Tips for Taking Charge of School Refusal - Thrive Alliance Group

By Zack Schwartz, MSW, LCSW, PsyA | Director of Thrive Services

10 Warning Signs of School Refusal

School refusal in children and adolescents is a significantly growing issue that impacts not only the student but the entire family, school personnel, and mental health professionals working with the student. Although school refusal may appear to be a very simple or concrete issue to resolve, it is often misunderstood and consequently minimized and mistreated. Without proper intervention, the student’s attendance deteriorates, his anxiety further increases, and the school refusal cycle is perpetuated. When left unchecked, school avoidance can become chronic and will present a significant obstacle to a child’s healthy development.

Most school refusal issues stem from strong feelings related to the process of separation/individuation. Frequently, the school avoidant child has anxiety about separating from his parent(s) and is intensely worried about peer/social relationships at school. In other cases, the child is afraid to separate from the parents due to concerns about the parents’ own feelings about separation. Unfortunately, the feelings that lead to school refusal are not often discussed, understood, or even identified. These can be overt feelings of anxiety or other underlying feelings such as abandonment, disappointment, guilt, worry, shame, embarrassment, etc. These unexpressed and unaddressed feelings are key precursors to school avoidance.

Although it is often difficult to recognize feelings that have not been expressed, there are early and often subtle indicators prior to the onset of significant school avoidance that parents and school personnel are advised to address before the situation intensifies.

The following are some of the common early warning signs of a student’s increasing anxiety that lead to school avoidance and refusal:

• Increasing/excessive tardiness
• Monday and post-holiday absences
• Increase of vague somatic complaints in the morning
• Unspecified illnesses or sickness in the morning “something is wrong with me”
• Frequent visits to the nurse’s office and/or bathroom
• Unsubstantiated issues with peers and teachers
• Avoidance/withdrawal of school-related activities, such as sports, clubs, etc.
• Crying and/or tantrums when topic of school is brought up
• Irrational reasons by the student about why he/she cannot go to school on a particular day (such as, “I’m already late and can’t walk in during the middle of a class”)
• Fantasy-like communication by the student related to his/her absenteeism (such as repeatedly promising to go to school tomorrow and then not going)

It is critical to recognize these signs at an early stage rather than assume that the child will just start feeling better and return to school. The reality is that the child’s emotional state will not improve when he/she is at home and not receiving interventions to address the behavior. It must be emphasized that, while the child may indicate that he/she is feeling better during a school day spent at home, these feelings are very temporary and they only provide relief for the child in the moment. The underlying feelings will continue to resurface the next morning when the anxiety returns about separating and going to school for the day.

8 Interventions for School Refusal

In an effort to facilitate a child’s attendance and participation at school, school professionals and parents/guardians often need to work together in being proactive to address the issue of school refusal rather than allowing the child to dictate the appropriate course of action. An effective means to help the child move out their front door and into the school door is to consistently employ home and school-driven interventions. While parents/guardians often worry that pushing the child to do something he/she doesn’t want to do will only make the situation worse, the current situation will inevitably continue to deteriorate in the absence of clear expectations and a unified message. It is critical that parents/guardians and school professionals are aligned in utilizing some or all of the following interventions:

• Making it as easy as possible for the student to go to school by meeting him/her at a discreet school entrance door and/or letting the student go to an emotionally safe place when arriving at school (e.g., CST, guidance, nurse’s office, etc.) rather than going to class immediately.
• Helping the student develop a step-by-step plan to both get to school and to map out the school day. This gives the student some control in the situation and can increase his/her investment in the process.
• Communication on a daily basis between student/family and school professionals to discuss attendance issues as well as making it clear to the student that he/she can reach out to the school professionals at any time.
• Empowering the parents/guardian to talk with the student to anticipate and resolve potential school avoidance issues each night before bed rather than reactively discussing them in the morning.
• Implementing incremental consequences to make home feel less comfortable than school. The most appropriate consequences for school avoidant behavior generally involve the limiting/removing of a short-term, daily pleasurable activity or privilege that the parent can easily monitor (e.g., taking away the child’s cell phone, not allowing the child to go out with friends, or curtailing the use of video games or other forms of entertainment).
• Coordination between family and school in conducting a home visit after multiple tardies or absences by the student.
• Facilitating a multi-disciplinary meeting at school with school personnel, student, family and providers to ensure that all involved are on the same page. Additionally, any extended family or peers who have meaningful relationships with the child should be considered as resources in helping to remedy this situation.
• Initiating/coordinating care with outside providers, agencies, pediatrician, etc., when additional support is needed outside of school.

Overall, it is important not to minimize school refusal by attributing it to the child being a so-called “bad kid” or simply oppositional, defiant, confrontational, or angry. Children who are susceptible to school avoidance may very well be angry but they are often also sad and anxious. As indicated above, it is important to remember that school refusal is an expression of the student’s unspoken feelings. If the student does not receive the support that enables his/her expression of these feelings, school avoidance can become increasingly entrenched and result in social isolation and problematic education gaps. Ultimately, if the issue of school refusal is to be resolved once and for all, it takes a concerted effort from parents/guardians, school personnel and mental health professionals.

For more in-depth information and refreshers about working with school refusal, please feel free to check out the following Sage webinars.

https://vimeo.com/89667863

https://vimeo.com/112515191

https://vimeo.com/159737738