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  • Writer's pictureIra Hays

Overcoming School Phobia: How Exposure Response Prevention and DBT Skills Empower Youth to Access Ac


School phobia is often misunderstood and is misdiagnosed. Many believe that school phobia and school refusal are the same although many differences exist. The following article addresses school phobia which is a complex anxiety disorder that affects children and adolescents. It is characterized by a strong aversion or fear of attending school due to various factors, such as separation anxiety, social anxiety, performance anxiety, or specific traumatic experiences. School phobia can lead to academic, social, and emotional challenges, making it crucial to address the underlying issues effectively.


ERP is a well-established cognitive-behavioral therapy technique used in the treatment of anxiety disorders. It involves gradual exposure to the feared situation (in this case, attending school) and preventing the usual avoidance behaviors that maintain the anxiety. ERP helps individuals confront their fears in a safe and controlled manner, allowing them to build tolerance and resilience.




In the context of school phobia, ERP involves a step-by-step approach, starting with exposure to school-related stimuli. Therapists and educators work collaboratively to create a supportive environment that gradually introduces the student to school routines and settings. As the individual's anxiety diminishes, they can begin attending school for increasing durations or in the presence of other triggering stimulus until regular attendance is achieved.


Dialectical Behavior Therapy (DBT) is an evidence-based treatment developed to address emotional dysregulation and improve interpersonal skills. Emotions play a significant role in school phobia, as fear and anxiety can often lead to overwhelming emotional responses. DBT equips individuals with essential skills to manage and navigate these emotions effectively.



DBT skills, such as mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness, can be particularly beneficial for individuals struggling with school phobia. Mindfulness helps students stay present in the moment, reducing anxious thoughts about past or future events. Distress tolerance enables them to cope with distressing situations without resorting to avoidance or harmful behaviors. Emotion regulation skills empower individuals to identify, understand, and manage their emotions, preventing them from becoming overwhelming. Interpersonal effectiveness equips students with communication tools to express their needs effectively, fostering healthy relationships with peers and teachers.




Combining ERP with DBT skills creates a powerful therapeutic approach for treating school phobia. Although we may avoid combining these skills in treating OCD or other specific anxiety disorders, it’s our experience that marriage works well for addressing school phobia. ERP helps students confront their fears about attending school, while DBT equips them with coping strategies to manage emotional responses throughout the process. This synergy ensures a comprehensive and holistic treatment experience that addresses the underlying anxiety and emotional regulation issues.



Overcoming school phobia requires a thoughtful and personalized approach that considers the unique challenges faced by each individual. Through Exposure Response Prevention and Dialectical Behavior Therapy skills, students can build resilience, regulate emotions, and gain confidence to attend school with reduced anxiety. Remember, seeking professional help and support is essential for the most effective outcomes. Together, we can break the barriers of school phobia and promote mental well-being for all.

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