3 Ways to Help Children with School Anxiety & Somatic Complaints

School refusal and reluctance to go to school due to frequent complaints of aches and pain can be a challenging topic for parents and caregivers to manage. The consequences of frequent somatic complaints such as headache, stomachache, and sickness may result in excessive time at the doctor’s office. Tardiness and truancy can become problematic, and this can increase stress within relationships with the school. Working together to help understand the underlying issue and creating a plan with all involved can be an effective solution.

Stressors within the school environment such as a new teacher or classmates can be triggers. Academic challenges, learning difficulties, and peer conflicts such as bullying can increase anxiety. Distress in challenging situations can be experienced by acting out behaviors and/ or internalizing emotions. Children often experience symptoms within their bodies, even before they can verbalize what they are feeling. Somatic complaints may signal a mental health concern, rather than a medical concern (especially when medical causes have been ruled out).

Coping with stressful or traumatic experiences at home can prompt anxiety and separation fears. Parental separation or divorce, intimate partner violence, and exposure to frightening situations are examples. Some children may be more susceptible to anxiety due to family history and biopsychosocial factors.

Meeting with a mental health professional can help assess the presenting concerns and determine if your child’s response may be related to adjustment, trauma, anxiety, a specific type of anxiety (e.g., separation, social, illness) a specific fear, or another area such as typical child developmental or co-occurring medical and developmental concerns. Your therapist can then create a tailored treatment plan to process distress and learn more effective ways of coping.

Supporting the child/ youth in therapy while supporting the caregiver with effective interventions to try at home can help take the skills learned in therapy and apply them in the home and school environment.

Here are three ways to help a child at home with school anxiety and somatic symptoms.

Continue with Your Daily Routines & Activities

Avoidance of everyday routines and activities can unintentionally reinforce behaviors such as school refusals and withdrawal from sports and social activities. It is important to keep your day-to-day activities as consistent as possible.

Note: If it is necessary to take days off from school due to somatic complaints, it is recommended to keep routines at home consistent rather than introduce associations with special privileges such as being able to stay home and do preferred activities over going to school.

Focus on Symptom Management Vs. Symptom Impairment

The use of language is important. “I am experiencing xyz and I can ________”. helps focus on what is within one’s control. Focus on the symptoms and not having a balance between symptom management and coping can magnify the worries and create more anxiety. Shifting away from pain and discomfort can help aid in healthy distraction. For example, breaks can be utilized during the day to help ease discomfort.

Introduce a Variety of Health Coping Strategies

Having several effective coping strategies can help add a variety of “tools” to your child’s toolbox. Your therapist can assess which strategies may or may not be currently effective and identify additional strategies including those that are evidence-based for the presenting concerns such as cognitive behavioral therapy and exposure-based therapies. Your therapist can help teach skills to practice as a family such as relaxation strategies, mindful meditation and movement, and creative play.

Written By: Charlotte Johnson, MA, LPCC