School Refusal – What to Do if Your Child Is Unable to Go to School?


Many young people experience anxiety about school from time to time or during certain periods. They might be worried about exams, difficulties with friends, or fitting into the requirements of the school day.

But for some young people, this anxiety becomes so intense that they become unable to go to school. This is known as school refusal or, when it persists over time, school avoidance.

School avoidance can have a big impact on young people’s well-being and futures, but change is possible. Sometimes, schools can adapt parts of their programs to address the issues that are making a young person anxious. Some young people require professional support to address anxiety disorders that may underlie school refusal.

This blog offers information on school refusal and school avoidance and explains some of the steps you can take to support your child to attend school.

Why Do Young People Want to Avoid School?

School-related anxiety can happen for different reasons. For some young people, school refusal may be based on a single aspect of school life, while others may worry about multiple aspects or experience more general anxiety.

Some causes of school anxiety include:

  • worries about making friends or fitting in
  • difficult relationships with teachers
  • finding schoolwork difficult or confusing
  • finding it hard to learn in the way that their school prescribes
  • having a neurodiverse condition like autism
  • having a special educational need (SEN)
  • not wanting to separate from a parent(s) during the day

Some young people who avoid school also have diagnosable anxiety disorders, including separation anxiety, social anxiety, and panic disorders. Younger children are more likely to have separation anxiety, while pre-teens and teenagers tend to have social or general anxiety.

Many young people with school avoidance also experience unexplained bodily pains such as stomach aches or headaches.

Using the Term ‘School Refusal’

School refusal is a term that teachers and researchers sometimes use to describe situations when a young person is unable to go to school. However, some people disagree with using the term because they think it implies that ‘refusing’ school is a choice.

Some other terms you can use include ‘emotionally-based school avoidance’ and ‘anxiety-related absence’ that you may feel better describes a young person’s experience.

What Are the Signs of School Anxiety and Avoidance?

School avoidance can take many forms. It might involve refusing to go to school at the start of a school day or persistent distressing arguments in the morning. Some young people arrive at school but leave before the end of the day. 

Some young people experience school anxiety but are still able to go to school. This doesn’t mean that their anxiety is any less severe or that they require less support. Some signs of school anxiety include:

  • not wanting to get ready for school
  • feeling very stressed about a small problem in school
  • sleeping difficulties
  • unexplained bodily pains
  • not completing schoolwork
  • showing anger or frustration at home or in school
  • withdrawing from social relationships

How Can School Avoidance Affect a Young Person’s Well-Being?

School plays a big role in a young person’s well-being and development. As well as academic and vocational education, schools are places where young people learn social skills, cognitive skills like problem-solving and emotional regulation, and life skills like time-keeping. 

Missing school can stop young people from learning and developing these skills. School refusal is associated with social difficulties, employment problems, and a greater risk of mental health disorders later on in life. It’s also linked to family difficulties and problems with friends.

Overcoming School Avoidance and Anxiety

School anxiety and avoidance are serious problems, but things can change. When school anxiety is related to a specific issue, schools may be able to make changes to reduce a young person’s anxiety and support them to attend school. 

In other cases, treatment for anxiety disorders can help young people manage or reduce their anxiety so they are able to go to school.

Finding Out What’s Wrong

Many young people find it difficult to articulate exactly what makes them anxious about school. If you can identify the problem(s), it’s much easier to make the changes they need.

It can help to make a mind map with a young person to explore their thoughts and emotions about school. For younger children, you could also use pictures or simple words.

Speaking With the School

If you and your child have identified specific issues or changes that could reduce their anxiety, you can speak with the school to ask for them to implement them.

You might want to speak to your child’s class teacher, tutor group, pastoral lead, or special educational needs co-ordinator. Explain to them the specific things a young person is finding difficult and suggestions for changes that might help. 

Once you’ve met, it’s important to follow up on the changes and your child’s feelings. If you think that the school or member of staff isn’t doing enough, you could ask to speak to a more senior figure or ask for support from the local authorities.

Seeking Professional Support

Sometimes, school anxiety is connected to mental health issues like general anxiety disorder, social anxiety, or panic disorders. In these cases, young people need professional support to manage and recover from symptoms. This support may co-exist alongside addressing specific issues at school.

Treatment for anxiety disorders usually involves therapy, sometimes alongside medication. Young people often benefit from a combination of different approaches, such as group therapy, mind-body therapy, and other methods.

Evidence-based therapies for anxiety disorders include:

  • Cognitive-behavioural therapy (CBT)
  • Psychoeducation
  • Medication such as SSRIs
  • Exposure and response therapy
  • Family-focused therapy

If you think that your child may have an anxiety disorder, it’s important to seek professional support as soon as possible. You could have an open conversation with them about reaching out for help or contact a mental health professional yourself.

The Wave Clinic: Building Life Advantage

The Wave Clinic is a dedicated treatment space for young people on the edge of Kuala Lumpur, Malaysia. Our programs aim to build life advantage for young people, combining education with life-skills development and exceptional clinical care.

We understand the importance of education in building young people’s futures. We offer personal learning programs to continue year-group learning, vocational qualifications, internships, and global citizenship opportunities. 

Our clinical programs are led and implemented by experts in young people’s mental health from around the world. We specialise in eating disorders, borderline personality disorder, and trauma-focused treatment, bringing together a team of unequalled experience and care.

At the Wave, we’re changing the way a generation experiences treatment. If you’re interested in our programs, contact us today.

Fiona - The Wave Clinic

Fiona Yassin is the founder and clinical director at The Wave Clinic. She is a U.K. and International registered Psychotherapist and Accredited Clinical Supervisor (U.K. and UNCG).

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