From Year 5 onwards, and sometimes earlier, attending school camp becomes a regular activity for school students in Australia. A vast array of school activities involve camps as a core part of their program, including educational field trips, music/band camps, sport camps and tours, and outdoor education programs. For many children, attending camp poses few, if any, emotional challenges. For some students, however, camp attendance raises genuine difficulties that cause significant distress to the student and their parents, and the staff who have to care for the student during camp.
Non-attendance is problematic for at least two reasons. First, these students miss out on the important educational opportunities that camp affords. Such benefits will usually include those derived from the educational component of the camp, but also from the opportunities to form and develop social and emotional competencies beyond the usual school environment. Second, camp non-attendance is usually an indication of some form of broader social and/or emotional difficulty which, if not properly managed, may become more entrenched over time (Byrne & Rosen, Reference Byrne and Rosen2015). For this reason, early and comprehensive intervention by the school psychologist is advisable.
In addition to camp refusers, there are students who ultimately attend the camp, but present as distressed while on camp. Typically, these students may engage in many camp activities but have episodes of significant distress during the course of the camp. Such students may withdraw from activities, cry, exhibit psychosomatic symptoms, express feeling homesick and missing home and parents, plead with teachers to call or text parents to say goodnight, and display protracted sleep onset. In our experience of a Sydney suburban independent boys’ school with approximately 1,600 students (K–12) where camps are a compulsory part of the educational curriculum at least once a year from Year 3, approximately 5% of eligible students either refuse to attend camp or are reluctant attenders.
Despite the fact that school psychologists work with students who are distressed about camp attendance, either before or during camp, there is surprisingly very little that has been written about it. The purpose of this article is to review and integrate existing and related literature in an effort to make explicit the role that a school psychologist can play.
Understanding Camp Refusal and Reluctance
There are a number of related bodies of knowledge that are helpful for school psychologists to draw upon when assessing and intervening with these students and families. We outline here the contributions made in three areas: anxiety, school refusal, and homesickness. A knowledge of such areas can guide the school psychologist in developing a formulation of the presenting case.
Anxiety
School psychologists should consider the possibility of anxiety disorders within school camp reluctance. Anxiety disorders are common in children and adolescents, so camp anxiety could be embedded within a broader anxiety difficulty. Lifetime prevalence of anxiety disorders in young people is as high as 15–20%, with girls showing rates twice as high as boys (Beesdo, Knappe, & Pine, Reference Beesdo, Knappe and Pine2009; Merikangas, Nakamura, & Kessler, Reference Merikangas, Nakamura and Kessler2009). Separation anxiety, social anxiety, and specific phobias are the most common forms of anxiety in young people (Beesdo et al., Reference Beesdo, Knappe and Pine2009; Merikangas et al., Reference Merikangas, He, Burstein, Swanson, Avenevoli, Cui and Swendsen2010), and any of them could account for a student's camp reluctance. For instance, most specific phobias begin before the age of 8 years (Becker et al., Reference Becker, Rinck, Türke, Kause, Goodwin, Neumer and Margraf2007), and two of the most common specific fears in young people relate to animals and the environment (Kim et al., Reference Kim, Kim, Cho, Kim, Shin, Yoo and Kim2010) — both of which could fuel camp reluctance. Lifetime prevalence of specific phobia by adolescence is as high as 19.1% (Merikangas et al., Reference Merikangas, He, Burstein, Swanson, Avenevoli, Cui and Swendsen2010). There may be some anxiety related to a chronic health difficulty such as asthma, diabetes, epilepsy or other chronic illness (McCarthy, Reference McCarthy2015). The student may experience generalised anxiety about his or her safety or that of family members while they are separated. Anxiety disorders are particularly common in children with an autism spectrum disorder (ASD), with specific phobia, obsessive compulsive disorder and social anxiety being the most prevalent combinations (Van Steensel, Bogels, & Perrin, Reference Van Steensel, Bögels and Perrin2011). Management of children with an ASD on school camp becomes a particular challenge for school personnel and requires forethought and consultation with the child's family to have appropriate preparations in place.
