School Refusal is a common, but often misunderstood and misinterpreted act of children and pre-teens. When left untreated, school refusal can lead to damaging results.

school refusal

What is school refusal?

School refusal is the consistent act of a child or teen to get out of attending school. School refusal is different than truancy. While truancy is a deliberate behavior, school refusal is the symptom of underlying mental health issues.

While some children will complain about school, drag their feet and make every morning a frustrating one, this may not necessarily be school refusal. For a small fraction of children, the issue goes much deeper and may require treatment. These students refuse to attend school and fight each and every morning making the process of attending school a battle.

Psychology Today states that, “This phenomenon, known as school refusal, isn’t a behavior problem. You can’t punish your child out of school refusal. Instead, it’s a form of anxiety that demands treatment.” In fact, 2-5% of students refuse school each year due to school refusal brought on by anxiety or depression.

Will my Student be Prone to School Refusal?

The Anxiety and Depression Associate of America (ADAA) state “It commonly takes place between the ages of five and six and between ten and eleven, and at times of transition, such as entering middle and high school.” The ADAA has also found that children who suffer from school refusal tend to have an average or above-average intelligence. Despite their intelligence level, students dealing with school refusal are at risk of developing serious educational and social problems as their fears and anxiety will keep them from engaging in everyday activities and social settings.

Students may experience school refusal issues for a number of reasons. These issues may occur when the student:

  • Moves to a new city/town or school
  • Begins school for the first time
  • Experiences a stressful life event
  • Has experienced trauma
  • Fears that something will happen to their parents while he/she is at school
  • Fears they will not do well in school
  • Fears another student or bully within the school

How is School Refusal Developed?

While it may appear that your child or teen is suddenly adverse to the idea of school, these issues did not simply appear overnight. Many students will quietly and gradually deal with anxiety and other issues surrounding their school experience. Psychology Today sites that oftentimes the development of school refusal relates to 4 stages or disorders: Separation anxiety, Social anxiety, Generalized anxiety and Depression.

Separation Anxiety

Separation anxiety is often experienced first by young children and is an overwhelming concern or anxiety for their parents’ safety. It often includes excessive fear of harm or death of the parent while the child is away. This fear also occurs in older pre-teens and teens as they enter middle school or high school.

Social Anxiety
Students dealing with social anxiety fear the perception of others. They are most concerned about being judged and scrutinized by peers and adults. They often have heavy anticipation and fear of public speaking.

Generalized Anxiety

Children or teens suffering from generalized anxiety may worry about a number of events or activities. This can work its way into the school setting but can also follow the child later in life into their career.


Those suffering from depression experience extreme and overwhelming symptoms such as depressed mood, sleep disturbance, isolation, suicidal thoughts/ideations that impact their daily lives.

Signs of School Refusal in Children and Teens

How do you know if your child is suffering from school refusal? There are a number of warning signs.

  • Physical avoidance of school
  • Deliberate and repetitive tantrums
  • Running or hiding during morning school hours
  • Lashing out with physical force
  • Physical complaints of headaches, stomachaches, chest pains, muscle pains, feeling dizzy or exhausted
  • Regular visits to the school nurse with no real medical issue
  • Illness on test day or presentation days
  • Frequent requests to call home
  • Low motivation in the morning
  • Staying in bed
  • Refusal to engage with peers
  • Avoidance of social activities
  • Willingness to complete work at home
  • Being sick until allowed to stay home

How To Help My Teen

How can I help my teen who is suffering from school refusal?

  • Step in quickly
    If the problem persists for more than 2 days, step in. Don’t allow school work to be left unfinished and classes to be missed. This will create a more difficult and overwhelming environment for your child.
  • Help Identify Issues

    Find out why your child refuses to attend school. Ask questions gently. Realize that this is not a behavioral issue and your child may be facing difficult situations at school. Determine the root cause of the issue. Is your child being bullied? Are they anxious about tests or presentations? Find the root cause of the school refusal.
  • Communicate and Collaborate

    Contact the school counselor or another important professional in your child’s education. Provide information to the school about avoidance and work together to create a plan for your child. Contacting a mental health professional may also help to shed light on the situation and any underlying causes of the refusal.
  • Be Firm
    Balance empathy and firmness for your child. They must attend school, but it is also important to resolve the issue behind their refusal.
  • Make staying at Home Boring
    Is there anything about home that makes it extra appealing to stay there? Eliminate those extras and make staying home from school as much like school as possible. Turn off devices and don’t allow screens. Turn off your wifi on “sick days.”
  • Sleep
    Encourage healthy sleep. Remove digital devices from the bedroom in the evenings. Exhaustion can exacerbate the symptoms of anxiety and depression and also be a player in school refusal.

There is no quick fix to school refusal. Your child may experience ups and downs as they deal with the symptoms of fear, anxiety, depression, and other underlying causes of school refusal.

For some students, a more clinical approach may be required. Cognitive Behavior Therapy is one way that students can learn healthy coping skills and the tools they need to succeed. CBT is a highly structured form of therapy and helps children identify their current thought patterns and behaviors. It then assists them in finding healthy ways to replace those thoughts and actions.

Residential mental health programs, such as Shepherd’s Hill Academy, allow students to enter into a different environment that is conducive to mental health and wellness. These programs include CBT and other modalities in the student’s treatment experience.

Shepherd’s Hill Academy offers a fully accredited on-site academy with teachers, principal and teacher’s aides. Individualized attention, goal setting, small class sizes and a mental health focus allow students who may otherwise avoid school to thrive.

Shepherd’s Hill Academy is a faith-based 12-month program for teens ages 12-17. The program offers fully accredited academics, therapy by master’s level clinicians, and a wilderness adventure setting. The program is fully unplugged, providing students with an environment free of peer distractions and digital devices proven to increase anxiety in teens.

Learn more about how Shepherd’s Hill Academy can help your teen recover from school refusal.