How does Compass Health Center address school refusal in adolescents. What treatment modalities are used in their program. How is academic support integrated into the treatment plan. What can parents expect from the Adolescent School Refusal Program.

Understanding School Refusal Behavior in Adolescents

School refusal is a complex issue that affects many adolescents, often stemming from underlying mood and anxiety disorders. At Compass Health Center, this behavior is recognized as a serious concern that requires professional intervention. But what exactly constitutes school refusal?

School refusal behavior may manifest in various ways:

• Frequent complaints of physical ailments (e.g., stomach aches, sore throats, headaches) upon waking up
• Symptoms that mysteriously disappear when allowed to stay home
• Repeated visits to the school nurse’s office
• Chronic tardiness or absenteeism
• Avoidance of specific school events or activities that trigger anxiety

These behaviors often indicate deeper emotional or psychological issues that need to be addressed. Compass Health Center’s Adolescent School Refusal Program aims to tackle these underlying causes and provide adolescents with the tools they need to manage their symptoms effectively.

The Compass Health Center Approach to School Refusal

Compass Health Center offers a specialized program designed to help adolescents aged 13-18 who are struggling with school refusal. This program is part of their Partial Hospitalization Program (PHP) and provides short-term stabilization for teens experiencing difficulty managing mood and anxiety symptoms that manifest as school refusal behavior.

The program’s primary goal is to facilitate the adolescent’s return to the classroom by equipping them with strategies to effectively manage their symptoms when faced with daily stressors. This approach not only addresses the immediate issue of school attendance but also aims to improve the overall quality of life for these young individuals.

Key Features of the Program

The Adolescent School Refusal Program at Compass Health Center is characterized by several key features:

1. Personalized treatment plans
2. Evidence-based therapies
3. Multidisciplinary team approach
4. Integration of academic support
5. Family involvement

These elements work together to create a comprehensive treatment experience that addresses the multifaceted nature of school refusal behavior.

Comprehensive Treatment Modalities

Compass Health Center employs a range of evidence-based treatment modalities to address school refusal behavior. These include:

• Psychiatric assessment and medication management
• Cognitive Behavioral Therapy (CBT)
• Dialectical Behavior Therapy (DBT)
• Acceptance and Commitment Therapy (ACT)
• Executive functioning support
• Mindfulness techniques
• Individual therapy
• Group therapy
• Family therapy
• Art therapy
• Yoga therapy
• Pet therapy

How do these various treatment modalities work together to address school refusal? Each approach targets different aspects of the adolescent’s emotional and behavioral challenges. For instance, CBT helps identify and change negative thought patterns, while DBT focuses on developing skills for emotion regulation and interpersonal effectiveness. The combination of these therapies provides a well-rounded approach to treatment, addressing the multifaceted nature of school refusal.

Individualized Treatment Plans: Tailoring Care to Each Adolescent

One of the cornerstones of Compass Health Center’s approach is the development of individualized treatment plans. These plans are crafted by a multidisciplinary team and are designed to address the unique needs of each patient.

An individualized treatment plan at Compass Health Center typically includes:

• A full psychiatric evaluation
• Regular consultations with a dedicated psychiatrist or psychiatric nurse practitioner
• Daily structured group therapy sessions
• Regular individual therapy sessions
• Family therapy sessions
• Experiential therapies for creative expression
• Ongoing reassessments and modifications to the treatment plan

Why is an individualized approach so crucial in treating school refusal? Every adolescent’s experience with school refusal is unique, influenced by their personal circumstances, mental health conditions, and environmental factors. By tailoring the treatment plan to each individual, Compass Health Center ensures that the specific needs and challenges of each adolescent are addressed effectively.

Integrating Academic Support into Treatment

A key feature of Compass Health Center’s Adolescent School Refusal Program is the integration of academic support into the treatment process. This approach recognizes that addressing school refusal isn’t just about managing symptoms—it’s also about maintaining academic progress and facilitating a successful return to school.

The academic support provided includes:

• Daily education services during the school year
• Supervised study time
• Case management
• Coordination of care among the Compass treatment team, school teams, and family

How does this integrated approach benefit adolescents in the program? By providing academic support alongside mental health treatment, Compass Health Center helps ensure that adolescents don’t fall behind in their studies while addressing their school refusal behavior. This can reduce anxiety about returning to school and make the transition back to regular attendance smoother.