School Refusal
School refusal literature has a solid base that can inform the school psychologist on the management of camp reluctance or non-attendance (Kearney, Reference Kearney2008a). This literature identifies school refusal as a multifaceted problem. Prevalence of school refusal is hard to quantify given the lack of consistency around definitions, although best estimates are around 5% (Egger, Costello, & Angold, Reference Egger, Costello and Angold2003; Kearney, Reference Kearney2008a). School refusal can be driven by two distinct processes. There is non-anxiety-based, surreptitious and wilful non-attendance such as truancy, due to behavioural or academic difficulties or absenteeism stemming from family-based problems such as homelessness or poverty. Then there is school refusal that is anxiety driven (Chu, Rizvi, Zendegui, & Bonavitacola, Reference Chu, Rizvi, Zendegui and Bonavitacola2015; Kearney, Reference Kearney2008a; Sewell, Reference Sewell2008). This is the more common understanding of school refusal, where a student's absenteeism and difficulty with regular attendance centres around separation from caregivers, generalised anxiety or social anxiety. However, in a large study of young people showing problematic school attendance and attending an outpatient clinic, nearly one-third did not meet criteria for any psychiatric diagnosis such as anxiety, depression or oppositional defiance (Kearney & Albano, Reference Kearney and Albano2004). This suggests that basing one's understanding of school refusal around the presence or absence of anxiety or depression may be missing the mark. More recent work in this area has focused on what function the absenteeism may serve, whether it be avoidance of discomfort, seeking attention of a significant other, or seeking out reinforcers that result from absenteeism, such as increased participation in pleasurable activities (Kearney, Reference Kearney2008a). Furthermore, there are many possible factors that can affect a child's school attendance, connected to the child themselves, their parents, family, school and community (Kearney, Reference Kearney2008b).
Homesickness
Homesickness has been defined as ‘distress or impairment caused by an actual or anticipated separation from home’ (Thurber & Sigman, Reference Thurber and Sigman1998, p. 903). While separation anxiety is primarily anxiety and distress about the departure of the caregiver, homesickness is primarily sadness or depression about separation from various attachment objects (Stroebe, Schut, & Nauta, Reference Stroebe, Schut and Nauta2015). Children who are homesick on school camp do not necessarily display separation anxiety in other contexts such as in school attendance or sport participation. Thurber (Reference Thurber1999) found that preseparation distress among homesick boys attending a summer camp was likely to be a mild anticipatory event and not part of a longstanding pattern of behaviour. Moreover, he concluded that feelings of homesickness at summer camps were the norm rather than the exception, and were strongest when the young person was attending their first camp. In an Australian study of male and female adolescents attending a year of boarding in an Outward Bound context, rates of homesickness six weeks into the year were higher for new students (91%) than for previous boarders (76%) and previous day students (59%). The authors hypothesised that prior social connections within a novel context may have provided a buffer from higher levels of homesickness experienced by new students (Fisher, Elder, & Peacock, Reference Fisher, Elder and Peacock1990). Studies of students in boarding schools have found similar levels of homesickness (66–76%), where it was regarded as something to be expected and that would dissipate over time (Bramston & Patrick, Reference Bramston and Patrick2007; Fisher, Frazer, & Murray, Reference Fisher, Frazer and Murray1986; Mander, Reference Mander2012).
Case Study Part 1
Joey is a boy in Year 5 at Pleasant Valley Primary School. Each year Pleasant Valley runs two camps for Year 5 students — one at the start of the year, and one at the end. He was referred to the school psychologist, Jane Smith, four weeks before the end-of-year camp by his mother, Therese. Therese said Joey was already saying that he would not go on the end-of-year camp and that she did not know how to make him go. She told Jane that Joey had not attended the start-of-year camp; that she had called the school to say he was sick, but that, in reality, Joey just did not want to go. Therese told Jane that in the days leading up to the start of year camp, Joey regularly reminded her that he wasn't going on camp — that he hated the sound of the activities, that he hated the sound of camp food, and that he did not want to be away from his X-Box. The night before the departure for that camp, Joey hardly slept and he cried at bedtime, begging his mother to not make him go. In the end, Therese agreed that he did not have to go to camp, and she rang school to say he was sick. Therese called Jane to see how she could help get Joey to attend the upcoming camp.
Assessment
The school psychologist's assessment will involve a clinical interview with the student, their primary caregiver, and their class teacher. It would be helpful to begin with the parent or caregiver and the teacher separately, then use the information obtained as a basis for discussions with the student. It would be advisable for the school psychologist to be cognisant of the possibility that the student's difficulty with attending camp may be a normal, albeit exaggerated, expression of the developmental process, particularly in younger students. In some cases, however, refusing to attend camp or experiencing significant distress while on camp can be a sign of an emotional or behavioural disorder. Hence, a thorough assessment becomes an integral step in developing a greater understanding of a particular child's experience.
