Educational Psychologist CPD on Emotionally Based School Avoidance (EBSA)

When a child or young person experiences such intense anxiety that attending school becomes overwhelmingly difficult, this is commonly referred to as "school refusal" by different professionals. However, this term can be stigmatizing and misleading for both parents and students alike, because it suggests that the act of avoiding school is a conscious ‘choice’ they are making rather than reflecting the extremity of emotion behind this and the attempts to avoid the school environment being a natural coping strategy. In response to these concerns, alternative terms like "emotionally-based school avoidance" (EBSA),
“Emotionally Based School Non-Attendance” (EBSNA), or "anxiety-related absence" are gaining popularity, as they offer a more accurate description that acknowledges the emotional and psychological factors at play.

Understanding the differences between "school refusal," "truancy," and "persistent absenteeism" is incredibly important for parents, teachers, and healthcare providers alike. More often than not, what we currently see is that when the term "school refusal" is used, this is typically linked to emotional distress or anxiety, while the term "truancy" is used more when there are other reasons to miss school which are not associated with anxiety. On the other hand, "persistent absenteeism" is a broader term that encompasses any frequent absence from school, whether it is excused or unexcused, and may or may not be related to emotional or psychological issues.

If you're interested in learning more about how important terminology can be, see:

https://www.edpsyched.co.uk/blog/ebsa-vs-school-refusal-understanding-the-difference

https://www.edpsyched.co.uk/blog/ebsa-terminology-a-guide-for-school-staff

The EBSA Horizons course for Educational Psychologists, seeks to continue to build on the shift in the narrative, moving away from the language of school refusal, and to present an alternative model of EBSA, in which the child's voice is at the heart of assessment and intervention, and emphasis is placed on understanding EBSA in the context of interacting, child, home and school-based factors.

• EBSA Horizons Training: The EBSA Horizons course is in eLearning format, broken down into five core modules to increase knowledge and skills across key areas relating to EBSA and the role of the Educational Psychologist. Each core module encompasses a series of subchapters, containing short animated videos, which you can view at your own pace.
• EBSA Horizons Assessments: There are a range of assessment approaches presented during the course, including a number of child-friendly resources that can be utilised directly in your psychological assessments with a child in order to access the child’s voice and to provide a functional analysis of the EBSA from the perspective of the child. As well as a comprehensive guide to the EBSA Horizons Risk and Resilience Profiles which enable exploration and analysis of pertinent factors at the level of the child, home and school to identify where interventions and strategies can have the greatest positive impact.
• EBSA Horizons Strategies: A detailed look at a range of evidence-based and practice-based strategies, alongside practical support to consider the requirements of a graduated return to school and the psychological underpinnings of such an approach. Interviews with a Parent and previous EBSA pupil to hear and understand what has helped to make the difference in their lives.

EBSA Horizons provides two day's condensed CPD / training. 

To get the most from EBSA Horizons, we'd suggest scheduling in two and a half days in your diary, giving the opportunity to reflect and consolidate knowledge as you move through the course.

EBSA Horizons gives you a year's access to all training and content. This gives you the chance to use EBSA Horizons for not just initial CPD development, but to return and use as a reference guide over time. 

EBSA Horizons Contents

Brief Introduction

• Getting Started with EBSA Horizons (how to use?)

1.   An Introduction To EBSA

1. What is EBSA & EBSA as a spectrum of need
2. Prevalence of EBSA
3. EBSA vs. other forms of non-attendance
4. Anxiety as a defining feature of EBSA
5. Moving beyond a within-child model of School Refusal
6. Pause and Reflect activity
7. CYP Interview 1 (discussing experience of EBSA) 

2.   Understanding EBSA Over Time

1. The Anxiety Cycle and EBSA
2. When stress exceeds support 
3. EBSA Over Time
4. Integration of models of anxiety and profiles of risk
5. Pause and Reflect
6. Parent Interview 1 (discussing early warning signs of EBSA)

3.   Understanding and Identifying The Functions Of EBSA

1. Creating a shared narrative

2. Working with Child and Young People

   2.1 Working with Child and Young People Pt 1

    2.2  Working with Child and Young People Pt 2

3. The School Wellbeing Cards: Introduction

   3.1  The School Wellbeing Cards: Cart Sorting Activity

   3.2  The School Wellbeing Cards: A Model of Active Collaboration

   3.3  The School Wellbeing Cards: Employing Active Listening Skills

4. Working with Parents / Carers

   4.1  Working with Parents / Carers

   4.2  Understanding Parent/Carer anxiety and EBSA

5. Parent Interview 2 (impact and consequences of EBSA for the child and the family)

6. Working with Schools

7. EBSA Risk and Resilience Profile

4.   Functional Analysis and Action Planning

1. Action Planning
2. Systematic Desensitisation
3. Constructing an Avoidance Hierarchy with a CYP
4. Constructing an Avoidance Hierarchy: The Habituation Cycle
5. Constructing an Avoidance Hierarchy: The Ladder of Strength and Courage 
6. Parental Perspective: Building Outwards From Home

