Emotionally Based School Avoidance (EBSA)

What is (EBSA)?

EBSA is when a child or young person repeatedly struggles to attend school because of intense emotional distress. It’s not defiance – it is usually driven by anxiety, panic, depression, sensory overwhelm, bullying, or undiagnosed neurodiversity. Distress often builds before school, and physical symptoms (stomach aches, headaches, nausea, panic) are common.

Key signs

High anxiety or dread about school mornings
Frequent physical complaints that ease when away from school
Avoidance behaviours (refusing to leave, clinging, hiding)
Mood changes: tearfulness, shutdown, irritability
Falling behind academically or missing lessons
Withdrawal from peers or teachers

How to support EBSA

Take a calm, curious, collaborative approach to find some understanding about what is evoking the symptoms. Avoidance may make sense as it reduces distress short-term, however this will not be a long term strategy.

What can you do?

Listen and assess safety (including risk of self-harm)
Build a simple formulation: triggers, thoughts, feelings, and avoidance patterns
Use integrative, evidence-informed methods:
- CBT for anxious thoughts,
- graded exposure to rebuild tolerance,
- emotion-regulation and sensory strategies,
- family coaching,
- and school liaison
Pace the work by the young person’s tolerance and build small, achievable steps

Practical steps families can try now

Validate feelings: “I can see you’re really scared” rather than minimising.
Keep routines steady: sleep, meals and morning structure help regulation.
Start tiny: short, achievable goals (e.g., visit school gate, stay 30 minutes).
Create a coping toolkit:
- breathing, grounding, headphones, safe space.
Avoid punishment;
- use problem-solving and celebrate small wins.
Talk with school: share the plan so everyone responds consistently.

When to seek more support

If avoidance is persistent, worsening, or accompanied by severe depression or self-harm, seek specialist help early—consistent intervention improves outcomes.

Here are practical support networks and services for families dealing with EBSA

Clinical and statutory services

GP — first contact for assessment, referrals to CAMHS, medication discussion, and sick-note advice.
CAMHS / community child mental health teams – assessment and therapy for moderate–severe anxiety, depression or risk.
Local authority Educational Psychology Service – school-focused assessment, attendance strategies, and advice for adjustments.
Local Inclusion/Special Educational Needs teams (SEN/Inclusion) – support plans, reduced timetables, EHCP advice, mediation with school.
School-based support – SENCo, pastoral leads, safeguarding teams, counsellors or wellbeing staff for daily adjustments and liaison.

Charities and specialist organisations

Anna Freud Centre — resources and training for child mental health and school-related anxiety.
YoungMinds — parent advice, crisis support info, guides on anxiety and school refusal.
Place2Be — school-based mental health services and resources.
NSPCC — support around safeguarding concerns, abuse or exploitation.
Ambitious about Autism — if neurodivergence is involved, practical resources and advocacy.
Social Anxiety UK — peer resources and coping strategies for social anxiety that often underpins EBSA.

Parent and peer support

Local parent/carer support groups — many areas have face-to-face or virtual groups for school refusal/mental health (search “school refusal support [your area]”).
Online forums and closed Facebook groups — peer advice, shared strategies, and emotional support (look for moderated, specialist-led groups).

Education & legal advice

SENDIASS (Special Educational Needs & Disabilities Information Advice and Support Service) — independent advice on school rights, EHCPs and exclusions.
Education Otherwise / Home education networks — if school absence becomes long-term and you consider alternatives.

Crisis and safety

NHS 111 / 999 — for immediate medical or psychiatric emergencies.
Samaritans (116 123) — emotional support 24/7.
Local crisis teams — check local CAMHS crisis or urgent care lines.

This blog was collated from internet sources for information by a counsellor in Fleet, Hampshire – Caroline at Caroline Ellison Counselling – this is my experience and these are my opinions. Carpe Diem.

How to stay focused with Adult ADHD

How to stay focused with adult ADHD

Staying focused with adult ADHD (Attention Deficit Hyperactivity Disorder) can be challenging, but there are strategies and techniques that can help you manage your symptoms and improve your ability to concentrate. However, it is important to remember that what works for one person may not work for another, so you may need to experiment with different strategies to find what works best for you.