Flexibility in Academic Support

Compass Health Center recognizes that flexibility is crucial in supporting adolescents as they transition back to school. The treatment team maintains regular communication with the adolescent’s school, adjusting the treatment plan as needed to best support the individual. This flexible approach allows for a gradual and supported return to regular school attendance, tailored to each adolescent’s progress and needs.

The Role of Family in Treatment

Family involvement is a crucial component of the Adolescent School Refusal Program at Compass Health Center. The program recognizes that school refusal doesn’t occur in isolation—it affects the entire family system and often requires family-wide changes to address effectively.

How does Compass Health Center involve families in the treatment process?

• Regular family therapy sessions with a dedicated family therapist
• Education for parents about school refusal and how to support their child
• A secure online portal for parents to check in with members of their child’s treatment team
• Involvement in treatment planning and goal-setting

Why is family involvement so important in treating school refusal? Family therapy can help address any family dynamics that may be contributing to the school refusal behavior. It also equips parents with the tools and understanding they need to support their child’s recovery and maintain progress after the program ends.

Measuring Success: Outcomes and Testimonials

The effectiveness of Compass Health Center’s Adolescent School Refusal Program is evident in the positive outcomes reported by patients and their families. While individual experiences may vary, many participants report significant improvements in their ability to manage anxiety and depression, leading to increased school attendance and overall well-being.

What do former patients and their families say about the program?

“Compass saved my life! I came into Compass with suicidal ideations and no hope. After a couple of weeks of being in the program, I did not have those thoughts anymore. Compass helped me change my mindset, from a negative pattern of thoughts to a more positive and optimistic frame of mind.” – Patient

“My child is leaving Compass more equipped to handle her emotions, her anxiety, her depression, and the things that all trigger these. She is willing to use the skills, which is a huge change, and this is all due to how well Compass worked for her.” – Parent of Child Patient

These testimonials highlight the transformative potential of the program, not just in addressing school refusal, but in improving overall mental health and quality of life for adolescents and their families.

The Importance of Specialized Care for School Refusal

School refusal is a complex issue that requires specialized care. The Adolescent School Refusal Program at Compass Health Center exemplifies the kind of comprehensive, multidisciplinary approach needed to effectively address this challenging behavior.

Why is specialized care so crucial for school refusal?

• It addresses the underlying mental health issues, not just the behavior
• It provides a range of evidence-based therapies tailored to each individual’s needs
• It integrates academic support to facilitate a successful return to school
• It involves the family in treatment, recognizing the systemic nature of school refusal
• It offers a supportive environment where adolescents can connect with peers facing similar challenges

By offering this level of specialized care, Compass Health Center is helping adolescents overcome school refusal and develop the skills they need for long-term success in managing their mental health and academic performance.

Looking to the Future

As awareness of school refusal as a serious issue grows, programs like the one offered by Compass Health Center are likely to become increasingly important. These specialized interventions offer hope to adolescents and families struggling with school refusal, providing a path back to regular school attendance and improved overall functioning.

For adolescents experiencing school refusal and their families, seeking help from a specialized program can be a crucial step towards recovery. The comprehensive approach offered by Compass Health Center, combining mental health treatment with academic support and family involvement, provides a model for effective intervention in cases of school refusal.

Adolescents School Refusal Program | Compass Health Center

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Ages 13-18

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About the Program

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Chicago

Northbrook

Oak Brook

ages

13-18

Treatment Levels

PHP

Service Overview

Compass Health Center’s school refusal services provide short-term stabilization for adolescents who are having trouble managing Mood & Anxiety symptoms that often present as school refusal behavior. This service is available for patients admitted to our adolescent Compass’s Adolescent Partial Hospitalization (PHP) Program.  

School refusal behavior may include frequent complaints of being ill with a stomach ache, sore throat, or headache upon waking up. These complaints usually resolve once the adolescent is allowed to remain at home, but may resurface the next morning. Adolescents may also avoid school by frequently requesting to visit the nurse’s office; showing up tardy or not at all; or being absent on test days or for events that trigger performance anxiety, such as giving presentations or participating in sports. Through the use of evidence-based treatment Compass’s goal is to help patients return to the classroom by providing them with the strategies needed to effectively manage Mood & Anxiety symptoms that present when faced with daily stressors.