5.   Supporting A Return To School and Stabilising School Placements 

1. Research on Effective Intervention
2. Introduction to Strategy Grids
3. Strategy Grid: Child Factors
4. Strategy Grid: School Factors
5. Strategy Grid: Home Factors
6. Coronavirus and EBSA
7. Ecological Systems Model of EBSA

6.   Supporting Autistic CYP Experiencing EBSA

1. Introduction To The Research Literature About ASC And EBSA
2. The Ideal School: Exploring Perceptions Of Autistic Students Experiencing EBSA
3. Pupil View Of EBSA: The Perspective Of Autistic Adolescents
4. Research On The Parental Experiences Of A Successful Return To School
5. Q&A with guest Educational Psychologists
6. The Parent Perspective: Interview With Sarah Banks
7. The Child Perspective: Interview with a Young Person
8. Chapter Summary and Reflections

7.   Entrenched EBSA

1. Motivational Interviewing and its application to EBSA
2. Cycle of Change model: A CYP friendly version
3. Motivational Interviewing and EBSA Resource pack

4. An interview with a CYP using MI Principles

5. Interview with Dr Naomi Fisher - Part 1: Home Education
6. Interview with Red Balloon - Alternative Provision for CYP experiencing EBSA
7. Lived experiences of effective support for autistic young people who have experienced extended school nonattendance

8. Interview with Dr Naomi Fisher - Part 2: The needs of CYP experiencing entrenched EBSA and the application of psychological models.

9. Chapter Summary and Reflections

8.   The Systemic Change Model of EBSA

1. Raising Awareness
2. Early Identification
3. Child Centred Approaches
4. Multi-Agency Response

The EBSA Risk and Resilience Profiles is a practical, evidenced-based tool that enables exploration of pertinent risk and resilience factors across the three key areas of: the child, the home, and the school context through a questionnaire format.

The main purpose of the tool is to:

1. Identify pertinent risk factors, that may be contributing to and maintaining the EBSA, and will therefore need to be targeted and reduced
2. Identify resilience factors, that strengthen and protect a child’s wellbeing and school attendance, which will need to be further harnessed

To accompany the EBSA Risk and Resilience Profiles, a fully automated excel scoring and analysis proforma is provided, enabling psychologists to convert the questionnaire data into a series of spider diagrams, providing a powerful visual illustration of the inter connection between risk and resilience across the child, home and school domains and to facilitate action planning.

The EBSA Risk and Resilience Profiles are applicable for all children across the spectrum of need, whether this is to provide insight into the risk and resilience profile of a child who is only just beginning to show the early warning signs of EBSA, all the way through to children whose non-attendance is chronic and persistent. There are also significant advantages to using the tool as a risk profiling and screening tool, in order to further facilitate early identification and intervention.

EBSA Horizons Resources

There is an EBSA Horizons Course activity pack, with reflective activities to facilitate learning throughout the course, as well as signposting to key resources. In addition to the EBSA Horizons Risk and Resilience Profiles, there are also a number of additional resources to facilitate your practice as an Educational Psychologist. For example,

• The EBSA Horizons Whole School Audit is an assessment and reflective tool to demonstrate thinking and the development of school practice over time. The intention of the tool is to facilitate long term systemic change in school provision, and the support for children and young people who experience EBSA.
• A visual summary of the Understanding EBSA over time model
• A visual summary of the Integrated Model of EBSA
• Thoughts, Feelings, Bodily Sensations & EBSA – child-friendly model of CBT formulation
• The Ladder of Strength and Courage – a child-friendly version of an avoidance hierarchy
• Action Planning – a visual proforma to record information gathered through assessment
• Case Studies and worked examples
• Resource lists relevant to your work with the child, the family and the school.

Absolutely! Dr Jerricah Holder is an active participant in the EBSA Horizons course community and encourages course participants to ask questions 😊

Although this is an online course, we do still want to promote interaction, collaboration and sharing of practice – so please do look at the descriptive content under each subchapter, where there is also a space to leave comments, share thoughts and reflections and ask questions. We will also signpost and link resources here as well, updating these in response to questions and comments.

Yes! And a lot of your colleagues have already joined!

This course is designed for professionals with experience and background knowledge in this areal and have welcomed many Social Workers, Child and Family Workers, School Nurses and Mental Health Support Teams. When on the course, you’ll find that it covers the key theoretical foundations before moving on to give us the knowledge and tools to extend upon our current practice and further improve outcomes for CYP. If you join and find that it’s not meeting your needs / expectations, we’re always happy to provide a refund.