ADHD staying Focused Tips

Here are some tips to help you stay focused with adult ADHD:

Seek Professional Help: First and foremost, consider working with a healthcare professional, such as a psychiatrist or therapist, who specialises in ADHD. They can provide you with a proper diagnosis, treatment options (which may include medication) and guidance on managing your symptoms.

Medication: ADHD medications, such as stimulants or non-stimulants, can be highly effective in improving focus and concentration. Consult with a healthcare professional to determine if medication is a suitable option for you.

Create a Structured Routine: Establishing a daily routine can help you stay on track and minimize distractions. Set specific times for work, meals, exercise and relaxation and stick to this schedule as closely as possible.

Use Task Lists and Planners: Write down your tasks and prioritise them. Breaking tasks into smaller, manageable steps can make them feel less overwhelming. Digital or physical planners, to-do lists and calendar apps can help you keep track of your responsibilities.

Eliminate Distractions: Identify common distractions in your environment and take steps to minimize them. This may include turning off notifications on your phone, using website blockers or creating a dedicated workspace that is free from distractions.

Time Management Techniques: Techniques like the Pomodoro Technique (working in short, focused bursts with breaks in between) or time blocking can be helpful in managing your time effectively.

Set Clear Goals: Define clear and achievable goals for your tasks. Knowing the purpose and expected outcome of a task can help you stay motivated and focused.

Stay Organized: Keep your physical and digital spaces organized. Use labels, folders, and color-coding to make it easier to find what you need and reduce clutter.

Practice Mindfulness: Mindfulness meditation and deep breathing exercises can improve your ability to stay present and focused. Regular practice can also help manage stress, which can exacerbate ADHD symptoms.

Exercise and Diet: Regular physical activity and a balanced diet can have a positive impact on your overall well-being and focus. Aim for regular exercise and consider consulting a nutritionist for dietary guidance.

Sleep: Prioritise good sleep hygiene to ensure you are well rested. A consistent sleep schedule and a comfortable sleep environment can make a big difference in your ability to focus.

Seek Support: Share your challenges and goals with friends, family members or a support group. They can offer encouragement, accountability and understanding.

Learn About ADHD: Educate yourself about ADHD to better understand your condition. Knowledge about your symptoms and how they affect you can empower you to make informed choices and develop effective strategies.

Be Kind to yourself

Remember that managing adult ADHD is an ongoing process and it is okay to seek help and make changes as you need them. Be kind and patient with yourself and celebrate all your successes big and small. With the right techniques, strategies and support, you can improve your ability to stay focused with your adult ADHD mind.

Additional Support

There is a lot of support out there. In my opinion this podcast by Huberman is really interesting – ADHD & How Anyone Can Improve Their Focus | Huberman Lab Podcast #37

Other support:

The UK ADHD Partnership – https://www.ukadhd.com/
ADHD UK is by people with ADHD for people with ADHD – https://adhduk.co.uk/

For individual support I am here for you. Contact me to book an initial session and I will support you.

Written by your local counsellor in Fleet, Caroline at Caroline Ellison Counselling – this is my experience and these are my opinions. Carpe Diem.

What is the difference between Shame and Guilt?

Shame and Guilt

Shame and guilt are two complex emotions that often intertwine but possess distinct characteristics and psychological implications. While both are associated with feelings of remorse and wrongdoing, they stem from different sources and impact individuals in various ways. Understanding the difference between shame and guilt is crucial for emotional well-being and personal growth.

Shame:

Shame is a deeply negative and self-deprecating emotion that focuses on the individual as a whole rather than on a specific action or behaviour. It arises when someone perceives themselves as inherently flawed, inadequate or unworthy. Shame often leads to feelings of humiliation, a desire to hide, and a belief that one is fundamentally defective. It is a pervasive emotion that can have damaging effects on self-esteem and overall mental health.

Key characteristics of shame include:

Global Self-View: Shame makes individuals feel like they are fundamentally bad people, regardless of their actions. It attacks their sense of self-worth and identity.
Isolation and Secrecy: People experiencing shame tend to isolate themselves and hide their perceived shortcomings, as they fear being judged or rejected by others.
Self-Focused: Shame is primarily an inward-directed emotion, causing individuals to excessively focus on their own perceived flaws and inadequacies.
Toxicity: Persistent shame can lead to psychological issues such as depression, anxiety and low self-esteem. It may also contribute to destructive behaviours as a coping mechanism.

