What is School Refusal? School refusal is not a clinical diagnosis; however, school refusal behavior can be just as problematic or interfering. School refusal may also be referred to as school phobia and/or truancy and refers to a child or teen’s difficulty remaining in class for the full school day and maintain age-appropriate school attendance or coping with the stressors of school. School refusal specifically refers to individuals between the ages of 5 and 17 who exhibit any of the following:
Being absent from school for extended periods of time
Attend school but do not stay for the entire day or skip specific classes
Chronic tardiness
Attend school only after extreme morning behavioral problems (i.e., temper tantrums, refusing to move) which are in attempt to prompt absenteeism
Experience or display extreme distress throughout the school days and subsequent pleas to parents to be absent in the future
It is important to note that school refusal behavior is not an appropriate consideration when any of the following are present:
Physical illness which makes attendance problematic or unrealistic
School withdrawal initiated by the parent
Family or societal conditions that dominate in the child’s life (i.e., homelessness, running away from home to avoid mistreatment)
Psychiatric conditions or other problems crucial to the behavior (i.e., learning disorder, depression, academic failure, psychosis, substance abuse)
Extreme dysfunction in the family (radical permissiveness or minimal parental supervision)
Verbal or physical threats at school or poor academic environment (i.e., bullying, inattention to child’s academic needs)
How We Can Help Our therapists will use cognitive behavior therapy (CBT) to help the student learn distress tolerance skills and effective self-talk. Our therapists will guide parents and school personnel to effectively implement an incentive plan and reduce accommodating behaviors in order to motivate the student to use his/her coping skills to manage his/her anxiety and fear. Exposure therapy, problem solving skills, and effective communication skills are used to help the anxious student reframe his/her beliefs about the need for control, ability to cope and tolerate distress and uncertainty, and assert appropriate needs. The goal is to help the student transition successfully back to the academic setting.