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What to Expect

Compass’s multidisciplinary team develops an individualized treatment plan for each patient that includes:

• Full psychiatric evaluation 
• Regular psychiatric consultations with a dedicated psychiatrist or psychiatric nurse practitioner 
• Daily structured group therapy 
• Regular individual therapy sessions with a dedicated individual therapist 
• Regular family therapy sessions with a dedicated family therapist 
• Experiential therapies that support creative expression, may include art therapy, movement therapy, yoga, or mindfulness 
• Ongoing reassessments and modifications to treatment plan 
• Available resource therapists providing executive functioning and vocational support

Compass’s customized treatment plans are tailored to the needs of each individual and adapted over the course of treatment. Participants work with therapists who specialize in school anxiety. The group therapy model provides the opportunity to connect with others, normalize experiences, and build group accountability. This individualized approach to treatment supports people in moving towards achieving a meaningful and functional life.   

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Academic Support

Adolescents in PHP receive daily education services during the school year to support their academic goals alongside treatment. This includes time each day for supervised study, case management, and coordination of care among the Compass treatment team, the adolescent’s school teams, and their family. Compass recognizes that flexibility is key to ensuring a successful transition back to school following treatment. Your adolescent’s team is in regular communication with their school to adjust the treatment plan as needed to best support them.

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Treatment Modalities

Psychiatric assessment and medication management

Cognitive Behavioral Therapy (CBT)

Dialectical Behavior Therapy (DBT)

Acceptance and Commitment Therapy (ACT)

Executive functioning support

Mindfulness*

Individual therapy

Group therapy

Family therapy

Art therapy*

Yoga therapy*

Pet therapy

Supervised study

Compass offers a secure online portal that parents can use to check-in with members of their child’s treatment team

*Not available at all locations

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testimonials

Our Success Stories

Compass saved my life! I came into Compass with suicidal ideations and no hope. After a couple of weeks of being in the program, I did not have those thoughts anymore. Compass helped me change my mindset, from a negative pattern of thoughts to a more positive and optimistic frame of mind.

Patient

My child is leaving Compass more equipped to handle her emotions, her anxiety, her depression, and the things that all trigger these. She is willing to use the skills, which is a huge change, and this is all due to how well Compass worked for her.

Parent of Child Patient

I liked how in Compass, everyone was respectful of my opinions, pronouns, and preferred name. There was no judging, and you can open up to people. I also like how I can relate to other kids. I also really appreciate learning new skills.

Patient

Compass is a godsend. An amazing program for children who are struggling and families who are seeking help and guidance. I could not imagine that she would be so much better in less than 2 months. I wish we could have found Compass without going to the ER. Thanks for all you do!

Parent of Child Patient

The evening IOP program challenged me in a supportive and respectful way to help change my way of thinking. Compass provided me with the tools to help deal with life situations in a healthy way.

Adult Patient

School Refusal Program in Falls Church, VA

In serious cases of stress while attending classes, school anxiety can inhibit a student’s well-being and ability to succeed. Holistic behavioral health can help address the roots of school anxiety and its effects, whether it manifests as obsessive compulsive disorder or the development of new phobias.

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School avoidance and refusal treatment in Northern Virginia

Our specialists can help your child build a better relationship with school.

Dominion Hospital’s teen and child behavioral health programs can help your child overcome school anxiety. Our care teams work with your child to develop social skills, let go of negative thoughts and increase their confidence at school.

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In just a few easy steps, you can get started on the road to recovery and wellness. Let us help you find the programs you need to heal.

In just a few easy steps, you can get started on the road to recovery and wellness. Let us help you find the programs you need to heal.

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Every child is different, but common signs they have a fear of going to school include:

• Complaints of illness before school
• Symptoms subside upon coming home

• Inconsistent school attendance
• Panic attacks or crying spells

The primary goal of our school refusal program is to reintroduce a child to the academic setting. We can help them achieve full-time attendance and teach you how to help your child with school-related anxiety.