The parent or caregiver
During a parent interview, it would be important for the school psychologist to enquire about any health and developmental concerns, such as their child's diet, sleep patterns, any toileting difficulties, any medications that will need to be taken, all of which could fuel concerns about camp. The caregiver would also be asked about any concerns around their child's social and emotional development, the presence of oppositional behaviour, anxiety, separation difficulties, mood fluctuations, experiences of sleepovers and playdates, peer relationships, and earlier disruptions to attachment figures through prolonged separation or trauma. In a broader context, the school psychologist would ask about any current family or marital tension or other stressors (such as illness, recent deaths, financial difficulties) that may help make sense of the student's camp reluctance. The parent or caregiver's reactions to the display and build-up of camp refusal behaviours will be important to investigate. Finally, previous efforts to assist the student around camp refusal or reluctance should be unpacked to better understand why these interventions did not work.
The teacher
The student's classroom teacher can provide information regarding the student's social, emotional and behavioural characteristics at school. For example, he/she is likely to have observations about the student's peer relationships, any behavioural concerns, how the student copes with stress and anxiety, as well as whether they have noticed any changes in the student over the course of the year or in the lead-up to the camp. The classroom teacher will likely also have some information on the student's family background and medical history that may be pertinent to the school psychologist's assessment.
The student
It will be important to ask the student about their own concerns about attending camp. Those concerns may centre on peer relationships, the camp environment, or time away from family. The school psychologist will be looking for any evidence of separation, generalised, phobic or social anxiety, any mood difficulties, and whether the student has any health concerns, including any worries about sleep, diet and toileting. Also worth noting are any similar experiences to camp the student has had and whether they managed their distress with some success, thus providing evidence of strengths that can be tapped into and built upon.
The school psychologist should supplement the interview information with standardised questionnaires, preferably administered to all three informants (child, parent, and teacher). Examples of suitable broad-based behavioural questionnaires include the Behavior Assessment System for Children (Kamphaus & Reynolds, Reference Kamphaus and Reynolds2015), the Achenbach Child Behavior Checklist (Achenbach, Reference Achenbach2009) and the Strengths and Difficulties Questionnaire (Goodman, Reference Goodman2001; Goodman, Meltzer, & Bailey, Reference Goodman, Meltzer and Bailey1998). Given the high likelihood of anxiety being a factor in the child's camp refusal, an anxiety questionnaire completed by the child and the primary caregiver would be helpful. Examples include the Spence Children's Anxiety Scale (Spence, Reference Spence1998), the Multidimensional Anxiety Scale for Children (March, Reference March2013), the School Anxiety Scale (Lyneham, Street, Abbott, & Rapee, Reference Lyneham, Street, Abbott and Rapee2008) and the Revised Children's Anxiety and Depression Scale (RCADS; Chorpita, Moffitt, & Gray, Reference Chorpita, Moffitt and Gray2005). As in any psychological assessment, the choice of which instruments to administer will be hypothesis driven.
The information gathered will help the school psychologist to better understand the expression of camp refusal in the student and its consequences. Furthermore, the school psychologist will have a better understanding of the individual student, their cognitive framework, level of independence, temperament, anxieties and insecurities, experiences separating from their caregivers, social emotional competence, and their ability to self-soothe. Based on the above information, the psychologist will then be in a position to develop a case formulation to guide intervention. Good case formulation will take into account any predisposing factors, current stressors or precipitating factors, perpetuating factors in the student's life, and the student's strengths and protective factors (Winters, Hanson, & Stoyanova, Reference Winters, Hanson and Stoyanova2007). By synthesising all this information, the psychologist will be in a position to develop an intervention plan to support the student, the parents and the teachers.
Case Study Part 2
Before meeting with Therese, Jane wanted to hear from Joey's teacher, Mr Jones. Mr Jones reported that he had no particular concerns about Joey in class — that he was a capable student who had a small but stable group of friends, was well behaved, but at times reluctant to ask questions in class. He reported that he had met Therese on numerous occasions and that she seemed a kind and caring mum. His only report of concern was that Joey seemed to be away from school quite often, although there were no particular medical difficulties noted on the school medical form.
