[Date]
[School counselor or principal's name]
[School name]
[School address]
Re: Reintegration plan for [Student name], date of birth [Date of birth], grade 8
Dear [Name]:
I am the treating child and adolescent psychiatrist for [Student name], a student in grade 8 at [School name]. The student has been missing days, arriving late, or leaving early with increasing frequency for several weeks, and is in treatment for the difficulties behind it. I am writing at the request of the student's parent or guardian to ask the school for a written reintegration plan and the supports set out below. The parent or guardian has signed a release permitting me to share this information with the school and to speak with staff.
What is driving the avoidance
With the family's agreement, I can share that the student is being treated for an anxiety disorder. The avoidance is driven by distress at separating from home or a parent in the morning and physical symptoms, such as stomachaches and headaches, that cluster around school mornings and resolve when school is avoided. School avoidance is maintained by the relief that avoiding brings, so each missed day makes the next one harder. The treatment is a return to school in planned steps, with the morning handled consistently and the day made survivable once the student is there. That cannot be done by the family alone; it needs the school to hold its side of the plan every day.
The physical symptoms are real and have been medically evaluated. [Note the evaluation and its date.] They are an expression of the anxiety, not a reason to send the student home; the plan below says what happens when they occur at school.
The stepped return
I recommend the following steps. The dates should be set at a planning meeting with the family and written down, and a step that fails is held for another week rather than abandoned.
- Weeks 1 and 2: half days, [morning or afternoon], beginning [Start date].
- Week 3 onward: full days, with a check-in at the end of week 3.
The morning
A named adult meets the student at the door each morning. The parent hands off and leaves without a prolonged goodbye; a long negotiation at the door is the single most common point at which a plan fails. Late arrival is excused while the plan is active. The goal is that the student arrives; the time matters less.
Supports during the day
- A brief check-in with a named adult on arrival each day.
- A break pass to a designated place, usable without explanation, with a plan for returning to class.
- Access to the school counselor on request.
- Work missed during the avoidance excused rather than assigned as make-up. Accumulated work is itself a reason not to return.
Attendance
Attendance should be recorded according to the plan while it is active, so that a planned partial day is not recorded as an absence and the record does not work against the student. I ask that no truancy referral be made while the plan is active and the family is following it. A truancy process punishes the family for a condition that is being treated and removes the cooperation the plan depends on.
Request
- Hold a planning meeting with the family within [one week] to set the dates, name the adults, and put the plan in writing.
- Put the morning routine, the steps, the supports, and the attendance arrangement above in place from the first day of the plan, with a review every two weeks.
- Evaluate the student for a Section 504 plan so that the supports have a formal basis; the avoidance itself documents a substantial limitation on learning and attending. I can provide a separate letter supporting that request.
- Invite me to the planning meeting or arrange a call beforehand. I can be reached at the number below.
A reintegration plan works when every adult does the same thing every morning. I will hold the family to their side of it; I am asking the school to hold its side.
Sincerely,
[Your name]
[Credentials and role]
[Practice or hospital]
[Direct phone and fax]
Enclosures: [Signed release of information.]