What is school anxiety

School anxiety may also be referred to as school refusal or school avoidance. It is a real psychological condition in which kids experience extreme distress about going to or staying in school. There are many reasons your child may have school anxiety, including:

• Anxiety or embarrassment from not understanding their coursework
• The benefits of home, such as more screen time, sleeping in or attention from caregivers
• Fear of a negative evaluation from a teacher or other educator
• Fear of separation from parents or caregivers
• A noisy or overcrowded school environment
• Negative social situations, such as bullying or a conflict with a friend

How to ease a childs anxiety about school

Whether it manifests as obsessive-compulsive disorder (OCD) or the development of new phobias, we help ease children into going back to school by:

• Building social skills
• Changing negative thinking patterns
• Decreasing rewards for missing school
• Decreasing social anxiety
• Developing anxiety coping skills
• Empowering parents to better support their child
• Improving executive functioning skills
• Increasing rewards for going to school
• Reducing family conflict
• Teaching parents to address non-compliant behaviors

Our school refusal program

We offer several treatment options that are rooted in a model of individualized, clinically driven and evidence-based care. Our multidisciplinary teams will work with you and your child to develop a personalized plan of care designed to address and treat whatever is causing your child’s school phobia. We follow a school avoidance curriculum, which is available through our children’s behavioral health and adolescent behavioral health programs.

Specifically, the school refusal program involves comprehensive therapeutic approaches, including:

• Cognitive-behavioral therapy (CBT) skills training
• Dialectical behavioral therapy (DBT) skills training
• Exposure therapy
• Expressive therapy
• Mindfulness training
• Parent training
• Psychoeducation
• Therapeutic homework and logbooks

Learn more about our related specialties.

Mental health and wellness

Addiction treatment

Adolescent mental health and wellness

Adult Mental health and wellness

Child mental health and wellness

Eating disorders

Electroconvulsive therapy

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Rejection from school. What is School Refusal?

IMPORTANT
The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.

School refusal is a form of anxiety behavior characterized by persistent avoidance of attending an educational institution. It manifests itself as an open unwillingness of the child to leave the apartment, enter the building of the school (sports center, creative studio). Associated symptoms: anxiety, fears, psychosomatic reactions. Diagnosis is carried out by conversation, psychological testing. Correction is carried out by methods of behavioral psychotherapy, supplemented by drug treatment – the use of tranquilizers, tricyclic antidepressants, serotonin reuptake inhibitors.

• Reasons for dropping out of school
• Pathogenesis
• School refusal symptoms
• Complications
• Diagnostics
• Treatment for school refusal
• Prognosis and prevention
• Prices for treatment

General

School refusal is a common complaint, the basis of which is a neurotic disorder: school phobia, fear of maternal separation, social phobia. Persistent reluctance to go to school becomes a frequent reason for visiting a doctor. The problem does not remain within the family, teachers and representatives of social services are involved. Peak periods of behavioral disturbance – the beginning of schooling, age 13-15 years, changing schools. The prevalence fluctuates, up to 0.7%. Severe, difficult-to-correct cases are typical for adolescents. Younger schoolchildren are susceptible to educational measures, refusal can be prevented by the efforts of parents and teachers.

Dropping out of school

Reasons for dropping out of school

The sex of the child, the level of intellectual development, the socio-economic status of the family do not affect the occurrence of this behavioral symptom. The formation of refusal is facilitated by microsocial factors: difficulties in interpersonal relationships, conflicts, disturbing character traits that have formed as a result of communication. Possible reasons:

• Weak disciplinary requirements. The absence of a clear system of rules of conduct and duties of the child is manifested by a refusal to perform daily routine activities. The deviation is typical for single-parent families.
• Emotional dependence of a parent. The formation of a behavioral deviation is facilitated by the desire of the mother to please the child, to prevent crying, disapproval, anger. The neurotic attachment of the parent, the fear of loneliness is the basis of the weak demand to attend school lessons.
• Difficulties in social interaction. Insufficient communication of the child, parents is manifested by the inability to resolve conflicts, negotiate, cooperate. Quarrels of classmates, academic stress, misunderstanding of teachers provoke rejection reactions.
• Personal characteristics. The development of refusal is facilitated by introversion, a tendency to avoid difficulties, a lack of confidence. Children have a narrow circle of friends, average academic performance, weak involvement in extracurricular school activities.
• Negative experience. Previous difficulties in adapting to an educational institution contribute to the development of school refusal. The disorder manifests itself in children who have experienced severe separation at the initial stage of attending a nursery, kindergarten, and elementary school.

Pathogenesis

The pathogenetic basis of school refusal is a neurotic disorder. Separation anxiety disorder is the most common among elementary school students. The fear of the child is reinforced by the lack of perseverance on the part of the parents. The weakness of disciplinary requirements is realized through the inability to impose restrictions, the sharing of children’s feelings of anxiety. At an older age, specific phobias predominate: fear of school, communication, open spaces, meeting with a specific person (teacher, classmate). Formally, the reason may be different, the children declare their unwillingness to learn, feeling unwell. Lack of parental, pedagogical, psychological assistance is a factor in the development of “chronic” refusal: the longer the child does not attend classes, the faster autism, anxiety, and depressive symptoms increase.