The next day, Jane met with Therese to get a more detailed account of her concerns for Joey. Therese reported that she was a single parent, having separated from Joey's dad four years earlier. She had one other child, Jess, who was in Year 8. Joey's dad had moved interstate and had very little contact with his children. At home, there was no evidence of behaviour difficulties or defiance, although Therese said Joey frequently became argumentative when she tried to get him off the X-Box. Therese's parents lived up the coast and the family visited them regularly on holidays. Otherwise, there were no significant events in Joey's earlier life history and no history of medical problems. Jane asked about any history of anxiety. There was no evidence of specific fears or generalised anxiety. However, Therese said that Joey did not like being away from her for any extended period of time and said that quite often at night he would come into her bed, wanting to sleep with her, to which she acceded. At preschool as well as kindergarten, Joey had some ‘tantrums’ at the gate, refusing to go in, and on a few occasions she had given in and taken him home. Over some weeks, he slowly seemed to settle into his school routine, but usually after Joey's dad had taken on the role of school drop-offs. She said that on a few occasions he had been invited to sleepovers, but despite some initial enthusiasm, had never actually been able to sleep over a whole night. The closest he had come was a few months ago when he agreed to sleep at his friend Ted's house, but Ted's parents called at 11 pm to say Joey was feeling unwell and should be picked up. Although Joey had no trouble ‘sleeping over’ at his grandparents’ house, Therese was always there too.
Having heard from Therese and Mr Jones, Jane next met alone with Joey. He presented as a personable boy, although he appeared somewhat reluctant initially to answer Jane's questions about camp. Joey confirmed to Jane that he got on well with other kids in his class and that he had no social concerns about attending camp. Similarly, he said that he had no particular fears regarding the activities of camp, nor about spiders, snakes or bugs. It was when Jane spoke with Joey about the sleepover at Ted's house recently that he became teary, and said he couldn't explain it, but he just doesn't like being away from home or his mum and sister. In fact, he said he wanted to go on camp, but was worried that he would miss his mum or that something bad would happen at home while he was away. He also said that he was worried that he would cry on camp and other kids would call him a ‘baby’. He said that whenever he felt worried or anxious, he went to his mum and she always ‘made him feel better’. Joey agreed to meet again with Jane to talk about how they might help him get on camp this year. Jane asked both Joey and his mum to complete a Revised Children's Anxiety and Depression Scale (RCADS). Both returned elevated scores on the Separation Anxiety scale, mildly elevated scores on the Social Anxiety scale, but no other scales, including the Depression scale, were of concern. On the basis of her assessment, Jane concluded that Joey's camp reluctance stemmed from a previously unacknowledged separation anxiety. Although she was not optimistic she could turn things around in the next four weeks, she set about formulating a plan.
Intervention
From the case formulation, the school psychologist meshes what has been learned during the assessment with the evidence-based interventions available. The reality is that a range of strategies are likely to be needed to assist a child who is a camp refuser or reluctant attender. These strategies are likely to be multimodal and target different participants (student, peers, camp caregivers, parents) at different times (Thurber, Reference Thurber2005; Van Tilburg, Vingerhoets, & Van Heck, Reference Van Tilburg, Vingerhoets and Van Heck1996). We have found it beneficial to consider intervention in at least five distinct areas — early identification strategies, school-based interventions before camp, student-based and parent-based interventions, and interventions made during camp.
Early identification strategies
It is likely that many schools would already take steps at the enrolment stage or early in an academic year to help prepare school staff members for possible difficulties at camp time. For instance, medical enrolment forms can include questions about any emotional health concerns around the future student's experiences of separation anxiety, or specific fears or bouts of homesickness. A message can be included in the school newsletter at the start of the year asking parents to inform the class teacher if there are any concerns about adjustment to school camp. This could also be included in the camp note that goes home to parents.
School-based interventions
These interventions refer to what school staff — frequently teachers in consultation with the school psychologist — can do to help reduce anxiety that reluctant camp attenders may experience. Theories of homesickness that highlight the importance of peer social support and connectedness would suggest that teachers can assist the reluctant camp attender by ensuring they have a say in which students share their cabin and their camp activities (Thurber & Sigman, Reference Thurber and Sigman1998). The student would also be able to choose a buddy for bus travel to and from the camp. The class teacher can also set up with the student a ‘go-to’ teacher who they would feel most comfortable to approach for support during camp. Thurber and Sigman (Reference Thurber and Sigman1998) also suggest familiarising the student with the novel camp experience prior to separation. This would involve the class teacher sharing with all students the camp website, showing the range of activities on offer, the type of student accommodation, the food that will be available and so on. Parallels could be drawn with prior camps, if relevant, to increase familiarity. This latter strategy can be delivered at a class level to further normalise the familiarisation process. Showing the student videos or photos of the camp from previous years may be a particularly helpful way to familiarise the student with what to expect during camp. The school psychologist can assist teachers prior to camp by clarifying a method of response to the reluctant student's distress that all staff members would use.
