School Refusal

A young girl sitting at her school desk, holding a pencil and looking over her notebook as part of treatment for child school refusal.

What the research says about school refusal

What is School Refusal and How Can Treatment Help?

School refusal refers to a situation where a child or teenager struggles with going to school due to significant anxiety or distress. Unlike truancy, where children skip school without their parents’ knowledge, school refusal involves staying home with parental awareness. It typically manifests through frequent absences, physical complaints on school days, or emotional outbursts about attending school. Treatment for child school refusal is essential to help children overcome these barriers and reintegrate into school life with confidence.

Many children experiencing school refusal may show signs such as crying, tantrums, or even threats of self-harm in the mornings before school. Others might attend school but leave partway through the day or refuse to attend school entirely. In some cases, children may plead with parents to stay home, expressing deep anxiety about going to school. Treatment for child school refusal focuses on addressing the underlying causes of this anxiety and helping children cope with school-related distress.

 

Key Characteristics of School Refusal

Treatment for child school refusal should be considered when a child exhibits the following behaviours:

  • Complete absence from school for extended periods.
  • Partial attendance, where a child attends some classes but leaves before the day ends.
  • Severe morning distress, such as crying, tantrums, or other emotional outbursts related to school attendance.
  • Reluctance to attend school, despite repeated assurances or promises.

In contrast to truancy, which may involve acting-out behaviours and is often linked to delinquency, school refusal is driven by anxiety and fear. This is why children may also exhibit physical symptoms of distress, including stomachaches, headaches, nausea, rapid heartbeat, and even panic attacks.

 

Triggers of School Refusal and Treatment Considerations

The causes of school refusal can vary. In some instances, anxiety may arise due to a stressful event at school, such as starting school for the first time, changes in the class environment, bullying, or fear related to a school event. However, treatment for child school refusal is not solely based on addressing school-related triggers. School refusal can also stem from unrelated life events such as family changes, health issues, or other stressors outside the school environment.

Understanding the factors that maintain a child’s reluctance to attend school is crucial for effective treatment. These factors may include:

  • Avoidance of unpleasant feelings, such as anxiety or depression, associated with school.
  • Escape from difficult or uncomfortable situations, such as exams or social interactions.
  • Increased attention or sympathy from parents or caregivers, which reinforces the behaviour.
  • Additional time for enjoyable activities, such as playing video games or watching TV, which the child may perceive as more desirable than school.

 

The Importance of Early Intervention for School Refusal

Left untreated, school refusal can have serious long-term consequences. In the short term, it can lead to academic decline, social isolation, and family conflict. Without intervention, children may experience difficulty with homework, suffer from declining grades, and become more socially alienated. Over time, if the issue persists, it can affect the child’s long-term psychological development, with studies showing that around one-third of school-refusing youths continue to face significant challenges later in life.

Early intervention is key to managing school refusal effectively. Treatment for child school refusal often involves Cognitive Behavioural Therapy (CBT) to help children challenge and reframe their anxious thoughts and behaviours. In some cases, treatment may also include Parent Training or Behavioural Family Therapy, which equips families with strategies to support the child’s return to school.

Our psychologists are highly qualified, holding Master’s or Doctorate degrees in Clinical Psychology. We provide treatment for child school refusal using Cognitive Behavioural Therapy (CBT) and other evidence-based treatments like Mindfulness and Dialectical Behaviour Therapy (DBT).