School refusal symptoms

The main manifestation is persistent daily refusals to attend school. The child openly declares his unwillingness, stays at home or returns from school before the start of the lessons. The reasons can be voiced: fear of being separated from mom, leaving the apartment, being on the street, meeting offenders, getting a bad mark. “Masked” refusal is manifested by a psychosomatic deterioration in well-being: headache, abdominal pain, general malaise, nausea, vomiting, fever. Symptoms occur on weekdays, just before going to school. Weekends, holidays are accompanied by normal health, the child remains cheerful, mobile. Attempts by parents to force a child to attend classes provoke tears, pleas, anger, physical resistance, and aggression.

Rejection from school manifests itself suddenly or gradually. The child misses all school days in a row or misses gradually become more frequent from one to five to six days per week. Factors that increase the reluctance to attend an educational institution are a change in teacher, school, loss of a friend, a long illness. In adolescents, the beginning of refusal is hidden – the interest in active work and communication gradually decreases. Debuts, relapses are provoked by long days off, holidays. Refusal to attend only school is associated with the fear of communication, peer bullying. Children who are afraid of separation refuse to go to sports clubs, creative studios, and friendly meetings.

Complications

Neurotic disorders and psychopathological personality changes are a complication of school refusal. The lack of professional correction contributes to the development of isolation, an increase in anxiety, and depression. Homeschooling is not a solution to the problem – the emotional disturbances that form the basis of it are intensified. The most likely complications are when refusing to leave the house – the child’s communication skills, interest in social processes, learning new things are reduced. In adolescence, a schizoid, psychasthenic personality disorder is formed, and there is a risk of social maladaptation.

Diagnostics

When parents complain about school refusal, a diagnosis of emotional disorder is performed, which is the basis of this symptom. Primary examination is carried out by a pediatrician, specific – by a psychiatrist, a medical psychologist. Clinical methods are used: interviewing parents, a child, observing behavior. Additionally, psychodiagnostics is carried out: the emotional, personal sphere is examined, projective tests, questionnaires are used. The failure and a number of other conditions are differentiated:

• School absenteeism. The motive of truants is the desire to do things that are alternative to studying. Lessons are replaced by walks, communication with peers, hobbies. Absenteeism is secret, common among high school students, among male adolescents with academic failure, from single-parent, dysfunctional families. Pathogenetic difference: refusal occurs with neurosis, absenteeism is a manifestation of a behavioral disorder.
• Retention by parents. The reasons for skipping lessons are the parents’ beliefs about the futility of the form of education, the neurotic development of the parent’s personality, pathological attachment to children, and a severe somatic illness that requires their constant help. Difficulties in differential diagnosis are associated with the desire of the mother (father) to hide the true cause of the deviation. Often, the unwillingness to learn is expressed by the child once, actively supported by the parents.
• Somatic diseases. There are difficulties in distinguishing between physical pathologies and psychosomatically masked rejection. Differential diagnosis takes into account the data of surveys of narrow specialists, the relationship of symptoms with the time of school fees (morning, weekdays).

Treatment for school refusal

At the first absences from school, it is possible to correct the child’s behavior through the efforts of teachers and parents. What is important is the consistency, the firmness of the intention of the elders to return the student’s usual schedule. Increased anxiety of the child, prolonged absence from classes requires the help of psychologists, a psychiatrist. Behavior correction is performed by the following methods:

• Cognitive behavioral therapy. Individual psychotherapeutic sessions include determining the reasons for refusal, developing tactics for returning to a normal regimen. Techniques for changing the emotional state, destructive beliefs are used. The basis of the behavioral component is gradual desensitization – a gradual habituation to a situation that causes anxiety is developed.
• Parent counseling. The father and mother are convinced of the need to attend school, its importance for the development of social skills. Educational techniques to eliminate the problem are considered in detail.
• Family psychotherapy. Parents are taught to set firm boundaries for permitted behavior, to exercise control over the child, without showing dictatorial qualities, without causing a feeling of humiliation. The skills of productive intra-family interaction are being worked out: conflict resolution without quarrels, argumentation of points of view.
• Medical treatment. Severe emotional disorders that reduce the effectiveness of psychotherapy require the use of drugs. Panic attacks, persistent anxiety, depression are indications for the appointment of tranquilizers, antidepressants.

