School Refusal
By Max Pohlman
When reading the term school refusal, you may at first be confused. You may ask why schools would refuse kids or if it’s even allowed. But school refusal actually refers to kids refusing to go to school because of emotional turmoil. When kids start having issues at school or home, they can develop feelings of anxiety and depression. Those feelings can cause kids distress and they might fight and refuse to go to school.
While some may think that their kids are acting out just for attention, it may actually be caused by anxiety. Tekin and Aydın (2022) performed a review of 30 studies about school refusal and anxiety. They came across multiple terms for kids not attending school that are often used interchangeably. However, they really shouldn’t because they each have their own definitions. One of the most common terms that is used instead of school refusal is truancy. Truancy refers to the illegal and unexcused absences from school (Tekin & Aydın, 2022). School refusal is not truancy, and to label a child who has anxiety as truant is detrimental to their mental health because they are dismissed and not offered help. According to Psychotherapist Katie Hurley in How to Help a Child Overcome School Refusal; Tantrums to avoid school are a symptom of a bigger problem, some signs of school refusal are…
Running away from school
Hiding from school
Lashing out
Headaches
Stomachaches
Chest and muscle aches
Feeling sick or exhausted
Having trouble getting out of bed in the morning
She also states that school refusal can continue even after kids make it to school. Kids may frequently…
Visit the nurse
Call home
Refuse to participate in activities
Over the years, school refusal has become a sizable issue. According to Hurley (2017), 2%-5% of children each year will refuse to go to school because of anxiety and depression. She outlines some common types of anxiety and depression seen in kids who refuse to go to school.
Separation anxiety is a common reason for younger kids to refuse school but also pops up during transitional periods of their lives, like changing schools.
Social anxiety is another common type of anxiety that is seen in students; they worry about being judged and often feel anxiety before a performance or publicly speaking.
Generalized anxiety is the term used to encapsulate excessive anxiety about a wide variety of things including feeling anxious for no understandable reason.
Depression, which can create a wide array of symptoms because it messes with your mood. Although many people present more irritability, refusing to participate in activities and acting differently from their usual selves, they may also have changes in their sleeping, eating, and socializing habits.
There are many anxiety disorders, but many people understand anxiety as an umbrella term to describe feeling uncomfortable and worried. My siblings and I have all refused to go to school at some point in our lives, and I can say from firsthand experience that it can wreak havoc on a family. My siblings had a hard time getting up and going to school. There were days my parents would fight for over an hour to get them ready and off to school. My sister had anxiety from school and would exhibit many physical symptoms. She would wake up with migraines and want to puke. Unfortunately, if she didn’t go to school, she would be marked as an unexcused absence and after so many, truant. This is problematic because she wasn’t faking these symptoms, instead her body was under so much stress about going to school that she would wake up with a migraine. Once I got to school, I became so anxious over tests, social situations, and expectations, that I often went home early from throwing up because of a stomachaches or headaches. These are just some examples of what school refusal may look like.
However, while avoiding school can provide short term relief, over time it can create a lot of problems. Tekin and Aydın found that some short-term problems include…
Family conflict
Falling behind in school
Becoming isolated from friends and peers.
In the long-term, school refusal was associated with…
Dropping out of school
Psychological problems in adulthood
Substance abuse
Economic instability
Burch (2018) suggests that avoiding school also deprives kids of the opportunity of learning how to cope with challenges in school and can lead to a cycle of school refusal. So, what can we do to help kids who are refusing school? Well, there are many options but all of them start with creating a team. Ideally the student, parents, teachers, a school psychologist, counselor, social worker, and even outside clinician work together to come up with a plan to reintroduce the child into school. This plan can look different for everybody. Tekin and Aydın suggest using outside therapy such as cognitive behavioral therapy (CBT) or family therapy. They also suggest making sure schools are a safe, open, friendly, and overall positive space where kids can learn and make mistakes without fear of being punished, compared to others, or being made fun of. Burch also suggests a gradual reentrance into school but tries to stress the importance of not letting school refusal become a pattern in the first place. She urges parents to step in quickly and help address issues while being firm with their kids that they must go to school. Tekin and Aydın suggest training teachers and raising awareness of school refusal and anxiety and coming up with preventative behavior programs that can teach children to regulate and reduce feelings like anxiety before they become a bigger issue.
There is no simple way to stop school refusal. Kids grow and experience setbacks all the time but acknowledging problems and setbacks, and continuing to provide kids with the tools and support they need can help them grow into themselves.
References
Hurley, K. (2017, October 25). How to help a child overcome school refusal. Psychology Today. https://www.psychologytoday.com/us/blog/worry-free-kids/201710/how-help-child-overcome-school-refusal?msockid=075cf90abc9260b92b4dec9fbdcd61ac
Martin Burch, J. (2018, September 18). School refusal: When a child won’t go to school. Harvard Health. https://www.health.harvard.edu/blog/school-refusal-when-a-child-wont-go-to-school-2018091814756
Tekin, I., & Aydın, S. (2022). School refusal and anxiety among children and adolescents: A systematic scoping review. New Directions for Child and Adolescent Development, 2022, 43–65. https://doi-org.ezproxy.mnsu.edu/10.1002/cad.20484