Back to School: Understanding School Refusal & Cultivating A Positive Path Forward

mental health Aug 16, 2023

As a new school year dawns upon us, the excitement of fresh beginnings fills the air: new classrooms, new relationships, new skills and new opportunities to learn and grow. Yet for some students, this period can be marked by uncertainty, worry and anxiety. While it’s normal to experience nerves, some kids and teens experience a level of fear or anxiety that ultimately leads to school refusal.  

As we embark on this journey into a new year, it's important to bring awareness to the realities of school refusal: what it is, some telltale signs, its underlying causes, and how caregivers can help guide their loved ones toward a positive and successful school year ahead. 

What Is School Refusal? 

School refusal occurs when a child or teen experiences intense anxiety or fear related to attending school that results in avoiding the environment altogether. It's not just your typical "I don't want to go to school" reaction once in a while – it causes a mix of intense and prolonged emotional and physiological reactions and behaviors. Sometimes, it's related to specific situations, like tests or social interactions, while other times, it can result from a combination of multiple factors and underlying causes. 

Common School Refusal Behaviors 

While every child is unique, here are some common behaviors to be aware of: 

  • Physiological Manifestations: Frequent complaints of headaches, stomachaches, and other somatic symptoms that tend to disappear outside of the school environment. 
  • Escape and Avoidance Tactics: Frequent visits to the nurse's office, requests to stay home or elaborate strategies to avoid school. 
  • Negotiation and Bargaining: Attempts to negotiate through offers such as promising to do all schoolwork from home in exchange for not having to go. 
  • Emotional Displays: Outbursts of tears, tantrums, and emotional upheavals during the morning routine. 
  • Procrastination Strategies: Strong and consistent efforts to delay departure for school. 
What's Cooking in Their Minds? 

Now that we've covered the 'what,' let’s talk about the 'whys' behind school refusing behaviors. Kids might be wrestling with a whole zoo of anxieties, including: 

  • Social Struggles: The cafeteria, the playground, group projects – these might seem like harmless settings, but for some kids, these social environments make them feel uncertain, self-conscious and even unsafe. 
  • Performance Pressure: The fear of falling short or failing tests, presentations and grades can be enough to make many kids want to avoid school altogether. 
  • Bullying & Alienation: Unfortunately, bullying is a common experience in schools. Bullying creates feelings of profound fear, isolation and vulnerability and can quickly crowd out all positive school experiences in a child’s mind. 
  • Separation Anxiety: Missing their familiar cocoon of home and safe relationships can be tough. Leaving a parent's side feels like leaving their safety net behind. 
  • Resistance To Change: New classrooms, new teachers, new friends – for some, change is exciting; for others, it's uncertain, unfamiliar and overwhelming. 
The Anxiety-Avoidance Cycle 

When a child feels anxious, their natural reaction is to avoid whatever is making them feel that way – in this case, school. In The Mindfulness & Acceptance Workbook For Anxiety, authors John Forsythe, PhD and Georg Eifert, PhD have a great metaphor to help us understand how this cycle can quickly spiral into some pretty disruptive patterns: 

“Poison ivy is a plant that produces a strong skin irritant. Most people avoid touching the plant because they know what they’ll get: a nasty, red, blistering rash that itches like crazy. Maybe you’ve had a poison ivy rash before and know what it’s like. It leaves you with a strong urge to scratch. And when you do that, you make matters worse. You end up with open sores on your skin. And if you haven’t washed the plant oils from your hands and exposed areas, you may spread the allergic reaction to other parts of your body. No amount of scratching will cure the inflammation; you need to stop the scratching and allow your body to heal itself.  

The anxiety itch is like this too. The discomfort rages through your head and body, and you have a strong urge to get relief. So you avoid. You struggle. The problem is that you can’t avoid exposure to anxiety in the same way you can avoid a poison ivy plant. Anxiety can show up anytime or anywhere. When you scratch your anxiety itch with avoidance, it makes the anxiety worse—the anxiety grows and spreads to infect most of your life. And all that avoidance scratching pulls you out of your life too.” 

Just like giving into the urge to scratch worsens a poison ivy rash, giving into the urge to avoid school in turn intensifies feelings of anxiety in the long term. Soon, the fear of school becomes all-encompassing.  Much like treating poison ivy, breaking free from avoidance-cycle of school refusal involves understanding, patience, and intentional strategies to help kids navigate their fears and regain a sense of control over their emotions and environment. 

Being a Beacon of Support 

Navigating school refusal as a caregiver can feel uncertain and challenging. Let’s talk about some strategies for providing emotional support while still encouraging and empowering your child to return to school.  

Open The Lines of Communication 

Create a safe space where they can share their fears and worries. Listen without judgment and let them know you're there to help through empathy, validation and an effort to understand where they are coming from. Additionally, asking specific, open-ended questions can help increase a child’s awareness into what they’re thinking and feeling. Here are a few examples: 

  • What triggers you at school... 
  • How can I help you with... 
  • Help me understand... 
  • Tell me more about what you're feeling... 
  • What do you think we can do next... 
Team Up with the School 

Together with teachers and counselors, you can create a plan to set your child up for success. Part of this plan could include designating a safe space in the school for your child to go to decompress for a brief period of time instead of leaving school altogether. Whatever the plan may be, ensure it is communicated clearly to all members of the team, including your child. 

Anxiety Coping Skills 

In partnership with a mental health professional, kids can learn and practice coping skills such as deep breathing exercises and mindfulness techniques to rely on in anxious moments. These kinds of skills not only help address the underlying issues that lead to school-avoiding behaviors, but also empower kids to apply them in other situations that may make them feel anxious, too. Check out this resource for some easy to apply techniques! 

If school refusal is something you’re struggling with in your household, know that you are not alone – there are resources and programs available to help you. If you are local to Northeastern Illinois and looking for services, please don’t hesitate to reach us at 224-424-0432 or visit our website at

Empowering Long-Term Resilience 

School refusal is complex and can manifest in many different ways. As we begin a new school year, it’s important to be aware of the signs, the underlying causes and some strategies for providing support to a child who’s struggling. By understanding their anxieties, providing a safe space, and taking small steps together, you're not just helping them return to school – you're empowering them to face all of life's challenges with resilience. 

Additional School Refusal Resources: 

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