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School Refusal

What is School Refusal?

School refusal, also known as school avoidance or school phobia, is a complex and often distressing behavior characterized by a persistent reluctance or refusal to attend school. School refusal is not the same as truancy, as it is typically driven by emotional distress, anxiety, or other psychological factors rather than a desire to skip school for other reasons.

Reasons for School Refusal:

There are various reasons why a child or adolescent may refuse to attend school, including:

  • Anxiety: Anxiety disorders, separation anxiety, social anxiety, generalized anxiety, or specific phobias related to school environments or activities can contribute to school refusal.

  • Depression: Symptoms of depression, such as low mood, lack of interest or pleasure in activities, or feelings of hopelessness, may lead to school refusal.

  • Bullying or Peer Issues: Experiences of bullying, social exclusion, peer conflict, or difficulties forming friendships at school can contribute to feelings of fear or discomfort.

  • Academic Challenges: Struggles with academic performance, learning disabilities, perfectionism, or fear of failure may lead to avoidance of school-related tasks or environments.

  • Family Issues: Family disruptions, transitions, conflicts, or stressors at home may contribute to school refusal behaviors.

  • Physical Health Concerns: Physical health issues such as chronic illness, pain, or undiagnosed medical conditions may lead to avoidance of school.

  • Trauma or Loss: Experiences of trauma, loss, or significant life changes such as divorce or relocation may trigger school refusal.

Signs of School Refusal

Recognizing the signs of school refusal can help parents and caregivers identify when a child or adolescent may be struggling. Signs of school refusal may include:

  • Repeated complaints of physical symptoms (headaches, stomachaches) before school or during school mornings

  • Excessive worrying or preoccupation with school-related activities

  • Resistance or refusal to get out of bed, get dressed, or leave the house for school

  • Tearfulness, tantrums, or meltdowns when faced with the prospect of going to school

  • Frequent requests to stay home from school

  • Decline in academic performance or engagement

  • Social withdrawal or isolation from peers

Impact of School Refusal: 

School refusal can have significant consequences for children, adolescents, and families, including:

  • Academic Struggles: Chronic absenteeism due to school refusal can lead to falling behind academically, difficulty catching up, and reduced opportunities for learning and achievement.

  • Social Isolation: School refusal may lead to social withdrawal, loneliness, and difficulties forming friendships, which can impact social development and well-being.

  • Family Stress: School refusal can cause stress, conflict, and disruption within families as parents struggle to manage their child's refusal to attend school.

  • Emotional Distress: Children and adolescents who experience school refusal may suffer from anxiety, depression, low self-esteem, or other emotional difficulties related to their school-related struggles.


Effective treatment for school refusal typically involves a combination of interventions that address the underlying causes and provide support to the child, adolescent, and family. Treatment options may include:

  • Cognitive-Behavioral Therapy (CBT): CBT can help children and adolescents identify and challenge negative thoughts and beliefs related to school, develop coping skills for managing anxiety, and gradually increase exposure to school-related situations.

  • Family Therapy: Family therapy can help improve communication, reduce conflict, and strengthen family relationships while addressing factors that contribute to school refusal.

  • School-Based Interventions: Collaborating with school personnel to implement accommodations, modifications, or interventions to support the child's return to school, such as gradual reintegration plans, social skills training, or individualized education plans (IEPs).

  • Medication: In some cases, medication may be prescribed to help manage symptoms of anxiety, depression, or other mental health conditions that contribute to school refusal.

  • Support Groups: Participating in support groups or peer-led organizations for children, adolescents, or parents dealing with school refusal can provide validation, understanding, and connection with others who have similar experiences.

How We Can Help: 

Our therapists specialize in providing compassionate, evidence-based support for children, adolescents, and families who are struggling with school refusal. We offer individualized treatment plans tailored to each client's unique needs and circumstances, with a focus on promoting healing, resilience, and successful school reintegration.

If you're concerned about your child's school refusal or are seeking support for your family, don't hesitate to reach out. Contact us today to schedule a consultation and take the first step towards addressing school refusal and supporting your child's well-being and academic success.

Therapists that work with School Refusal

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