The Balancing Act: Managing K-12 School and Treatment

By Katie Bendel, LMSW

It is possible for children with eating disorders to balance intensive treatment and K-12 school. Get answers on how we support academic success in treatment.

Is it possible that missing school time could cause my child more stress, and won’t that make their mental health worse? What if my teenager has missed too much school and is already way behind? Will treatment get in the way of their long-term academic goals, like getting into AP classes or college?

All these caregiver questions and concerns are understandable. If you have experienced the same or similar thoughts, you are not alone. You want what is best for your loved one, and you want to make sure you are doing everything you can to make that happen. Caregivers often feel understandably overwhelmed by all these questions and feelings.

Children and adolescents struggling with mental health disorders often need intensive treatment, and they also need school. For many, that can feel like an impossible conundrum. As a former Clinical Assessment Specialist for Eating Recovery Center, I’ve helped numerous families process through their questions and worries surrounding this topic. They would often tell me, “I know that both school and treatment are important, and I’m not saying school is more important than their health, but I want them to have both, and I can’t figure out how that works.”

The good news is: It is possible to balance both. We’ll explain how. Here are the most common questions, and answers, that pop up during the admission process.

  1. If they are in treatment most of the day, when is there time for school?

    At ERC, time to complete schoolwork is built into the inpatient, residential, and partial hospitalization treatment programs. School time during these programs typically occurs Monday to Friday for two to three hours per day, and takes place at the treatment center. ERC follows typical fall and spring academic calendars. Your child can typically stay enrolled in their current school and complete assignments provided directly by their school. The Virtual Intensive Outpatient Program or in-person Intensive Outpatient Program offer hours outside a typical school schedule (i.e., Monday, Wednesday, Thursday, 4 p.m.-7 p.m.), so students can largely maintain their class schedule and attend treatment after school hours.

  2. Who helps coordinate between the school and the treatment team?

    ERC asks caregivers for permission to coordinate with their kiddo’s school directly. This is typically a relief for most caregivers, who are already juggling a lot! An ERC teacher will then work with the school directly to explain ERC’s academic structure – including how much time is scheduled for school, and the support provided during that time. ERC asks the school to assign work that is reasonably achievable during the academic hours provided.

  3. Is there a teacher or tutor who provides support at the treatment center?

    ERC provides an Educational Specialist or teacher. The teacher reviews assignments with each student. After review with the ERC teacher, students are empowered to complete schoolwork independently. If they need a little extra support, ERC staff are available to facilitate one-on-one help. Academic support can be in the form of tutoring by the ERC teacher (for most subject areas) or tutoring by independently contracted, content-expert tutors.

  4. What if my loved one’s school will not accept course work completed off campus or will not work with the treatment center?

    While the goal is to keep your loved one enrolled in their home-based schools during treatment, certain schools and districts mandate physical attendance and must withdraw the student upon admission to a treatment program. In these cases, online course options are explored, and children/adolescents are enrolled in an online program through their home-based school or district’s online program, which reviews transcripts and advises online course enrollment based on each child/adolescent’s academic background. These credits can be completed at home, even if a patient discharges from treatment and returns to another state. At the end of the semester, transcripts are sent to your loved one’s home-based school and credit hours are processed.

  5. Is it possible for students to stay on track and advance to the next grade level?

    As you may know, it is not uncommon for children and adolescents to experience academic decline when struggling with their mental health. Caregivers might notice trouble getting out of bed, frequent absences, leaving school early due to headache or stomachache, decline in grades, loss of motivation, or even hopelessness. Many caregivers worry that by changing the school routine the academic problems will only get worse. It’s understandable to have this fear, and there is hope for a better outcome. Symptoms like fatigue, physical discomfort, restlessness, difficulty concentrating, lack of motivation, and so forth can make trying to complete schoolwork extremely difficult. With mental health treatment, these symptoms start to slowly lessen or become more manageable, making academic work less daunting. Children/adolescents are typically able to stay on track, and their chances of long-term academic success and achievement will increase [1].

  6. Is it possible that distancing them from their friends or extracurricular activities will spike their symptoms?

    Many caregivers also worry about their loved one’s mental health worsening with distance from peers, inability to participate in extracurricular activities, or disruption of the normal school routine. In this area, the risk of taking time away from school is less than the risk of not accessing care [1]. Taking time away from school and friends/family is hard, and we will not minimize that. Your loved one may experience new or increased anger, grief, or fear when transitioning into treatment. The good news is, treatment is an opportunity to learn coping skills, and to practice using them in real time. We’ll be here to walk you and your loved one through their distress. We consider this an opportunity to better understand your loved one and to show them new ways of coping.

  7. Is there anything I can do before treatment to prepare for school success?

    Yes! Advocate for your loved one to have all available support and accommodations possible. Under federal law, children with chronic or life-threatening illness and/or disabilities are entitled to educational support and accommodations [2]. Your loved one’s school should be able to help you create a 504 Plan or an Individualized Education Program (IEP). Eating disorders, mood disorders, anxiety disorders, and trauma-related disorders fall under the Individuals with Disabilities Education Act (IDEA). Once admitted to treatment, health providers can give any needed documentation to access this support. Some accommodations that we suggest including in a 504 Plan or IEP are as follows:

  • Consider attendance in treatment equivalent to school attendance.
  • Assign no penalties for failure to log on to a virtual class meeting or failure to complete assignments related to information shared in virtual class meetings.
  • Reduce assignments to those essential for course credit
  • Limit repetitive assignments.
  • Accept partially completed assignments if the student has satisfactorily exhibited mastery of the concept.
  • Provide due date extensions as requested.
  • Provide alternative assignments as requested.

Every person is different, and there are unique circumstances in which the processes may vary. But all in all, the answers above represent the majority of circumstances. The process of getting things in place may truly feel like an impossible balancing act, but we are here to help! If you’d like to talk about treatment options for your loved one, give us a call at 877-825-8584.

For more caregiver support, we encourage you to check out the following resources:

ERC Caregiver Support Groups


  1. American Psychological Association. (2022, June). Child and adolescent mental and behavioral health resolution. Retrieved August 1, 2022, from
  2. U.S. Department of Education. (2020, January 10). Protecting students with disabilities. Retrieved August 1, 2022, from
Written by

Katie Bendel, LMSW

Katie believes that recovery and wellness are best developed and reinforced by community with others, and connection to our core values such as integrity, and empathy. As a social worker, she believes…

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