Are School Days A Constant Struggle In Your Home?


Does not want to go to school, school refusal

Does the thought of going to school cause considerable fear and distress for your child? You may have noticed major changes in their mood, behavior, sleep, appetite, or ability to concentrate when school is in session.

Has your child been complaining of unexplained physical symptoms—such as headaches, stomach aches, or nausea—that suddenly disappear when they are allowed to stay home? They may also frequently go to the nurse’s office with no apparent signs of illness. On the other hand, your child may have a documented illness that has caused them to miss school in the past, making you wonder whether they are truly ready to return.


Are you unsure what to do when your child refuses to go to school? The struggle to get your child out of bed on school days may be a constant source of stress, causing you to face each morning with trepidation. You might also dread receiving yet another phone call from a principal or teacher reporting that your child is always late for school, frequently skipping classes, or even skipping school altogether.

For both the students and their families, school refusal can be a concerning, difficult, and frustrating ordeal. The good news is that with the proper support, school refusal can be managed and your child can return to school and thrive.


What Is School Refusal, And Who Is Affected?

School refusal (also commonly referred to as school phobia), affects a significant portion of the population in the United States. According to the National Association of School Psychologists, as many as one in twenty children are routinely missing school due to depression and anxiety.

Boys and girls have roughly the same rate of school refusal.

On the surface, children with school refusal may appear disobedient, but in actuality, most of these children are not simply “playing hooky” to have a good time with friends. Rather than being driven by a desire to seek out pleasurable activities, school refusal is instead driven by an aversion to school. This avoidance is often driven by depression, anxiety, or a social or learning issue, according to research published in The European Journal of Education and Psychology.

The problem of school refusal is often complex and multi-faceted, but some common causes include:


Students who struggle with school refusal often have severe anxiety, which can present in different forms. Separation anxiety is common, especially (but not exclusively) among younger children, who may become preoccupied with fear about being separated from a loved one.


Social and performance anxiety are also prevalent. These students worry about how they are judged and perceived by others. They may fear humiliation and/or failure socially, academically, or athletically.


Generalized anxiety disorder (GAD) causes some students to experience excessive and uncontrollable anxiety and worry, which impacts daily functioning. They can be perfectionistic, restless, irritable, and inattentive. Trouble falling asleep or staying asleep is also common.



Depression and school refusal often go hand-in-hand. Children and teens with depression may experience the following symptoms:


  • Despondent mood


  • Irritability


  • Lack of interest in activities they previously enjoyed


  • Changes in sleep or appetite


  • Fatigue


  • Feelings of guilt, inadequacy, or hopelessness


  • Difficulty concentrating


  • Risky behavior (including self-harm in some students)


In many cases of school refusal, depression and anxiety are experienced at the same time.


Physical Complaints

At times, school refusal has roots in medical issues. For example, a child who missed time from school due to asthma, a gastrointestinal (GI) issue, or another health problem may be anxious about leaving the safe setting of home. Caregivers may also have conflicts about their child returning to school after an illness.


Loss And Family Transitions

The following stressors may trigger school refusal in some children:


  • Starting a new school (or a new level of school, e.g. kindergarten, middle school, high school)


  • Welcoming a new sibling


  • A move to a new house or city


  • The illness or death of a friend or loved one


  • Divorce


Cope With School NYC’s School Refusal Treatment Program

The longer a child is allowed to stay home from school, the harder it becomes to re-enter the school setting. If left untreated, school refusal can lead to prolonged absence and serious consequences. It is therefore important that steps are taken to address school refusal as quickly as possible.


Each case of school refusal is unique and has its own set of challenges. For this reason, it is important to develop a comprehensive school refusal treatment plan involving the child or teen, family members/caregivers, the school, and our treatment team.


Individual Therapy

Individual school refusal treatment with one of our licensed counselors can teach your child how to overcome school-related anxiety and/or depression. Individual therapy sessions involve the following strategies:


  • Examining fears and exploring reasons the student is not going to school


  • Looking at all the factors that may be contributing to the refusal: e.g. anxiety, depression, learning or social challenges, bullying, difficulties at home, etc.


  • Validating the child’s feelings and difficulty about attending school


  • Teaching the child new coping strategies


  • Exposing the child to fears in such a way that he or she can more comfortably tolerate them


  • Providing support and encouragement


Family Therapy and Parental Counseling

School refusal affects the whole family, so involving parents and other family members in our school refusal treatment program can provides the best results. Family therapy and parental counseling can help you and your loved ones to:


  • Explore family dynamics and other factors that may be driving the school refusal


  • Better understand and empathize with the refusing child


  • Encourage and enable the child to use new, healthier coping strategies


  • Establish household best practices that take the stress out of morning routines and encourage school attendance


Our experienced and compassionate counselors can teach you how to help a child with anxiety, depression, or other issues go to school. In addition to addressing the psychological elements of school refusal, we’ll also incorporate practical elements into your child’s school refusal treatment plan to get them back in school as quickly as possible. Together, we can establish a timetable for your child’s return to school, in some cases including accommodations such as temporarily shortened school days to ease the transition.


With your permission, we can also work with the teachers, counselors, and administrators at your child’s school to put a plan in place that allows your child to catch up on schoolwork. Acting as a liaison, we can help ensure that everyone is on the same page, that your child has a supportive person at school they can check in with, and that every possible step is being taken to get your child back on track.


As you consider school refusal treatment, you may have some questions. . .

How effective is treatment for school refusal?

Success rates depend on several factors, including consistency, rapport with the therapist, and the nature of the problem. If the treatment recommendations are followed, there is generally a high rate of success. As overwhelming as the current situation may feel now, reduced stress in the mornings, higher attendance rates and improved academic success is possible.

School Refusal Treatment

How long does treatment usually take?

The duration of treatment varies based on the severity of the problem and the factors described above (regular therapy attendance, the involvement of family members in the treatment plan, the relationship with therapist, etc.). Some students stay in therapy until their symptoms subside. Others choose to continue to receive support for their school avoidance issues or to work on other goals. For instance, some children may wish to join a social skills group.


Do you accept my insurance?

Cope With School NYC is out of network with all insurance carriers. We provide a receipt with all the information you need to submit claims to your insurance carrier. Check with your provider to see if you have an out-of-network behavioral health benefit. While we know that therapy is a financial commitment, it is a worthwhile investment considering the serious repercussions of school refusal down the line.


Set Your Child Up For Success

If your child or teen is refusing to go to school, it can be a time of intense sadness, confusion, helplessness, and frustration for the whole family. Fortunately, you do not need to endure this difficult time alone.


The therapists at Cope With School NYC specialize in helping children, teens, and young adults thrive in school, setting them up for happy and independent futures. We tailor treatment to meet the unique needs of each individual and family to get your child back on track. If you are in the New York City area, contact us today for a free 10-minute phone consultation.