My Child Doesn't Want to Go School: What Do I Do?

What is School Refusal?

As a parent, we know how hard it is to shift from a vacation mindset to waking up early, working long hours, and getting back into work responsibilities can cause feelings of anxiety. These are the same difficulties and feelings many children have during the early weeks of a new school year. For some, school can feel so overwhelming that it creates distressing anxiety around attending and staying in school, and it becomes easier to avoid school altogether to relieve stress. I was hoping you could think about it from the fight-flight-freeze response, the body's response to protect us from a perceived threat or danger. From this perspective, this can look like acting out (fight), skipping class/school (flight), and unwillingness to engage/shut down in school (freezing). The motive of school refusal/avoidance is a tool used to escape distressing elements of school, which allows immediate but short-term relief.

According to a Psychology Today article by Alison Escalante, M.D., "Parents and children don't understand that staying home from school doesn't help." It makes it harder to return to school, to keep up academically, and potentially feel socially disconnected from peers and teachers. So, the more a child stays home from school due to feelings of anxiety, the more anxious they become about it, and that anxiety can often develop may develop into depression". Additionally, this short-term relief response prevents children from learning coping skills to address school-related anxiety, resulting in a cycle of school avoidance.

Identifying School Refusal

So, how do you identify school refusal? Most of us will answer well when our child refuses to go to school or skips. However, school refusal can manifest in several behavioral ways. According to Julia Martin Burch, Ph.D., These behaviors include difficulty attending school on time, leaving before the school day ends, or not attending school at all. School refusal can also manifest psychosomatically with headaches, fatigue, stomachaches, and other physical symptoms of anxiety that may make it hard to go to school or make it feel necessary to leave early.

What Should I Do If My Child Won’t Go To School?

Understanding your child's school refusal/avoidance is critical to addressing the issue and finding ways to support them. According to Julia Martin Burch, Ph.D. below is a list of strategies parents can use to combat school refusal:

Step in Quickly: Children missing school assignments and social experiences can escalate, making school avoidance a problem that is even more difficult to control. It's suggested to look out for difficulties your child may have around attending school on time and staying for the entire day.

Help Identify Issues: Gently talk with your child about why they're avoiding school, as you want them to be open and honest about the issue. You can ask questions like "What is making school feel hard?" Are they struggling socially or being bullied? Are you afraid of having a panic attack in the classroom? Are they worried about academic performance or experiencing Fear of being separated from you for a full day?

Communicate and Collaborate: Collaboration with Your child's school can be essential in combating school avoidance. Remembering you cannot handle the issue alone is key, and establishing a support system is vital. Utilize the school guidance counselor, psychologist, or social worker to share information about why your child struggles to attend school. This can help create a plan with your child and the school to identify ways to help address what they are avoiding at school.

Be Firm About School: Again, you want to be empathetic to your child's experience but firm about them attending school. Acknowledging the physical symptoms of anxiety, such as stomachaches, headaches, and fatigue, and validating that it can be unpleasant while ensuring they're not in danger. Children's symptoms need to be validated while also teaching them to persevere.

Make Staying Home Boring: Assess the home environment. Are there things that make staying at home more appealing, and how can we make the home environment less attractive? This can start by restricting access to screen time (cell phone, TV, iPad, etc.) and limiting sleeping/lounging in bed unless they're sick. The day should still have a routine as if they were in the school environment, asking the school to send assignments that need to be completed or even asking for a home tutor. Make clear expectations that if they do not attend school, all electronic devices will be taken, or home Wi-Fi will be turned off.

What is the Treatment for School Refusal?

Managing school refusal can become difficult for families utilizing licensed mental health professionals who specialize in school refusal treatment, particularly in areas such as child adolescent anxiety, and can be additional support in helping your child re-engage in school.

According to the Child Mind Institute, effective treatments are Cognitive behavioral therapy (CBT), which teaches skills to manage anxious thoughts and cope with fears. Exposure therapy focuses on gradual exposures to anxiety-inducing stimuli and situations. This is done to assist the child in eventually attending one or two classes to attend a full day of school by the end of treatment. According to the National Library of Medicine report, dialectical behavior therapy (DBT) is also an effective treatment for school refusal. It utilizes mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness skills. This treatment modality addresses comorbid psychiatric problems, family dysfunction, and other contributing problems.