School Refusal

If you are concerned that your child may be struggling with School Refusal or School Phobia then Clinical Partners will be able to help you.

What is School Refusal?

Most commonly affecting those aged 5-6 and 10-11 years old, school refusal is a reluctance or refusal to go to school, accompanied with real emotional distress for the child.
In younger children, school avoidance or refusal may be due to separation anxiety. In older children, social anxiety is more often the underlying cause. School refusal is different to truancy – often children who are school refusers want to attend (whereas those who play truant often have a very strong dislike for school).

Symptoms of School Refusal

The following are common signs that your child may be struggling with school refusal.

• Frequent complaints of feeling ill (often in the morning and disappearing later in the day)
• Frequent calls from school informing you your child is ill or upset
• Your child frequently visits the school nurse
• Temper tantrums/outbursts in the morning or Sunday nights
• Crying and tearfulness
• Pleading or begging you to let them stay at home
• Truancy or lateness to lessons
• Distress when dropping the child at school

Find out more about the causes of behavioural issues here

Causes of school refusal

There is no one reason as to why your child may refuse to go to school – often it is a combination of several factors.

1. Transition at school – moving into a new school year, going back to school after a long holiday or following an illness and moving to a new school can all increase the risk of school refusal.
2. Anxiety about performance at school – for instance, worries about academic or sporting performance can increase the chance of school refusal.
3. Bullying - if your child is being bullied or experiencing social difficulties, such as friendship problems, they may be more likely to develop school refusal.
4. Mental health conditions - such as depression, anxiety, separation anxiety and social anxiety can increase your child’s risk of school refusal.
5. Concerns about others - a child who is worried about a family member, perhaps because of an illness or bereavement, may show signs of school refusal

What help is available for children who have School Refusal?

The first step many families take is to get a comprehensive assessment by a Child and Adolescent Psychiatrist. This helps to understand if mental health disorders, such as anxiety or depression are present.

Often children who have school refusal also struggle with anxiety disorders - it’s important to know this so the right treatment option can be found.

Psychological and behavioural therapies, such as CBT and other psychological therapies can be really effective at helping children overcome their fears. Our Psychologists and Psychotherapists are experienced in helping children with school-related issues, so understand the complexities well.

Parenting support can be invaluable in teaching parents the best way of handling difficult situations in a way that will support your child’s progress. It also gives parents a space to talk to a child behavioural expert about their experiences and frustrations – it can be very hard to talk to family and friends honestly about what is happening in your family.

Read more about treating behavioural issues

School refusal is not a disorder in itself, but rather an indication that the young person might suffer from a disorder. In my practice, by far the most common reason for school refusal in Separation Anxiety Disorder, but I have also seen young people who would refuse to go to school who had autism, psychosis, depression and many other disorders as well as no disorders. It is important to understand that school refusal is different from truancy. Unlike truancy, the young person with school refusal typically feels distressed and sometimes ashamed by their inability to go to school. CBT is by far the most effective intervention for anxiety-based school refusal.

Dr Dennis Ougrin

MBBS, MRCPsych, PGDip (Oxon), CCT, PhD

Consultant Child Psychiatrist

London

Dr Ougrin is a psychiatrist with nearly 10 years of clinical and academic experience specialising in child and adolescent psychiatry. He also has undertaken much research in the area of self-harm and has developed an effective intervention for...