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Treating School Refusal

How Can I Help My Child?

Addressing school refusal as early as possible is important for providing your child with the greatest opportunity for success in school. Here are some steps you can take at home, and with professionals, to provide your child with support.

Assessments

School refusal is a complex problem for many children and teens that struggle with it. A comprehensive assessment conducted by a mental health professional is recommended, so that specific factors of school avoidance behaviors can be identified. Through an assessment, a professional can help your family understand the specific factors causing school-related anxiety for your child, and how you can best address it through practices at home, at school, and through treatment.

What does effective treatment look like?

Behavioral Interventions

Exposure-based treatments are the primary behavioral recommendations for school refusal. Exposure treatments involve gradual exposure to feared situations to reduce the anxiety response over time. This approach includes education for the child about anxiety and how it impacts their body.

This could look like gradual exposure to the school environment by having a teacher visit at home, going to the school parking lot, and then walking inside the school.

Individual Cognitive Behavioral Therapy

Cognitive behavioral therapy skills are often taught to children and teens alongside exposure practice. In CBT, they will learn how to modify and challenge negative thoughts, and techniques to decrease anxiety by facing fears.

Parent-Teacher Interventions

Parent-teacher behavioral interventions include sessions with parents to provide behavioral strategies for getting your child to school, reinforcing school attendance, and education about school refusal and anxiety. It also includes consultations with teachers and counselors to provide them with specific recommendations for how to support your child’s return to school through the use of positive reinforcement and academic, social and emotional accommodations throughout the school day, if necessary.

Things you can do at home

  • Avoid allowing your child to stay home from school or getting doctor’s notes to excuse school absences unless a medical condition requires it.
  • Learn about your child’s feelings and fears. Help them be worry detectives and create simple experiments. For instance, “You said you’re worried something bad might happen if you go to school. Let’s be detectives and see.” At the end of the day, help them use their detective skills and realize nothing bad happened! This will help them face their fears.
  • Emphasize the positive aspects of going back to school. This could include being with friends, learning a favorite subject, gym class, or playing games at recess!
  • Meet with the school counselor and your child’s teacher for extra support and direction.
  • Help your child create a strong support system. Work with them to identify people in school that will cheerlead and encourage them to go to school, stay in school, and participate in class and activities.  
  • Provide rewards and positive encouragement for attending school and facing fears!
  • Decrease positive reinforcement for staying at home during the school day. Make staying at home boring by limiting access to toys, television, etc. Simulate a school day at home as much as possible. Get the schoolwork your child is missing from their teacher and have them complete it at home during the day when they are supposed to be at school.

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