The Social Construction of School Refusal: an Exploratory Study Of
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The Social Construction of School Refusal: An Exploratory Study of School Personnel’s Perceptions by Anna Marie Torrens Salemi A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy Department of Community and Family Health College of Public Health University of South Florida Major Professor: Kelli R. McCormack Brown, Ph.D. George Batsche, Ph.D. Roger Brindley, Ph.D. Jeannine Coreil, Ph.D. Donileen Loseke, Ph.D. Robert J. McDermott, Ph.D. Date of Approval: April 7, 2006 Keywords: school attendance, absenteeism, social constructionism, qualitative methodology, school personnel © Copyright 2006, Anna M. Torrens Salemi TABLE OF CONTENTS LIST OF TABLES viii LIST OF FIGURES ix ABSTRACT x CHAPTER I: STATEMENT OF THE PROBLEM 1 Introduction 1 School Refusal 2 The Role of Public Health 3 Public Health Significance of School Refusal 4 The Role of School Health 9 Theoretical Perspective 12 Purpose of the Study 14 Research Questions 17 Delimitations 18 Limitations 19 Definitions of Relevant Terminology 21 CHAPTER II: REVIEW OF THE LITERATURE 25 Introduction 26 Overview of Schooling 27 School Refusal as a School Health Issue 28 Various Forms of School Absenteeism 29 School Dropout 30 Dropout, School Refusal, and Labeling 30 The Role of the School 32 The Role of School Personnel 35 Difficulties Within Schools 36 Public Health Implications of School Refusal 38 Identification of School Refusal 39 Occurrence of School Refusal 39 Characteristics of Students with School Refusal 41 Reported Estimates of School Refusal 42 Consequences of School Refusal 44 Short-Term Outcomes 44 Long-Term Outcomes 45 i Social and Economic Costs 45 Historical Construction of School Refusal 46 Defining School Refusal and Absenteeism as a Problem 47 Delineation of School Refusal from Other Forms of Absenteeism 47 Development of Clinical Knowledge 51 Ecological Expansion of School Refusal 53 School Refusal as a Complex Issue 54 Barriers to Future Advancement in Research and Practice 55 Theoretical Implications 56 Theoretical Perspective 58 History of Social Constructionism 59 Tenets of Social Constructionism 61 Critique of Social Constructionism 65 Applicability to Public Health 66 Applicability to School Refusal 68 School Refusal as a Cross Cultural Phenomenon 69 Social Construction of School Refusal 69 Discourses on School Refusal 71 The Adult Discourses 71 Psychiatric Discourse 72 Behavioral Discourse 73 Citizen’s Discourse 74 Socio-medical Discourse 75 Student Discourse 76 The Cultural Context of School Refusal 77 Popular Media and School Refusal 78 Overview of the School District of Shermer County 79 Summary of the Literature Review 81 CHAPTER III: METHODS 84 Introduction 84 Research Questions 85 Study Design 86 Study Population 88 Setting 88 Inclusion Criteria 89 Exclusion Criteria 89 Sampling Design 90 District Level Elite In-Depth Semi-Structured Interviews 90 School Level In-Depth Semi-Structured Interviews 91 Observations 95 Descriptive Self-Administered Survey 95 Data Collection Tools 95 In-Depth Semi-Structured Interviews 96 Elite In-Depth Semi-Structured Interviews 97 ii Observations 98 Descriptive Self-Administered Survey 100 Data Collection Procedures 101 Levels of Permission, Negotiations, and Entry 101 In-Depth Semi-Structured Interviews 103 District Level Elite Interviews 105 Recruitment for District Level Elite Interviews 106 School Level Interviews 107 Recruitment for School Level Interviews 107 Observations 108 Descriptive Self-Administered Survey 109 Pre-Testing, External Review, and Pilot Testing 110 Levels of Confidentiality 112 Field Notes 113 Tape-Recording 114 Transcription 114 Debriefing 115 Non-Participation 116 Data Analysis 117 Qualitative Data Analysis 117 Analysis of the Survey 122 Interpretation 123 Trustworthiness and Quality in Qualitative Research 124 Credibility 125 Dependability 127 Transferability 128 Strengths and Weaknesses 128 Methodology Definitions 130 CHAPTER IV: RESULTS 133 Introduction 133 Research Questions 133 Final Sample 136 District Level Elite In-Depth Semi-Structured Interviews 136 School Level In-Depth Semi-Structured Interviews 137 Observations 139 Descriptive Self-Administered Survey 140 Description of Study Participants 140 Demographic Characteristics of Interview Participants 140 District Level Participants 140 School Level 141 Individual Participants Within Schools 141 Demographic Characteristics of Survey Participants 142 Section I: Establishing an Understanding of Personnel’s “Attendance Issues” Frame of Reference 142 iii School Personnel and Their Roles 143 Categories of School Personnel 143 Perceptions of Absenteeism 145 Constructing Meaning for Terminology 146 Absenteeism 148 School Refusal 149 School