Student-based intervention
The aim of these interventions is to provide the student with skills and strategies that they can use in the lead-up to and during the camp to better cope with their own distress about camp attendance. The school psychologist (or a clinician based in the community) can support the student by coaching them in strategies that can help to manage their emotional control while on camp, especially during the evening and at bedtime. Strategies drawn from cognitive behaviour therapy (CBT) and dialectical behavior therapy (DBT) approaches to distress tolerance for school refusal are particularly suitable (Chu et al., Reference Chu, Rizvi, Zendegui and Bonavitacola2015; Ek & Eriksson, Reference Ek and Eriksson2013; Kearney, Reference Kearney2008a; King, Heyne, & Ollendick, Reference King, Heyne and Ollendick2005; Silverman, Armando, & Viswesvaran, Reference Silverman, Armando and Viswesvaran2008; Pina, Zerr, Gonzales, & Ortiz, Reference Pina, Zerr, Gonzales and Ortiz2009). They can be taught to the student or identified in the weeks leading up to camp and then practised by the student prior to camp so that they are more familiar tools when needed on camp. CBT strategies have included psychoeducation, coping thoughts, graded exposure, and parent management techniques. Other strategies include the use of mindfulness exercises; listening to music to reduce stress; coaching the student to recognise that feelings will come and go in surges and that these surges can be ridden imaginatively like a wave; maintaining connection with friends and joining in activities that provide distraction; talking to a friend or the ‘go-to’ teacher; using cognitive strategies, such as recognising faulty thinking or using positive affirmations; having a soothing small toy from home that can be held in the pocket during the day or held close at bedtime; or having the student write a message to the family in a journal that can be shown to them on return home.
Parent-based interventions
The school psychologist can assist the student's parents by advising them about how to respond to their child's anti-camp sentiments. Parents can validate their child's negative feelings about camp without holding lengthy conversations. They can resist being drawn into discourse about the negativity of camps, in this way closing down discussion that otherwise would provide the student with opportunity to air their grievances. In addition, the parents can assist with graded exposure to separation by providing opportunities for overnight stays in the months leading up to a camp. Parents can also be coached on how to manage their child on the morning of departure for camp. This can be achieved by allowing additional time in the morning for dealing with avoidance behaviours, driving the student to school to make the camp bus, prearranging with the class teacher to meet the student at the drop-off zone, or even having a friend take the student to school on the morning of camp. It would be beneficial for the parent or caregiver to normalise homesickness during discussions and let the child know that many children miss something about home when they are away. Parents should also show enthusiasm for the camp experience and optimism that their child has many things to try to feel better if they become distressed. Parents should avoid comments that sound ambivalent or anxious, such as ‘I hope you will be okay’ or ‘I hope you'll like the food there’. Rather, they should be encouraged to display confidence in the camp and in the student's ability to cope, even if they experience some distress (e.g., ‘You'll enjoy being with your friends’; ‘There'll be some fun activities’). It is important that parents do not plant the idea that the distressed student can be collected if they are unhappy on camp (Thurber & Walton, Reference Thurber and Walton2007). A ‘pick-up’ deal decreases the chances that the reluctant attender will have a successful camp attendance and also places the school staff in a difficult position. Similarly, parents should agree that allowing students to take mobile phones on camp is only likely to increase the student's distress and undermine the likelihood of success. Parents and students planning a special meal for the first night home from camp, as an acknowledgement and celebration of the student's courage and achievement, adds some extra motivation for the student.
Interventions during camp
We have already noted that there could be a ‘go-to’ teacher for the student. This teacher, along with all camp staff, will have been coached in how to support the student by validating their distress and offering encouraging messages, including reminders of the distress tolerance actions. The student will have a range of predetermined tools, as listed above, that can be used to self-regulate distressful emotions. These can be employed by the student as needed, but a teacher may need to remind the student to use them in moments where they seek support or it is noticed they are distressed. The response from teachers would include validation of the student's sadness and distress, and normalising homesick feelings. The ‘go-to’ teacher could check on the student at dinnertime, during evening activity, and at bedtime to monitor their distress levels. Expressions of encouragement and optimism that the student will be able to cope with their distress may also be beneficial. It is recommended that there is no phone contact between the student and parents or caregivers, and that the student draws on the support of peers and school staff as needed while he or she rides through their emotions (Thurber & Walton, Reference Thurber and Walton2007). Distraction is a powerful coping tool for students to use when distressed. Accordingly, the ‘go-to’ teacher should encourage the student to throw themselves into the (usually enjoyable) camp activities as a form of distraction.
