The Treatment Hypothesis of Yoga for Children with School Refusal, and Attempt to Building a Comprehensive Support Network Led by Family Doctors

School refusal is defined as child-motivated non-attendance related to emotional distress experienced in connection with academic or social situations in school or home. Even though school refusal is not a formal psychiatric diagnosis, children has several somatic and psychological problems such as abdominal pain, headache, nausea. In the case of school refusal, it is suggested that interpersonal problems (e.g., violence, bullying) that have occurred school or home are triggered chronic stress. Under the chronic stress condition, abnormal activity of hypothalamic-pituitary-adrenal axis, autonomic nervous, enteric nervous system, and increases in blood cortisol level were reported. These abnormality lead to abdominal pain, headache, nausea. The practice of yoga with a focus on the unification of the mind, body, and spirit through the practice of physical movements, meditation and breathing exercises. During yoga practices, it can also regulate physiological stress responses. Especially, yoga has beneficial effects on the autonomic nervous system and enteric nervous system though hormonal changes associated with stress in children with school refusal is suggested. It will be possible to work with relevant institutions to develop specific therapeutic programs for children whose health has improved.