Guilt:

Guilt, on the other hand, is centred around a specific action or behaviour that is perceived as morally or ethically wrong. It stems from a sense of responsibility for one’s actions and their impact on others. Guilt focuses on the act itself rather than the individual’s identity, allowing for a healthier separation between one’s actions and their core self.

Key characteristics of guilt include:

Action-Based: Guilt is tied to a particular behaviour or action, making it easier to address and rectify. It prompts individuals to take responsibility for their actions and make amends.
Empathy and Concern for Others: Guilt involves recognising how one’s actions have affected others and feeling empathy for their experience. This can motivate positive change and behaviour.
Externalization: Guilt often involves externalizing the wrongdoing, viewing it as a mistake rather than a reflection of one’s identity.
Constructive Potential: Healthy guilt can lead to personal growth, as individuals are encouraged to make reparations and avoid repeating harmful actions.

In summary, the primary distinction between shame and guilt lies in their focus and impact. Shame revolves around a sense of inherent unworthiness and global self-view, while guilt centres on specific actions and their consequences. Or put simply, Shame is when we feel we have done something wrong according to our own rules and Guilt is when we feel we have done something wrong according to other peoples rules.

While both emotions can be uncomfortable, guilt has the potential to be more constructive, as it prompts individuals to take responsibility, make amends, and learn from their mistakes. Recognising these differences can help individuals navigate their emotions, promote self-acceptance, and foster personal development.

Written by your local counsellor in Fleet, Caroline at Caroline Ellison Counselling – this is my experience and these are my opinions. Carpe Diem.

What is Shame?

“I am bad. The focus is on self, not behaviour. The result is feeling flawed and unworthy of love, belonging and connection. Shame is not a driver of positive change.” – Atlas of the Heart – Brene Brown.

Shame is systemic, we feel it in our whole body. Shame is often delivered from our primary carer from infancy to teach us a moral code. It can be constructive, supportive and guiding when used for good. However, Continue reading “What is Shame?”

What is Emotional Intensity Disorder?

Emotional Intensity Disorder (EID) is sometimes known as:

Emotional Unstable Personality Disorder (EUPD) or
Borderline Personality Disorder (BPD).

Emotional Intensity Disorder is a mental health personality disorder that affects the regulation of emotions. Emotional dysregulation is when a person experiences intense emotions that they are unable to manage in constructive ways. Continue reading “What is Emotional Intensity Disorder?”

Dementia Action Week

Dementia Action Week 16th – 22nd May 2022

My Mum’s journey with Dementia continues and each day that passes feels like a blessing and a worry all at the same time. Mum has stopped trying to eat and my Dad and her carers are daily finding new ways to get enough nutrition into her. From shakes made from protein rich beans, fruit and milk to trifle, they are trying it all. Continue reading “Dementia Action Week”

Mother’s Day without Mum

Mother’s Day without Mum!

My Mum has gone in mind but is still with us in body and soul! Today I called my Dad to say

“Happy Mother’s Day”

It left me feeling empty when I put the phone down and I came to my cabin to write this whilst it was still clear in my head and heavy in my heart. Continue reading “Mother’s Day without Mum”

What is Anger?

Anger is one of our core emotions. Emotions are complex feelings we experience mentally, physically and behaviourally:

Mentally we experience our emotions and feelings.
Physically we feel them through awareness, tension and feelings in our body from the pit of our stomach to the tips of our fingers.
Behaviourally we experience our feelings and emotions as an impulse to act.

Continue reading “What is Anger?”

What is Overwhelm?

Overwhelm is the emotional feeling of being overwhelmed. It is an emotional feeling which can take over with an intensity that feels difficult to manage. It can affect your ability to think and act rationally and evoke anxiety and stress. Continue reading “What is Overwhelm?”

Lonely at Christmas 2020

Loneliness this Christmas

As l sit in my counselling cabin this morning with a cup of coffee, I reflect on the conversations had with family this week. With Christmas ahead of us and the hope of all being together temptingly close, my Mother-in-Law called to say Continue reading “Lonely at Christmas 2020”