Explain school refusal plan and possible SSRI to parents — CASC communication station

Open. Name role and time; ask priorities (certificate, medication fear, guilt). [6]

Explain. “Missing school has become a pattern that briefly turns the anxiety alarm down, so the brain learns school is dangerous. That is school refusal — a behaviour we can reverse. It is not laziness and not simply bad parenting.” Functional analysis in plain language: fear of school/separation plus home comforts can both maintain the pattern.[1]

CBT and school. “Treatment is small, supported steps back into school with coping skills — not throwing them in the deep end without a plan. Your role is coach: fewer last-minute cancellations, more planned steps we agree with school.” Caregiver training supports outcomes.[5][6]

Certificates. “If they are truly unwell for a short time we can document that, but a certificate for the rest of the year usually makes return harder. We need dates and a graded plan.” [1][6]

Medication. “If anxiety stays high, an SSRI such as sertraline can help the alarm settle. A large study found therapy plus sertraline helped more young people with anxiety get much better than either alone or placebo. Another school-refusal study found adding fluoxetine did not clearly beat good CBT alone for attendance — so medicine is for the anxiety/mood problem, not a magic school pill. We start low, go slow, review early.” [2][3]

Safety monitoring. “A small number of young people can feel more agitated or have new thoughts of self-harm when antidepressants start. Uncommon but important — we watch closely and you contact us urgently if mood or safety changes.” [4]

Close. Summarise, teach-back, crisis contacts, school meeting date, next CBT session, medication review if started. [6]