School Refusal: How to Help Our Children Thrive This School Year

Back to school transitions bring many stressors for children, teens, parents, and teachers.  Since the COVID-19 pandemic, school refusal and struggles related to school attendance have become a worsening mental health crisis.  Each Fall, the shift from relaxed summer schedules to early morning wakeups, days in the classroom, homework, and social pressures creates mild anxiety, mood disturbances, and irritability in many students.  For those prone to more debilitating anxiety and depression, however, the return of the school year can feel overwhelming to the point of refusing attendance altogether. 

What is school refusal?

School refusal includes a range of behaviors aimed at avoiding distress related to school.  These behaviors include refusing to attend school at all, difficulty remaining in class, frequent visits to the school nurse or counselor, resistance to getting out of bed or ready for school in the morning, frequent crying spells before and during school, and other forms of excessive distress about going to school. 

The Cycle of Anxiety and Avoidance

While each student experiences school-related distress uniquely, the common underpinning for most is anxiety—often leading to avoidant coping strategies.  When children and adolescents experience uncomfortable emotions about going to school, many will then attempt to avoid the situations about which they feel anxiety.  In the moment, avoiding the stressor provides an immediate relief from anxiety.  However, the more school is avoided over time, the more anxiety and fear builds in the individual. 

During COVID-19, students could not confront most of their school-related anxieties in virtual settings.  Meanwhile, the pandemic saw widespread increases in anxiety, depression, and other mental health problems among children and adolescents.  As students have returned to in-person education, school refusal issues have increased pronouncedly, with mental health experts deeming it a growing mental health crisis.

What to do if your child won’t go to school:

If your child is exhibiting school avoidant behaviors, know that you are not alone and the situation can improve with appropriate interventions.   The School Avoidance Alliance reports that child-motivated school refusal affects between five and 28 percent of students at some point in their youth.

For effective treatment, it is crucial to seek the help of a qualified mental health professional.  A therapist can help uncover and treat the underlying issues contributing to school avoidance.  These may include anxiety, depression, Obsessive-Compulsive Disorder, Panic Disorder, learning disabilities, bullying, trauma, perfectionism, low self-esteem, and other mental, emotional, and environmental factors.  Therapy, combined with close collaboration with school administration to develop appropriate accommodations, such as 504 plans or Individualized Educational Plans (IEP), is paramount for supporting your child holistically. 

Karla Smith Behavioral Health’s Approach

At Karla Smith Behavioral Health, we emphasize the wellbeing of the entire family.  When adolescents struggle with school refusal or other issues, our team develops a treatment approach that addresses the needs and dynamics of the family system.  Our therapists support clients in returning to school through individually tailored treatment plans that also incorporate family therapy, group therapy, support groups, and regular outreach to school administrators.

If you are concerned about your child’s school avoidance or other mental health issues, contact us to learn more about our services and schedule an initial appointment.