Managing School Refusal and Anxiety

Just like adults have days where they don’t want to go to work, it’s only natural for kids to have days where they don’t want to go to school. However, an extreme pattern of school avoidance catches up with some children. This is tough, because frequent absences can have a negative effect on social skills and academic performance. Not to mention, conflict around getting to school can lead to a strained parent-child relationship. Luckily, evidence-based interventions, such as Cognitive Behavioral Therapy (CBT) and Supportive Parenting for Anxious Childhood Emotions (SPACE), can provide concrete tools to facilitate in managing school refusal.

What Exactly Causes School Refusal?

School refusal, defined by the inability to maintain age-appropriate functioning in school attendance and/or adaptively cope with school-related stressors, can be caused by a variety of reasons. These reasons could be social anxiety, bullying, academic pressure, or even learning disabilities. For this blog, we will specifically address school refusal explained by anxiety and associated avoidance behaviors. For instance, a child may feel anxious about something at school, worry about their ability to handle it, and want to stay home. Because it is often difficult to see children in distress, parents often “give in” or accommodate. They might let the child miss the school day or come home early. While this helps children feel less anxious in the short term, continued absence from school heightens anxiety and related school refusal behavior. When parents provide supported opportunities for children to confront their fears, children learn they can indeed tolerate their anxious emotions.

What Does School Refusal Look Like?

School refusal is more than just a reluctance to attend classes; it is a manifestation of rooted anxiety and fear that a child has about being in a school setting. One important aspect of our job as parents is to understand the feelings behind our child’s behavior. What exactly is your child anxious about in the context of attending school? For some children, the idea of being called on in class is overwhelming. Others are worried about separating from their parents, or facing the school bully.  Anxiety in children can show up in different ways. From physical symptoms like stomach aches and headaches to emotional responses such as irritability, excessive worrying, and panic attacks. Even though anxiety might look like “misbehaving” or “acting out,” school refusal in this case is not defiant or oppositional.

How Can Parents Help Their Kids With School Refusal?

So, you’ve identified that your child is exhibiting school refusal and school anxiety. What do you do? The goal, now, is to determine what is driving the refusal behavior. Try making some educated guesses and see how your child responds to them. You could also encourage your child to express feelings about school through drawing or, if older, writing a letter. However you choose to have this conversation with your child, focus on being validating and understanding. As parents, we play a pivotal role in helping our children navigate and manage their school refusal and anxiety. Foster open communication by creating a safe space for children to express fears and concerns comfortably. It can also be helpful to make a timeline: what happens before and after your child asks to stay home for the day? Understanding triggers and acknowledging emotions empowers parents to collaborate with teachers and school staff in developing strategies for the student’s well-being.

What Are Some Strategies That Can Help With School Refusal?

Once you have a better sense of what is contributing to your child’s school refusal, create a structured plan. A child worried about separation from a parent can benefit from gradual practice spending time apart from the caregiver. Another might feel unsure or nervous about how to interact with peers. In this case, consider practicing social skills at home and providing additional opportunities for positive peer relationships, like extracurriculars or community groups.

Anxiety-related school refusal is directly related to difficulty tolerating distress. One of the most important things parents can do is to teach their children ways to cope with strong feelings. Try brainstorming with your child things she can do when feeling overwhelmed. This could be taking bubble breaths, counting down from 10, or squeezing Play-Doh between her fingers. Caregivers can model using such skills when feeling nervous or frustrated. In fact, caregivers’ own regulated state can help the child feel safe and calm through a process called co-regulation. Other helpful strategies to help children manage anxiety include routines and structure (say, a morning checklist) and employing clear warning statements (in five minutes, we will start to get dressed for school). 

What Can Parents Do About School Refusal?

Children who are anxious benefit from validation and encouragement. We encourage parents to express empathy and acknowledge the child’s feelings (I understand you are worried about not having things to talk about with friends) AND confidence (I know you can do it, just like we practiced). Such supportive statements send the message that their child can handle anxiety, which is internalized by the child. Empowering children with coping mechanisms is crucial in managing school refusal and anxiety. Mindfulness, deep breathing exercises, and seeking professional counseling are techniques that help develop your child’s resilience and enhance their ability to navigate challenges.

Sometimes, parents act in ways that unintentionally reinforce the refusal behavior. These actions are often driven by a biological drive to protect the child. But ultimately this can cause issues in the long-term.  If a child gets to stay home and play video games or have an extra special meal, she may be motivated to continue doing so.  If school refusal is becoming a pattern with your child, assess the family dynamics at play and identify opportunities for change. Provide your child with other opportunities to earn video game time, so that staying home from school is not as appealing. Consistent, clear expectations and effective commands are also helpful at addressing refusal.

How Can Schools and Teachers Help With School Refusal?

When managing school refusal, the best results happen when parents align with teachers and school faculty. Parents don’t need to divulge the intricacies of their child’s anxiety. But, they can work together with educators to make a plan to help the child cope. It can be helpful to provide simple education about the school refusal and support faculty in taking a supportive response, rather than a judgmental or critical one. Many caregivers have success when they identify a point person to serve as a liaison between family and school staff to advocate for appropriate accommodations. While a child is working on returning to school, reduce academic demands, minimize assignments involving public speaking, or allow the child to have lunch in a quiet space. These accommodations actively support the child’s return to school, rather than helping the child in avoiding the anxiety connected with returning to school.

Does Fear of Failure Influence School Refusal?

Children receive a lot of feedback in school. For some, the critical feedback is overwhelming and drives a desire to stay home. While we can’t necessarily change the nature of academic emphasis on performance and grades, we can help children feel more comfortable handling such assessment. For example, caregivers can model making mistakes and problem-solving solutions. We encourage caregivers to focus on praising effort instead of outcome. For example, provide positive attention around how focused or persevering your child was in tying his shoes instead of exclusively focusing on the fact that he did (or didn’t) succeed in doing so. 

It is important to address school refusal as soon as possible. School absences can snowball, and missing a day or two can very easily escalate to missing weeks at a time. School refusal and anxiety are complex challenges that require a compassionate and multi-faceted approach. Many families benefit from collaborating with a mental health professional. More specifically, one with expertise in working with children and adolescents, and trained in anxiety and related disorders. If you are looking for more support in managing school refusal in your child, please click here for a consultation call to learn more about how we can help.