Community Psychiatric Centers
Monroeville, Greensburg, Monessen, and Wilkinsburg Pittsburgh
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April 8, 2024

Strategies To Address School Refusal

As this school year comes to a close, I speak with many parents who have struggled with school refusal and are worried about managing the next school year. This post describes the nature of school refusal and some strategies and considerations to address this challenging situation. 

Your Child Won’t Go to School

An all-too-common situation (especially since COVID-19) is a child being reluctant or even refusing to attend school. This post will focus on anxiety-based refusal; the child is refusing to attend school due to genuine anxiety reactions. Consequently, the night before school your child is fretting about the next day, and the mornings are fraught with drama and emotion as you try to convince your child to attend. And commonly they continue to resist and present as emotional, maybe even to the point of vomiting.

Physical Complaints

Does your child complain of stomachaches, headaches, and vague pains, or simply not feeling well especially the morning before school? This is quite common. Anxiety often manifests in somatic complaints that further complicate the situation given you’re not sure if the complaint is genuine or simply to avoid school.

What Causes School Refusal?

This problem can be seen as simply a manifestation of an anxiety disorder. In that respect, anxiety shows itself in lots of different ways but a primary aspect of anxiety is a tendency to avoid that which makes us anxious. In this situation, the prospect of attending school, leaving home/mom, or both, is causing undue anxiety and panic reactions. People are often genetically predisposed to anxiety.

What To Do?

There are number of steps to address this issue, depending on the age/size of your child and the severity of the problem.

The goal is always to rely on the carrot, rather than the stick. In that respect, we want to rely on praise, rewards, encouragement, and incentives rather than punishments. Consequently, we offer extra rewards for going to school, and often we’ll remove enticing past-times if the child refuses school, such as toys and video games. However, if your child continues to refuse and your child is small and manageable in that respect, you may find it necessary to physically escort or literally carry your child to school. You may want to enlist some help, such as mom and dad working together in that respect, but the message is ‘you’re going to school one way or the other’.

Once your child realizes that their avoidance and emotion is futile, usually you’ll notice improvement and less resistance. If your child refuses to get dressed in the morning, some parents have had success informing their child that they will be taken to school in their pajamas, if that’s necessary, and they can change in the nurse’s office. In that respect, this is a solidly no-nonsense approach to school refusal.

What If Your Child is Too Big To Carry Them Into School?

Things get more complicated when your child is larger, and you can't physically escort or carry them into school. It’s advised to utilize counseling, which will be discussed further below. Also, reinforcement for attendance and we also make the home life (during the school day) as boring as possible to entice school attendance. However, what if that doesn’t work?

Can Counseling Help School Refusal?

In these situations, it’s helpful to utilize professional support such as a therapist. At Community Psychiatric Centers, we can utilize outpatient counseling, in-home support, and medication management to help the situation. The therapist will work on coping skills, deep breathing, healthy self-talk, and desensitization techniques. The latter involves getting your child out of the house daily and in the presence of others that could include a sport, club, group, church, or anywhere there are people. There should not be a day that goes by that your child is not out of the house.

Even better, play at the school’s park, meet up with friends from your child’s classroom for play dates, and ask for videos or Facetime from his or teacher with enthusiastic and fun messages. Medication can also  be considered to reduce anxiety and improve general emotional stability.

What About In-Home Services?

Counseling can also take the form of in-home services (IBHS…). This approach can be helpful if the practitioner can come to the home in the morning and assist in getting the child to school. Here at Community Psychiatric Centers, we offer such in-home support, which can be invaluable. The Youth Advocate Program also offers an in-home truancy prevention program that can be worth exploring.

Should You Try Home or Cyber Schooling?

While you’re trying to get your child to school, your child needs to be educated. How will that take place? Often the school district will send homework, which helps to keep up some assignment completion but clearly, it’s not a long-term solution and does not facilitate your child to receive a proper education. Some parents will consider a cyber school, which isn’t necessarily a bad option under the following conditions:

  1. You’ve tried all the above to get your child to school, to no avail
  2. Weeks are going by, and you’re worried about truancy charges and your child’s lack of education at home
  3. You consider cyber school while, at the same time, your child is getting out-of-the-house on a daily basis for groups, clubs, church, sports, walks, trips to the store, going to the park or library, to anywhere there are people.
  4. It’s considered time-limited as you’re assertively working toward getting your child to a brick-and-mortar school.
  5. You start with cyber and then work your child, one class at a time, back to regular school.
  6. Preferably a cyber-school that offers synchronous teaching (live teaching with a live classroom).

When to Consider An Alternative School Placement...

An alternative school placement is often considered such as a school-based partial program or alternative school. The idea is that the alternative placement will offer smaller classrooms and more support to help your child feel comfortable. This option has merit and can be quite helpful in the short term! The goal would be to progressively get your child back to regular school. However, what I’ve found, is that we can’t get the child to the alternative school any more than we can get them to regular school.

Summing Up

Managing school refusal can be quite a challenge. We use multiple strategies, with the ultimate goal of getting the child back to a brick-and-mortar school classroom. Otherwise, we run the risk of the child becoming increasingly anxiety-ridden and housebound. While we’re working on attending a regular school, there is involvement in daily out-of-the-home activities. In the meantime, a cyber school may be attempted, but such would be time limited with a step-by-step approach to a return to regular school. Counseling and medication can be helpful, especially in-home support. Alternative school placements can be very effective if you can get your child to the placement.

Don’t hesitate to email any questions to or call for an appointment at (724) 850-7200. God bless you and your kids.

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