Intervention for School Anxiety and Absenteeism (ISAAC): Mixed-method feasibility study of a coach-assisted, parent-focused online program

Abstract

The aftermath of the Covid-19 pandemic has seen an increase in persistent school absenteeism and Emotionally-Based School Avoidance (EBSA). However, suitable evidence-based psychological interventions are often unavailable. We aimed to assess the feasibility, acceptability and potential impacts of a new parent-focused online program, Intervention for School Anxiety and Absenteeism (ISAAC), which has been co-designed with parents and practitioners. This exploratory mixed-method study recruited participants from three schools in southern England, enrolling N = 9 parents for whom an index child, aged 5–11 years, was experiencing signs of EBSA. The intervention consisted of three web-based psychoeducational modules respectively addressing parental stress, accommodating behaviors, and communication with school staff. Module completion was assisted by weekly calls with a non-specialist “coach.” Feasibility was measured using indicators of retention, module participation, overall program completion and coaching fidelity. Acceptability was assessed using semi-structured interviews, module ratings and written qualitative feedback. We also collected parent-reported measures of children’s school avoidance, absences, anxiety, parental stress, accommodating behaviors, and quality of parent-school communication. Overall, the intervention was feasible to deliver to parents with six (67%) participants completing the full intervention. Participants found the intervention acceptable across thematic domains of affective attitude, burden, coherence, self-efficacy and perceived effectiveness. Participants particularly appreciated the coach’s support. Outcomes were small to moderate with the largest effects observed on school avoidance (d = 0.51) and family accommodations (d = 0.53). In conclusion, ISAAC shows early promise with the potential to deliver scalable online support for families affected by emerging EBSA. Future research should move toward establishing effectiveness in a randomized controlled trial.