Prognosis and prevention

The prognosis of refusal in most cases is favorable, 70% of children resume regular attendance at lessons. A successful outcome is most likely in younger students, with mild symptoms, early intervention of parents, teachers, and psychologists. Prevention is based on a positive attitude towards the school of parents, the presence of discipline. The emotional stability of the mother, the firmness of the father’s decisions make it possible to prevent the formation of school abandonment. It is important to demonstrate calmness to the child when parting, to emphasize the temporality of separation, to share their own interesting school stories.

You can share your medical history, what helped you in the treatment of school refusal.

Sources

1. self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.

   How should school patients be taught?

   November 25, 2019

   News

   The Ministry of Health and the Ministry of Education adopted Recommendations on the organization of education for schoolchildren who need long-term treatment. The document specifies who should teach young patients and how, and explains the rights of children and their parents

   According to the Ministry of Health, 6 million children receive medical care in hospitals every year. Of these, 250 thousand are in hospitals for more than 21 days. Due to long-term treatment, children cannot attend schools, although they could study. At the same time, the law guarantees the availability of free education to every child, regardless of the circumstances. And if he cannot go to school for health reasons, his education should be organized in a hospital or at home ¹ .

   In October, the Ministries of Education and Health approved the Guidelines for the Organization of Education for School Patients (hereinafter referred to as the Guidelines) ² . We asked Anna Mamonova, lawyer of the Advokat Agency, and Elena Tsypina, lawyer of the Chamber of Advocates of the Chelyabinsk Region, to explain some points of the document to the parents.

   Who should teach young patients?

   1. First-level hospitals provide patients in a particular municipality with primary health care, palliative care, emergency medical care and specialized care, usually pediatric and surgical profiles. Most often, children are in them for less than three weeks. The number of schoolchildren who need longer treatment is from 1 to 10 at a time. In this case, it is advisable to educate the child in a school at the place of residence.

   2. In hospitals of the second level, providing medical care to the population of several municipalities, from 30 to 100 children can simultaneously receive long-term treatment; in third-level hospitals providing high-tech medical care – from 30 to 250 children and more.

   In hospitals of the second and third levels, training can be organized according to several models. They are listed in the Recommendations, and the lawyer Anna Mamonova spoke in more detail about them. Patient education can include:

   • educational organization operating on the basis of a medical organization. This is an ordinary general education school that has concluded an agreement with a medical organization for the provision of educational services;
   • educational organization for students who need long-term treatment. This is a specialized organization that can be determined by the regional executive authority in the field of education;
   • educational unit of a medical organization that has a license for educational activities. “In the recommendations, they are called hospital schools, which is not entirely correct, since this term was used in pre-revolutionary Russia to designate medical schools,” Anna Mamonova noted.

   According to the lawyer, the types of educational organizations in the Recommendations are not clearly defined. For example, in the Letter of the Ministry of Education and Science dated May 27, 2016 No. VK-1179/07 “On additional clarifications”, they are indicated in a more accessible form. According to this document, children in need of long-term treatment can receive general education: 1) in an educational organization at the place of residence of the child in which he is enrolled, including using distance technologies; 2) in the educational unit of a medical organization providing treatment, rehabilitation and health improvement; 3) in a subdivision of an educational organization located in the premises of a medical organization; 4) in a nearby educational organization – in this case, children are taught by teachers who come according to the schedule.

   According to the Recommendations, if several hospitals of the same or different levels operate on the territory of the municipality, it is advisable to educate children in one school for students in need of long-term treatment.

   The education of a child who has been treated in a hospital for less than 21 days is carried out by the school of which he is a student. But if a short stay of a schoolchild in a hospital is one of the periods in a long-term treatment, then he can learn in the same way as children who are in the hospital for more than three weeks.

   Lawyer Elena Tsypina drew attention to the fact that for a child, training by the staff of the school he attended would most likely be more comfortable. But at the same time, in the Recommendations, the patient and his parents retain the right to choose an organization that carries out educational activities. And we can assume that children who are on short-term treatment also have such a right.

   How to improve the learning process during a short hospital stay?

   If necessary, the school that the child attended before the illness must arrange for his education in the hospital or at home ^hospital.
   

