How to Help a Child or Teen with Back-to-School Anxiety

Is your child refusing to go to school? You are not alone. School refusal can be characterized by a child’s consistent reluctance or refusal to attend school due to emotional distress. Unlike school truancy, which is often characterized by a lack of interest in school and is done without parental knowledge, school refusal involves significant anxiety, difficulty and distress, with parents usually aware of their child’s struggle. Recognizing and understanding the underlying causes and knowing how to support your child through this challenging period is crucial for their well-being and academic success. 

Common Causes of School Refusal  

• Bullying and Peer Issues: Bullying, whether physical, verbal, and/or cyber, can significantly impact a child’s willingness to go to school.  Children who are bullied at school may develop a strong aversion to attending. Fear of facing bullies or being ostracized by peers can create a hostile and unsafe perception of the school environment.  Even subtle peer conflicts, such as exclusion or teasing, can contribute to school refusal. 

• Academic Pressure: Children who struggle with academic performance may develop a fear of failure or embarrassment. Learning disabilities, unidentified disabilities, or simply feeling overwhelmed by the curriculum can lead to anxiety about attending school.  High expectations from parents or self-imposed pressure to perform well can also cause anxiety. Fear of failing or not meeting standards may result in school avoidance.  

• Transition Periods: Moving to a new school, progressing to a higher grade, or changes in family circumstances (like divorce or relocation) can trigger school refusal due to the stress of uncertainty of new environments.  

• Mental Health Issues: Conditions such as depression, generalized anxiety disorder, social anxiety, or specific phobias can contribute to school refusal. These issues often require professional intervention for effective treatment.  

• Family Issues: Family dynamics and home environment play a crucial role in a child’s emotional well-being.  Divorce, parental conflict, illness in the family or recent loss can create an unstable environment, leading to school refusal. Children may feel the need to stay home to offer support or because they are afraid to leave a parent alone or separate from them. 

• Traumatic Events: Personal or family-related traumatic events, such as a death in the family, illness, or other significant life changes, can result in a child developing an aversion to school.  

• Physical Health Problems: Chronic illnesses, undiagnosed medical conditions, or frequent illnesses can contribute to school refusal. Children might be genuinely unwell or use physical symptoms as a way to express their emotional distress. Addressing these health concerns is essential in mitigating their impact on school attendance.  

How to Support Your Child Through School Refusal  

Supporting a child through school refusal involves understanding their fears, creating a supportive environment, and working collaboratively with professionals and school staff. Here are strategies to help your child:  
 

Communication:  

• Listen Actively: Provide a non-judgmental space for your child to express their feelings. Validate their emotions and let them know you are there to support them.  
• Identify Triggers: Gently probe to understand specific triggers or fears related to school. Knowing the root cause can help tailor the approach and intervention to their needs.  

Professional Supports:  

• Seek Counseling: Engage with a child psychologist or therapist who can work with your child to address their anxiety and develop coping strategies.  Cognitive Behavioral Therapy (CBT) is often effective in helping children manage anxiety and develop coping strategies. In some cases, medication may be prescribed to alleviate severe symptoms.  

• Collaborate with School: Work with school social workers, school counselors, teachers and administrators to create a supportive plan. This might include adjustments in the school routine, peer support, or additional academic help.  Regular communication with the school can also keep you informed of your child’s progress and any ongoing issues.  

Gradual Reintegration:  

• Step-by-Step Approach: Start with small steps to reintegrate your child into school. This could involve initially having your child attend for a few hours or specific subjects they enjoy.  

• Consistent Routine: Establish a predictable daily routine to reduce anxiety. Consistency in morning and evening routines can help create a sense of stability.  

Positive Reinforcement:   

• Celebrate Small Wins: Acknowledge and reward progress, no matter how small. Positive reinforcement can motivate your child to continue making efforts.  

• Encouragement and Praise: Offer consistent encouragement and praise their bravery in facing their fears.  

Teach Coping Skills: 

• Mindfulness and Relaxation: Introduce techniques such as deep breathing, mindfulness, and relaxation exercises to help manage anxiety. Practice these regularly as a family.  

• Problem-Solving Skills: Encourage your child to think of solutions to their fears and practice problem-solving in a supportive manner.  

Create a Supportive Home Environment:  

• Empathy and Understanding: Show empathy and understanding towards your child’s feelings. Avoid criticism for their school refusal.  

• Engage in Positive Activities: Encourage involvement in activities they enjoy outside of school to build confidence and reduce stress. 

Address Bullying:  

• Open Dialogue: If bullying is a cause, maintain an open dialogue with the school to ensure appropriate measures are taking to address and prevent bullying.  

• Peer Support: Encourage your child to connect with friends or peers who can provide a supportive network. 

Addressing school refusal involves understanding its complex causes and taking a compassionate, multifaceted approach. By fostering open communication, collaborating with the school, and seeking professional help when needed, you can support your child in overcoming their school anxieties.  

Higher levels of care are available for families where weekly outpatient therapy is not sufficient.  Compass Health Center offers two levels of care, Intensive Outpatient Programs (IOP) and Partial Hospitalization Programs (PHP), focusing on addressing school refusal and anxiety. Upon admission to the PHP or IOP level of care, licensed clinicians complete the School Refusal Assessments with families and patients to help determine the child’s function of school refusal, which helps determine the individualized intervention most appropriate for your child. In certain instances, Exposure Response Prevention Therapy (ERP), a highly effective treatment for anxiety disorders, including school refusal, could be recommended. School refusal is often rooted in anxiety, and ERP can help students gradually face and manage their fears. Compass Health Center’s program includes a multidisciplinary approach, including family therapy, collaboration with the school with education specialists, and optional medication management.  

Remember, the goal is to help your child feel safe and confident in their educational journey, ensuring that their emotional and psychological well-being is prioritized. For more information, please contact our expert team for support. 

Further Reading: 

• Why is My Child Refusing to Go to School? | A Clinician’s Guide for Parents of Children and Teens 
• Which Mental Health Diagnoses are Treated at the PHP/IOP Levels of Care at Compass? 
• Managing Back-to-School Stress: Strategies for a Smooth Transition 
• Specialties: School Refusal 
• Family Action Network Presents, Leslie Brankin, Anna Finis, and Toni Boos: Understanding and Treating School Anxiety and Refusal