Recommending a Student Not Attend Camp
While it is preferred that all students attend camps for the variety of benefits that ensue, the school psychologist may recommend that a student not attend a particular camp because it would not be in their best interests to do so. It may be that during previous camps the child's level of distress was so severe that it would be unfair to expect the child to attend the current camp until he/she had developed better skills to regulate their emotion. Furthermore, the demand on teacher time may make it difficult to provide sufficient support to the distressed student as well as others in the group. In this circumstance, it may be best to allow non-attendance and then put interventions in place in the months leading up to the next camp, with the expectation that the student will have a better chance of succeeding at that next camp. In situations where the student's distress is severe enough to warrant a recommendation to not attend camp, the school psychologist should facilitate a referral to an external clinician to further support the child and family. Referral to an external psychologist may also be due to the presence of complex family system dynamics that require the support of a therapist to be available for more intense family intervention. Alternatively, there may be medical issues to address, such as enuresis or encopresis, or a significant sleep disorder. This would require a referral to a paediatrician and/or psychologist who specialises in these areas.
Case Study Part 3
As Jane set about devising an intervention plan for Joey, she was struck by how little time there was to make any effective changes in the four weeks before camp. She made a mental note for next year to review the information about camp that was sent to parents at the start of the year to ensure it flagged any difficulties that may influence camp attendance. She also resolved to always find out early in the year which students did not attend the start-of-year camp and why!
Jane organised to meet with Joey once per week for the next three weeks, including giving Joey ‘homework’ to do between sessions. In the first week she taught Joey some mindfulness-based exercises for coping with anxiety. In the second session they focused on managing negative thoughts (‘I can't cope away from home’, ‘Something bad might happen if I am not there’). And in the third week they had a joint meeting with Mr Jones to discuss some logistics of coping with the camp. Specifically, they established Mr Jones as Joey's ‘go-to’ teacher for when Joey became distressed. When Mr Jones discovered that Joey liked playing Uno, he said he would bring his pack on camp and they could play cards together for a while if Joey needed to be distracted. Joey and Jane showed Mr Jones the cognitive and mindfulness strategies he was learning, to be used on camp week. They also organised that Joey would share a bunkroom with his best friend, Ted, which Joey said might make him feel a bit better about going on camp. They also reviewed some of the camp activities, which even Joey had to admit he thought he might enjoy — especially the sailing.
Jane called an additional meeting with Therese to discuss what she could do to help get Joey off to camp. Jane explained the core role that exposure has in helping kids cope with separation and that Therese should remain firm in telling Joey she expected him to attend camp. She was particularly concerned about how frequently Joey ended up in his mother's bed at night. Although there was not enough time to establish a comprehensive exposure hierarchy, Jane was able to get Therese to agree that she would not allow Joey to sleep in her bed anymore. They also arranged that on the morning of camp, Ted's dad would pick Joey up to drive both boys to school together. She also suggested that Therese organise with Joey a celebratory dinner on his first night home after camp as a reward for the bravery he would show by attending camp. Finally, Jane explained to Therese that Joey's difficulty with separating was bigger than just this camp. As such, whether Joey made it on camp or not, she thought they should make an appointment to see a local psychologist who specialised in childhood anxiety, to work on helping Joey be able to do sleepovers with friends — as well as attend his Year 6 camp next year! She told Therese that both she and Joey would need to learn some new ways of coping.
Conclusions and Recommendations
The area of school camp refusal has received very little attention in the literature. Researchers have more commonly focused on school refusal, anxiety, or the experience of homesickness when attending boarding school or a longer term American summer camp. Nevertheless, these bodies of research add to the school psychologist's understanding of what may influence a school student's reluctance to attend a school camp. In this article we have advocated for an approach to intervention for school camp reluctance and refusal that fits naturally with good psychological practice. School psychologists should be informed of the literature regarding the range of theories and research related to camp refusal. The psychologist should undertake a thorough assessment of the presenting difficulties, including seeking information from the parents, teachers, and the student. Use of standardised assessment tools is a valuable component of any such assessment. The school psychologist will then use that information in devising a formulation that will guide their intervention. Standard psychological approaches, including CBT and DBT, provide the psychologist with a range of intervention strategies. Furthermore, the school psychologist can put in place wider school changes that will help improve student familiarity with school camps and identify students who are potential and actual camp refusers. In this way, supports can be put in place before camp refusal becomes more entrenched and problematic later in the student's school life.