   Together with parents, they should be documented (for example, in an act of agreement, agreement of the parties, etc.):

   • form of study and individual curriculum, class schedule and mode of study;
   • special educational needs due to the child’s medical treatment and current health condition;
   • how parents inform the school about the transfer of the patient to hospitals and about the “hospital school”, whose teachers teach the child in the hospital;
   • the need to inform parents about learning outcomes and adjustments to the individual curriculum;
   • forms of social support for a sick child by participants in the educational process.

   Anna Mamonova warned: “As follows from the Recommendations, the school in the child’s place of residence is obliged to take all necessary measures to implement educational programs. That is, the organization of the educational process in the case of short-term treatment in a hospital or treatment at home is the responsibility of the school. However, parents should be prepared to interact with teachers, including ensuring that the child receives the necessary educational materials, homework, etc.”

   Elena Tsypina added that if a child can only study at home, then parents should obtain the conclusion of a medical organization on the need to educate a child at home and apply to an educational institution. If the child is being treated in a hospital, then parents will need to choose the type of educational process by submitting an application to the administration of the medical institution.

   How is the lesson in the hospital?

   When organizing the learning process in the hospital, the class-lesson system is more often used. However, the scheme “one age – one class – one program of study – one year” changes in the conditions of treatment, and it is allowed to teach children in different age groups.

   At the same time, sanitary rules often do not allow bringing together children from different departments in the same room, and therefore a single school sector cannot be organized for them. Classes can take place in hospital wards and boxes.

   For some diseases, in order to avoid transmission of infection, teachers use materials not on paper, but on electronic media – tablets or laptops, which are treated with disinfectants before and after classes.

   The mode and duration of classes are determined on the basis of the recommendations of the attending physician, taking into account the psychophysical state of the child, his cognitive abilities and life limitations. The maximum total weekly educational load cannot exceed the indicators established by the sanitary and epidemiological rules and regulations ⁴ .

   Education of schoolchildren in hospitals, as well as at home, is carried out according to individual curricula. They are developed and approved by the educational organization that trains the child, and agreed with the attending physician and parents. When studying according to an individual plan, the schedule of classes and the volume of the study load may be changed by the educational organization, taking into account the current state of the child’s health and the treatment prescribed for him.

   Can siblings study with patients?

   The Recommendations provide for situations when, due to long-term care of a child in a hospital, the family is far from home, and none of the children can attend school. In such cases, those responsible for organizing the educational process of schoolchildren are recommended, after agreement with the attending physician, to find an opportunity for their brothers and sisters to study together with sick children.

   Anna Mamonova explained that “although the Recommendations are not binding, they represent the legal position of the leadership of the Ministry of Education and the Ministry of Health. This means that, for example, in the event of a refusal to ensure the child’s right to education, parents must file a complaint with higher authorities, and it is highly likely that it will be satisfied. However, it should be borne in mind that joint education of sick children and their healthy siblings is not possible when the child is sick with an infectious or other dangerous disease and there is a threat to the health of the second child.

   What are the legal rights of school patients and their parents?

   The child and his parents have the right to choose an educational organization whose teachers will teach the student during treatment.

   “If the right to such a choice is limited, then it is necessary to apply to the leadership of the educational institution with a statement in which you should describe the situation and state your position with reason,” Elena Tsypina explained. Anna Mamonova added that if the organization of the educational process does not meet the requirements, parents can file a complaint with the regional executive authorities in the field of education and health care and the prosecutor’s office.

   According to the Recommendations, prior to the start of training, the patient’s parents should be asked to sign the consent:

   • informing teachers about the child’s illness and side effects during treatment, about the peculiarities of his emotional state, which should be taken into account in the learning process;
   • about informing about what information about the patient’s health and in what cases can be transferred to classmates, the parent class committee and others for the social support of the child during treatment.

   “Parents are not required to sign such consent. In this case, the rule of law will apply, according to which the dissemination of information constituting a medical secret is unacceptable ⁵ . If this rule is not observed, the medical organization may be held administratively liable, and the person who disseminated the information may be subject to disciplinary, civil or criminal liability,” Elena Tsypina said.

   Employees of educational and medical organizations should respect the position of the child and his parents when refusing to share information about the disease with anyone. Information about the child’s health can be transferred to outsiders only with the written consent of the patient or his parents, if he has not yet turned 15, as well as in cases provided for by law.

