School Refusal

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Many children enjoy going to school but for some school is experienced as terribly uncomfortable and evokes intense fear/anxiety.  Not wanting to go to school can occur at any time but is most likely to occur during times of transition (for example, going from elementary school to middle school), after a period at home (such as, summer vacation or brief illness), or after a period of stress (for example, a recent move, change in school, death of a pet/family member).  Children may have physical complaints (such as, a headache or stomachache) that occur just before they are supposed to leave for school or go to the nurse frequently while at school.  Illnesses often seem to improve when the child is at home only to return the next day when it is time to go back to school.  Children/adolescents may refuse to get up to go to school or have extreme reactions when forced to go to school.


Refusal to go to school when children are younger is often related to separation anxiety.  As children get older, school refusal is typically related to anxiety that may be related to something within the school environment (such as problems with learning or peer difficulties) or being present in school itself may lead to panic attacks (and the fear of having a panic attack, and subsequent inability to escape, that leads to the fear of attending).  School refusal can also be related to sadness/depression.


When to seek help:

  • If your child has increased levels of distress/worry about school
  • If your child refuses to go to school for more then a couple days in a row
  • If your child is missing school due to physical symptoms that seem to improve when at home
  • Your child is having intense emotional reactions about going to school
  • If there are concerns that your child or teenager is experiencing depression


Recommended strategies:

  • Cognitive behavioral therapy (CBT)
  • Collaboration with school personnel
  • Medication management if significant anxiety or depression





Separation Anxiety

Learning Problems