School refusal affects around 1-5% of school-aged children and is most common among 5 to 10 year olds. There are several reasons why a child may refuse school including a specific school-based fear such as exams, avoidance of social interactions, separation anxiety from parents, or a problematic family dynamic.
To be clear, school refusal is very different from truancy, because truancy involves the absence of anxiety about attending school, attempts to hide non-attendance from caregivers, and maladaptive behaviors such as substance use or stealing.
Problematic family dynamics that tend to be linked with school refusal include over-dependency, disengagement, family isolation, and conflict within the home. Another dynamic commonly seen with school refusal is when one parent is very close to the child, while the other parent is disengaged.
Literature has shown that what works for school refusal is addressing the problem early and intervening as soon as possible. Early intervention has shown to lead to better prognosis as it supports the child returning back to school. Although this may seem obvious to some, how this can be done is often complicated by parental or child anxiety, poor partnerships with the school, lack of resources, and complex family dynamics, as mentioned above. Therefore, the very first step in understanding school refusal in your child is learning the primary function of the behavior. Is it separation anxiety, a specific fear in school, or a problematic family dynamic?
Although it may seem overwhelming and exhausting to get to the root of problem, you are not alone. Family therapy with a cognitive-behavioral approach can help identify the anxiety and/or depressive symptoms, but also family patterns that may be triggering or maintaining the school refusal. Improving relationships with the school will allow school personnel to be informed of the root to the refusal and provide resources and accommodations to best meet your child’s needs. Family therapists can help you have this very important conversation, as including as many parts of the system as possible is the key to successful treatment.