   Elena Tsypina gave examples of such cases: “The provision of information constituting a medical secret is allowed when providing medical assistance to a minor in order to inform his parents; for the purpose of examining and treating a patient who, due to his condition, is unable to express his will; with the threat of the spread of infectious diseases, mass poisoning and lesions; when investigating an accident at school, during competitions or playing sports in the section; at the request of the bodies of inquiry and investigation, the court in connection with the investigation or trial, at the request of the prosecutor’s office in connection with the exercise of prosecutorial supervision; when exchanging information by medical organizations in order to provide assistance, taking into account the requirements of the legislation of the Russian Federation on personal data; in order to exercise control in the system of compulsory social insurance, as well as control the quality and safety of medical activities, etc. ⁶ “.

   Anna Mamonova recalled that the rights and obligations of parents are spelled out in Art. 63 and 64 of the Family Code: “Parents are obliged to raise their children and ensure that they receive a general education. At the same time, they are given the right to choose an educational organization and form of education, taking into account the opinions of children. Parents are also obliged to protect the interests of the child. If he complains about the conditions of his stay in the hospital or about the attitude of the medical or teaching staff, they have no right to ignore such complaints and must make sure that everything is in order.

   How to organize training after discharge from the hospital?

   During illness, a student cannot be expelled from school ⁷ . Anna Mamonova explained: “The application of disciplinary measures, including expulsion from school, to students during their illness is not allowed due to the requirements of the Law on Education. Moreover, the educational organization must ensure a psychologically comfortable return of the child to the previous class, taking into account the changes in appearance, physical, cognitive abilities and other changes that have occurred in him after the illness, which distinguish him from his peers, and also create conditions for continuing education, taking into account the state of health student, the recommendations of the attending physician and the characteristics of the treatment, rehabilitation, health-improving process.

   Elena Tsypina said that in the event of serious health problems, the educational institution should send the child to undergo a psychological, medical and pedagogical commission, which will determine the type of correctional educational institution where he can continue to study.

   As stated in the Recommendations, after discharge from the hospital, children with diseases included in the List of diseases, the presence of which gives the right to study in basic general education programs at home, can study at home ⁸ . It may also be allowed to study at home based on the decision of the medical commission of the medical organization in which the child is observed ⁹ .

   Education of a student after long-term treatment can be carried out in various forms: full-time, part-time, part-time, including using distance learning technologies. In e-learning, schools are recommended to appoint a tutor to accompany the child in person.

   How will the attestation take place?

   At the end of a long-term treatment, the “hospital school” issues a certificate of study to the patient with marks for each academic subject. The school at the place of residence is obliged to accept this document and count the learning outcomes based on it, or admit the student to the intermediate or final certification ¹⁰ .

   The basis for passing the state final certification at home or in a hospital is the conclusion of a medical organization and the recommendations of the psychological, medical and pedagogical commission.

   Recommendations of the Ministry of Health and the Ministry of Education must be followed?

   Anna Mamonova explained that the Recommendations are not a normative legal act, and therefore cannot be considered binding. “They are more of a road map to address the very urgent problem of education for children in long-term care. This confirms the fact that the document indicates the need to develop and adopt regulations at the regional level and says that there are no legislative mechanisms for regulating educational activities that take into account the specifics of teaching children in hospitals. All these issues require proper legal regulation,” the lawyer said.

   At the same time, Anna Mamonova drew the attention of parents to the fact that the right to education is guaranteed by Art. 43 of the Constitution of the Russian Federation. Any unreasonable restriction of it, including in connection with the state of health, is a gross violation. “Therefore, in case of problems, do not lose self-confidence and self-control and immediately seek protection of your rights and the rights of the child,” the lawyer advised. Elena Tsypina concluded by explaining that one can apply to the regional executive authority in the field of education, the prosecutor’s office and the court – the choice will depend on the situation.

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   ¹ Federal Law of December 29, 2012 No. 273-FZ “On Education in the Russian Federation”.

   ² Methodological recommendations on the organization of education for children who are on long-term treatment and cannot attend educational organizations for health reasons (approved by the Ministry of Education of the Russian Federation and the Ministry of Health of the Russian Federation on October 14 and 17, 2019).

   ³ Part 5 Art. 41 of the Federal Law of 29December 2012 No. 273-FZ “On Education in the Russian Federation”.

   ⁴ SanPiN 2.4.2.2821-10 “Sanitary and epidemiological requirements for the conditions and organization of training in educational institutions” (approved by the Decree of the Chief State Sanitary Doctor of the Russian Federation of December 29, 2010 No.