It’s August 15 and you are having the same conversation with each kid client on your caseload. All of them definitely need to move their appointment spot because school is coming up. Most sessions during the day you hear “do you have an appointment after school?”
You already know without looking that all of your evening spots are full. To the max. Your answer is “no, I can move it to Tuesday at 1 or Wednesday at 8 - would either of those times work?”
You also have a family and friends you care about spending time with and an a life outside of therapy, so adding on hours upon after school hours leaves you feeling frustrated, stressed, and overwhelmed. Especially when clients no-show those prime spots because something else came up as a priority.
Parents come into therapy appointments stressed about the impact of their child missing school and all kinds of worries like will they fall behind? Won’t they be embarrassed if they have to leave school? What do they tell their classmates?
So this leaves us with the question - Should kids miss school to attend mental health therapy appointments?
The short answer?
Let’s break it down. Any child you are recommending continuing with mental health therapy after the diagnostic assessment has a diagnosable mental health condition. And those difficulties? Well…they need treatment by a mental health professional.
Mental health therapy is extremely different than a child consistently missing school to watch movies, go on trips, relax at home, and play video games. Mental health therapy is considered a medical appointment.
According to the state I live in, medical appointments are considered an excused absence.
Specifically Minn. Stat. § 120A.22, Subd. 12 that states:
Legitimate exemptions. (a) A parent, guardian, or other person having control of a child may apply to a school district to have the child excused from attendance for the whole or any part of the time school is in session during any school year. Application may be made to any member of the board, a truant officer, a principal, or the superintendent. The school district may state in its school attendance policy that it may ask the student's parent or legal guardian to verify in writing the reason for the child's absence from school. A note from a physician or a licensed mental health professional stating that the child cannot attend school is a valid excuse. The board of the district in which the child resides may approve the application upon the following being demonstrated to the satisfaction of that board:
(1) that the child's physical or mental health is such as to prevent attendance at school or application to study for the period required, which includes:
(i) child illness, medical, dental, orthodontic, or counseling appointments;
(ii) family emergencies;
(iii) the death or serious illness or funeral of an immediate family member;
(iv) active duty in any military branch of the United States;
(v) the child has a condition that requires ongoing treatment for a mental health diagnosis;
Breaking down the jargon (which it is really helpful to specifically know state statutes and laws around excused absence in your state), the state of Minnesota sees any counseling appointments or ongoing treatment for mental health as a valid and legal reason to miss school. Period.
So if we take into account that children in your office have a diagnosable mental health condition where it is medically necessary to have treatment (see more about medical necessity here) AND that state deems this an important enough reason to miss school, prioritizing the treatment of mental health likely will mean missing some school.
And this makes sense.
Mental health difficulties affect all aspects of a child’s life. When mental health difficulties are so intense it results in a mental health diagnosis, this means that the mental health difficulties, the anxiety, distress, anger, or trauma, are affecting multiple areas of a child’s life in significant ways.
It means that they aren’t able to focus and be in their prefrontal cortex enough to learn at their capacity. It means their social relationships may be inhibited. They may have low self esteem and struggle to try. They may have behaviors that impact classroom learning or lead to be disciplined at school.
With the treatment of mental health, all of these impacts are lessened. And the child? Well… they just get to focus on being a kid and a student!
If you need support in getting your ideal schedule and you are overwhelmed and burnt out by working nights and weekends check out my program Signature Scheduling Systems. Make this the year you get balance in your practice and a schedule that works for you!
I'm Ann Meehan, an LPCC,