen and unseen, and He will tell you what you have been doing”
Qur'an 9:105
Psychological evidence
A meta-analysis across 75 childhood anxiety trials found programmes weighted towards exposure did better than those weighted towards anxiety management, and suggested the comfort focused parts can quietly serve avoidance. The trials pooled here vary a good deal in what they actually contained, so the contrast is approximate. As a rule of thumb it is still worth asking of any plan whether it mainly helps a child cope with staying away.
Whiteside SPH, Sim LA, Morrow AS, Farah WH, Hilliker DR, Murad MH, Wang Z. (2020). Clinical child and family psychology review · doi
Review detail
Why it works. Going in is the thing that shows the fear it was wrong, so little shifts until that happens.
When not to. If a child is genuinely unwell or exhausted, that is a medical question first and a behavioural one second.
Feedback
none yet6Offer school again at ten, and at eleven, and after lunch. One refusal at half past seven should not be allowed to decide the whole day.
Morning dread usually peaks around the time they would be leaving and then drains away over a couple of hours. A child who could not face it at half past seven can often manage third period, and will almost never suggest that themselves. Keep the offer open, ask lightly, take no for an answer each time without a row, and mean it when you ask again.
Islamic evidence
My sons, go and seek news of Joseph and his brother and do not despair of God's mercy (Quran 12:87). Jacob sends them out again after years of nothing, which is roughly the patience this asks for.
“My sons, go and seek news of Joseph and his brother and do not despair of God’s mercy- only disbelievers despair of God’s mercy.’”
Qur'an 12:87
Psychological evidence
Reviews of exposure written from an inhibitory learning view argue that the work is done by finding out the expected disaster did not happen, and that this is only learned by going towards the thing. These are theoretical reviews assembling laboratory and clinical evidence, not trials of hourly offers. Read at that level, each fresh offer is another chance for the prediction to be tested rather than confirmed.
Craske MG, Treanor M, Conway CC, Zbozinek T, Vervliet B. (2014). Behaviour research and therapy · doi
Review detail
Why it works. The fear comes down as the morning goes on, so leaving the door open catches the hour when going in becomes possible.
Feedback
none yet7Put it the way a grandmother would. Eat your peas and carrots and then you can have your pudding: go in, and then the thing you have been wanting.
Technical language falls out of your head at seven in the morning. A homely sentence survives, and it survives the argument too, because it is hard to be indignant at peas and carrots. Pick one reward that genuinely matters to this child, keep the rule to a single sentence, and resist adding clauses to it after a bad morning.
Islamic evidence
only those who are steadfast in patience, only those who are blessed with great righteousness, will attain to such goodness (Quran 41:35). The good thing sits on the far side of the patience, which is the shape of this whole arrangement.
“but only those who are steadfast in patience, only those who are blessed with great righteousness, will attain to such goodness”
Qur'an 41:35
Psychological evidence
In a secondary analysis of a one day acceptance and commitment therapy workshop with 83 participants, binge eating was examined as a form of experiential avoidance, done to get away from an inner state rather than purely for enjoyment. It is small, indirect and from another area of life entirely. The idea worth borrowing is that a treat can be doing a job, so where it sits in the day is not a trivial detail.
Lillis J, Hayes SC, Levin ME. (2011). Behavior modification · doi
Review detail
Why it works. Something wanted, placed on the far side of something hard, gives the hard thing a reason to happen.
Feedback
none yet8Parents keeping a pattern going are almost never doing it knowingly. Say so out loud, before you explain any of the rest.
A parent who hears that their comfort has been part of the problem will either argue or quietly stop coming, and both of those cost the child far more than the mistake ever did. The sentence that works says this was well meant, that it made sense at the time, and that it has had an effect nobody wanted. After that you can talk about changing it, with the parent still in the room.
Islamic evidence
My servants who have harmed yourselves by your own excess, do not despair of God's mercy. God forgives all sins (Quran 39:53). When a parent is sitting in guilt, that is the sentence to reach for first.
“Say, ‘[God says], My servants who have harmed yourselves by your own excess, do not despair of God’s mercy. God forgives all sins: He is truly the Most Forgiving, the Most Merciful”
Qur'an 39:53
Psychological evidence
In a community clinic study of 197 anxious young people, dropping out of treatment was frequent and to some degree predictable from the start. It is one clinic, and it describes what happened rather than explaining it. It still makes the point sharply: leaving early is the commonest way this kind of help fails, so how families are spoken to is a clinical matter rather than a nicety.
Gonzalez A, Weersing VR, Warnick EM, Scahill LD, Woolston JL. (2011). Administration and policy in mental health · doi
Review detail
Why it works. Blame makes people defend themselves rather than change anything, and often makes them leave.
Feedback
none yet9Nobody is asking you to go cold. Comfort your child properly, and watch where it lands: alongside them as they go, rather than waiting for them if they stay.
A hug at the door and a hand on the back on the way to the car sit on the side of going. A whole afternoon of being looked after because they did not manage it sits on the other side, however natural it feels. The question to hold is what the warmth is attached to, rather than how much of it there is.
Islamic evidence
We shall certainly test you with fear and hunger, and loss of property, lives, and crops. But give good news to those who are steadfast (Quran 2:155). The hardship is not removed and the comfort is not withheld, and that balance is what a parent is being asked for.
“We shall certainly test you with fear and hunger, and loss of property, lives, and crops. But [Prophet], give good news to those who are steadfast”
Qur'an 2:155
Psychological evidence
An empirical review of acceptance and commitment therapy for anxiety and obsessive compulsive problems found psychological flexibility, as measured by the standard questionnaire, is consistently related to anxiety. Most of that evidence is cross-sectional and leans on one self-report scale with known weaknesses. The implication is modest: flexibility is the aim, which argues against rigid rules in either direction, whether comfort at any cost or none at all.
Bluett EJ, Homan KJ, Morrison KL, Levin ME, Twohig MP. (2014). Journal of anxiety disorders · doi
Review detail
Why it works. Comfort given while someone approaches a hard thing helps them approach it, and comfort given for getting out of it teaches getting out of it.