For many kids school is a place of friendship, growing curiosity and building confidence. However, for some kids, just the thought of stepping foot into school brings stomach aches, tears and fights begging parents to stay home. Parents try validating and compassion, then boundaries and punishment as the school refusal drags on. But what if the key to getting your kid back to school was a shift in mindset not added discipline?
While school refusal is seen as a power struggle of defiance, it is more often than not, anxiety shrouded by meltdowns and big behaviors.
What School Refusal Actually Is
School refusal is a pattern of behavior leading to difficulty attending and remaining in school due to emotional distress. This is different from truancy, laziness and delinquency
Often this is paired with physical symptoms of stomachaches, headaches, nausea that are all very real and cannot be chalked up to manipulation. This pattern of missing school points to an underlying cause - finding that cause instead of trying to fight the behavior is the key many parents struggle with.
What's Usually Driving It
Anxiety about something at school
Younger children, or children going through a transition (could be a new middle schooler!) can experience separation anxiety when leaving a caregiver
Social anxiety shows up with fear of embarrassment, difficulty finding friendships and forming relationships
Specific fears (real or perceived) are a common underlying cause including riding the bus, a teacher, a test, etc.
Escaping uncomfortable feelings
If school triggers a negative emotion, avoidance is a common pattern which provides temporary relief but no long-term solution
Attention from parents
Sometimes children are not able to voice feelings of sadness or of missing parents or needing connection - instead it shows up as repeat sick days to spend more time with mom and dad and get that craved 1-1 attention
Tangible rewards outside school
The comforts of home can outweigh the environment of school: screens, a cozy bed, pets and time with parents
Why "Just Make Them Go" Doesn't Work — and What Does
Forcing a child to go to school might be a short-term win for parents, but it does nothing to address the underlying behavior and therefore rarely breaks the pattern. Instead, forcing kids leads to power struggles that take over a peaceful homelife, damage the parent-child relationship and can lead to kids hiding behaviors instead of fixing the root cause of anxiety.
Coercion and force do not teach skills that kids are lacking - the anxiety is still present and will find other ways to manifest if no skills are taught.
Gradual return, not cold turkey is what evidence-based treatments show works best. A structured approach to returning to school should include a plan for the day on what to do when anxiety emerges and practicing those skills ahead of time.
How CBT Can Help with School Refusal
CBT targets the thoughts and behaviors maintaining refusal:
Cognitive Restructuring: challenging and reframing the negative thoughts around school instead of dismissing them
Exposure: gradually facing fears with support and structure in place to build confidence
Parent Coaching: Clinicians can help parents build tools to manage emotional regulation (for both kids and adults) rather than punish or avoid
School Collaboration: Teacher and school support is essential for kids to have wrap-around support and the highest success rate
Long-standing patterns of school refusal are exhausting, disheartening and cause parents to worry their kids will never attend school again. Parental fear leads to punishment and coercion, or giving in to avoidance - neither of which change behavior or address the root anxiety issue. Trained clinicians can help kids and caregivers identify the root anxiety that is showing up as school refusal and help implement a plan to manage the anxiety and get kids back in school with confidence and calm.
If you are tired of fighting the battle of school refusal, reach out for an immediate consultation. Dr. Victoria Bacon is an expert in school refusal and works with families to get kids back to school.