拒学（school refusal）是指学生拒绝上学、在上学期间缺课、在上学前表现出严重的情绪困扰，以及/或表现出相关的躯体症状。拒学是儿童青少年常见的问题之一，且因新冠疫情的影响日趋严重。

从家庭系统角度出发，分析、理解这一现象，有助于为家庭提供对应的支持策略，找到家庭和孩子共同改变的契机，促进青少年的社会适应和心理健康发展。本研究主要从家庭系统角度出发，依据萨提亚家庭治疗理论干预青少年拒学问题。个案L，16岁，不去上学超过4个月。通过初始访谈以及相关量表测量，个案符合研究标准。咨询师与家庭共进行了13次咨询，分为4个阶段，1-2次为建立关系阶段，3-5次为拓展探索与觉察阶段、6-9次为改变与转化阶段，10-13次为巩固落实阶段。在咨询前、中、后测以及回访阶段对家庭进行家庭功能评定量表（FAD）测量，对父母进行抑郁-焦虑-压力量表（DASS-21）测量，对L进行上学情况评估表调查，儿童抑郁量表（CDI）、儿童焦虑性情绪障碍筛查表（SCARED）测量。测量结果数据显示L的焦虑、抑郁症状下降，父亲的抑郁、焦虑、压力情绪下降，母亲的抑郁、焦虑、压力情绪中测有上升，之后回落。家庭成员认为家庭总的功能有所提升。L上学前的负面情绪减少，上学意愿增加。家庭成员反馈通过咨询改变了他们的沟通姿态，求生存应对姿态减少，一致性沟通增加，家庭成员之间表达情感的机会增加。

研究表明：萨提亚家庭治疗干预青少年拒学问题，具有一定的可行性和适用性。同时将发源于国外的萨提亚家庭治疗模式应用于中国家庭时，应注重文化适应性评估及潜在影响。

School refusal is defined as a student's refusal to attend school, absence from school during the school day, severe emotional distress prior to attending school, and/or related physical symptoms. School refusal is one of the common problems among children and adolescents, and it is becoming more and more serious due to the impact of the novel coronavirus epidemic.

Analyzing and understanding this phenomenon from the perspective of the family system can help to provide families with support strategies and identify opportunities for joint change by the family and the child, so as to promote adolescents' social adaptation and psychosocial development. This study focuses on the family system perspective, and is based on the Satir theory of family therapy to intervene in adolescents' refusal to go to school. Case L, 16 years old, has not been attending school for more than 4 months. The case met the criteria of the study through the initial interview and relevant scales. A total of 13 counseling sessions were conducted between the counselor and the family, which were divided into four stages: 1-2 sessions for relationship building, 3-5 sessions for exploration and awareness, 6-9 sessions for change and transformation, and 10-13 sessions for consolidation and implementation. Measurements were taken before, during, and after counseling, as well as during follow-up stages, including the Family Assessment Device (FAD) for assessing family functioning, the Depression-Anxiety-Stress Scale (DASS-21) for parents, and the School Status Assessment Scale for L, along with the Child Depression Inventory (CDI) and the Screen for Child Anxiety Related Emotional Disorders (SCARED). The measurement results showed a decrease in L's anxiety and depression symptoms, a decrease in the father's depression, anxiety, and stress emotions, and an initial increase followed by a decrease in the mother's depression, anxiety, and stress emotions. Family members perceived an overall improvement in family functioning. L's negative emotions before school decreased, and his willingness to attend school increased. Family members reported that counseling had changed their communication styles, reducing survival-oriented responses, increasing consistency in communication, and providing more opportunities for expressing emotions.

This study suggests that Satir Family Therapy intervention for adolescent school refusal issues has a certain feasibility and applicability. when applying the Satir family therapy model originated in foreign countries to Chinese families, attention should be paid to cultural adaptability assessment and potential impact.