Phobia 150 School Avoidance 152 Separation Anxiety 153 Applied Use of Terminology Within the School Setting 154 Reported Reasons for Absenteeism 154 The Role of the School 157 The Role of the Family 158 Perceived Barriers to Attending School 160 Perceptions of Remaining in School All Day 163 Examples of Perceptions of Bullying 164 Examples of Low Connectedness 164 Section II: Exploring School Personnel’s Reported Perceptions of School Refusal 165 Descriptions of School Refusal as a Behavior 166 Descriptive Terms and Words 166 Described Differences in School Refusal by Grade Level 168 Describing School Refusal as “School Phobia” 170 Parents Role in School Phobia 174 School Refusal as a Symptom 175 Illness as School Refusal 177 Legitimate and Non-Legitimate Illness 178 Mental Illness as School Refusal 183 Schools and Their Environment 184 Cycles and Patterns of School Refusal 187 Describing the Student with School Refusal 188 Constructing the Student Experience of School Refusal 189 Internal versus External Experiences of the Student 190 Family as a Description of the Student 191 Attributes of Students Who Refuse School 192 The Reported Disconnect of Students’ Perception of Reality 196 Deconstructing Stories of School Refusal 197 Differentiating Students 198 Evaluating Experiences 199 Interacting with Students 199 Other Personnel 201 Perceptions of Parental Influence 202 Typifications of Students 204 The Defiant Student: “They’re not fearful; they just want a good time” 206 iv The Adult Student: “They’re the quasi-head of the household” 208 The Failing Student: “Caught in a vicious cycle” 210 The Bored Student: “The lazy gifted student” 211 The Invisible Student: “Just passing through” 212 The Physically Refusing Student: “Drag ‘em in” 213 The Socially Uncomfortable Student: “They just don’t fit in” 214 The Sick Student: “What medical condition?” 215 The Victim: “Bullied and abused” 217 Composites of Two Typifications 218 Jose: The Defiant Student 218 Brittany: The Sick Student 219 Influences on School Personnel and their Understanding of School Refusal 220 Internal and External Influences on Personnel’s Perceptions 221 Frustration as an Influence 223 The Politics of Attendance 225 Section III: Identification and Intervention in the Practical World 227 Identification of Students with School Refusal 227 Deviations from the Intervention Protocol 228 Differentiating Student Referrals 228 Personnel Perceptions of the Process 229 Perceived Outcomes of School Refusal 230 Personnel’s Concerns for Students’ Refusing School 230 Programs 232 Alternatives for Students Refusing School 234 Withdrawing Students from School 234 Recommendations for Schools from Schools 236 The School Setting 236 Working with Students Who Refuse School 237 The Role of Parents 239 Results from the Survey of School Refusal 240 School Demographics 241 Student Population 241 Identification and Response to School Refusal 241 System of Identification 241 School Personnel 243 School Refusers 244 Characteristics of School Refusal 244 The School Response to School Refusal 245 Summary of Results 247 CHAPTER V: CONCLUSIONS 250 Introduction 250 Study Summary 250 Study Background 250 Purpose of the Study 251 v Methods 252 Key Findings 252 The Language of Attendance Issues and School Refusal 253 General Constructions of School Attendance Issues 257 Descriptions of School Refusal as a Behavior 261 Describing the Student Who Refuses School 265 Deconstructing School Personnel’s Stories of School Refusal 268 Influences on School Personnel and their Understandings of School Refusal 271 Identification and Intervention in School Refusal 273 Perceived Outcomes of School Refusal 276 Recommendations 277 The Survey of School Refusal 278 Prevalence and Characteristics of School Refusal 279 School Response 281 Summary Conclusions 283 Limitations of the Study 290 Sample 290 Study Design 291 Data Collection Tools 292 Interviews 292 Observations 294 The Survey of School Refusal 294 Strengths of the Study 295 Sample 295 Study Design 295 Data Collection Tools 297 Implications and Recommendations 297 Recommendations for Education, Public Health, and School Health Practice 299 Dissemination of Findings 299 Policy 300 Educational Training 302 Prevention and Early Intervention 303 Recommendations for Research 304 REFERENCES 307 APPENDICES 326 Appendix A: Delineated Terms and Definitions Related to School Refusal 327 Appendix B: Timeline for Data Collection 328 Appendix C: Approval to Use the Survey of School Refusal 329 Appendix D: General Interview Guide 330 Appendix E: Probes for Interviewing 334 vi Appendix F: Demographic Information Sheet 335 Appendix G: Document Extraction Tool 336 Appendix H: Observation Guide 337 Appendix I: Survey of School Refusal 338 Appendix J: Pre-Testing Protocol 342 Appendix K: Summary