Rosenthal Lucie, Moro Marie Rose, Benoit Laelia
Department of Child and Adolescent Psychiatry, Toulouse University Hospital (CHU de Toulouse), Toulouse, France.
Department of Child and Adolescent Psychiatry, Centre Hospitalier Spécialisé Pierre-Jamet, Fondation Bon-Sauveur d'Alby, Albi, France.
Front Psychiatry. 2020 Jan 9;10:942. doi: 10.3389/fpsyt.2019.00942. eCollection 2019.
School refusal is an important problem in adolescent psychiatry. However, little is known about the experience of school refusal among minority youth (migrants and minority ethnic groups). This study assesses how parents of various cultural backgrounds experience their adolescents' school refusal. This qualitative study is based on interviews of 11 parents of teenagers diagnosed with school refusal at three adolescent outpatient mental health units in Paris and its suburbs. Interpretative phenomenological analysis was used for the thematic investigation. The analysis found four themes: (i) confronting school and school refusal distresses parental representations; (ii) school refusal as a failure of the family's obligation to succeed after migration; (iii) representations of school that fluctuate with time since arrival: idealization, followed by mistrust and disappointment in the inequalities, even the racism; (iv) solutions envisioned for school refusal, confronting the healthcare system, stigma, and, again, inequality. All parents question their parenting choices when their children become school refusers. However, when families belong to minority groups, school refusal calls into question parents' relations with the French school system and their immigration choices. At the same time, the construction of a multicultural identity for children and adolescents in transcultural situations requires them to strike a balance between two worlds, and school refusal endangers this delicate negotiation. Subsequent misunderstandings can lead clinicians to misdiagnose school refusal as truancy. Clinicians must take the parents' culture and migration history into account to minimize the risk of complete failure of treatment for school refusal and the ensuing inequality of care and opportunity that can result.
学校拒学是青少年精神病学中的一个重要问题。然而，对于少数族裔青少年（移民和少数族裔群体）的学校拒学经历却知之甚少。本研究评估了不同文化背景的父母如何看待其青少年子女的学校拒学情况。这项定性研究基于对巴黎及其郊区三个青少年门诊心理健康单位中11名被诊断为学校拒学的青少年的父母的访谈。采用解释现象学分析进行主题调查。分析发现了四个主题：（i）面对学校和学校拒学困扰了父母的认知；（ii）学校拒学被视为家庭在移民后未能履行成功的义务；（iii）对学校的认知随到达时间而波动：从理想化，到对不平等甚至种族主义的不信任和失望；（iv）针对学校拒学设想的解决方案，涉及与医疗系统、污名以及再次出现的不平等作斗争。当孩子成为拒学学生时，所有父母都会质疑自己的育儿选择。然而，当家庭属于少数群体时，学校拒学引发了父母与法国学校系统以及他们移民选择之间的问题。与此同时，在跨文化情境中为儿童和青少年构建多元文化身份要求他们在两个世界之间取得平衡，而学校拒学危及了这种微妙的协商。随后的误解可能导致临床医生将学校拒学误诊为逃学。临床医生必须考虑父母的文化和移民历史，以尽量减少学校拒学治疗完全失败的风险以及随之而来的护理和机会不平等。
