Wow!  It’s really that time of year again.  While there are a range of thoughts and feelings that students have about heading back to school, it is the students that have a true phobia about attending that I hope to reach in this post.  Hopefully, this will find its way to parents that have seen their child seriously resist school and it will provide other parents with good information so they recognize what they see if their child begins to truly resist school.

A preliminary study on children and adolescents that refuse school revealed that not only is this group more likely than their peers to suffer from an anxiety disorder, there is also a pattern in the way that they cope with their anxiety.  Researchers investigated something that psychologists call emotion regulation and they found that kids and teens that refuse school tend to have difficulty reframing safe situations as such and also hide their feelings about their fears from others.  These two phenomena are referred to as cognitive reappraisal and expressive suppression, respectively, and they both may contribute to a student’s ongoing school refusal.

The study took place in Australia and used a sample of children and adolescents in treatment at a school refusal clinic.  As opposed to truancy where students typically try to hide their absenteeism and also have behavior problems, this group of participants refused school for reasons of anxiety.  The study group was matched for age and sex to a same size group of peers that did not refuse school. 

As one might guess, the school refusal students had higher levels of anxiety when compared to their peers.  They met criteria for diagnoses such as generalized anxiety disorder, social phobia, and separation anxiety disorder.  Many of these students also had mood disorders (e.g., depression) and/or behavioral disorders (e.g., oppositional defiant disorder). 

The school refusal students were found to oftentimes view everyday situations as threatening in some way.   For example, something as routine as eating in the cafeteria or being called on in class could seriously overwhelm the students described in the study.  In addition, they were less able to reframe situations as safe.  In other words, they used cognitive reappraisal less frequently than their peers.  Also, the school refusal students hid their anxieties from others.  This expressive suppression is thought to serve two purposes.  One, the individual can avoid the uncomfortable emotion more easily.  Two, it can protect the individual from being ridiculed by others or other negative social consequences.

While the authors state that these results are just the beginning of understanding the possible role of emotion regulation in school refusal and that more research is needed in this area (including in the US), there are some takeaways worth noting.  First, school refusal in this study was closely linked to anxiety.  That anxiety was fueled further by an inability to reframe non-threatening situations as non-threatening.  Second, participants that refused school were also more likely to conceal their true feelings. 

Perhaps clinicians, parents, teachers, and others that encounter these students can bring some relief to them by working to increase a sense of emotional safety in the school environment as well as warmly and openly allow for honest discussion about the anxieties associated with attending school.  While this is where I would normally say more on recommendations, chronic school refusal problems would probably be best served by an experienced professional who is skilled at understanding and treating the underlying causes of school refusal.  This person could spend time getting to know your child as an individual and work directly with your child to help decrease anxiety, reframe the school experience in a more positive light, and promote effective emotional understanding, management, and communication.  Finally, he/she could work in conjunction with parents and school personnel and provide feedback and recommendations that can ease the transition back to regular school attendance.

Please bear in mind that this study is not describing the student that occasionally complains about going to school or wants to stay home now and then.  This post is addressing a much higher level of school refusal.  For any parent whose child is sometimes refusing school or tentative about going, however, looking at their worries about going may be a good place to start.

Thanks for reading.  -Anita

Source: Hughes, E. K., Gullone, E., Dudley, A., & Tonge, B. (2010). A Case-controlled Study of Emotion Regulation and School Refusal in Children and Adolescents, Journal of Early Adolescence, 301 (5), 691-706.

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9 Responses to School Refusal: Exploring Why Children and Adolescents Refuse School

  1. Melissa says:

    I think many of us that are homeschooling are pretty aware that the “ordinary” physical and social context of corporate school environments overtax the resources of our particular kids. I’m a research psychologist and have observed that many in our homeschool group have self-selected into this option because of one or more of our children having extreme anxiety in response to the school setting. However, we observe our kids thriving in the settings in which they have more control in their learning paths and environments. And they are able to do so in smaller social contexts that are not peer intensified in the early years. (We have a much higher adult to child ratio than schools in the early years.) But as the children blossom and grow they expand and explore topics, settings, and challenges with great confidence alone or with their peer groups. So glad we have this option for our kids!!

  2. Leanne says:

    Really interesting article! Have you ever had a case where the child is actually being bullied by the teacher and/or principal of a school? Unfortunately my son has gone through this since grade seven, as far as I know, he is starting grade 12 this year. It has been a huge challenge for him, as well as myself, just to get through it. This year he is doing the RAP program until December and will be back to class in January so the stress level is way down. In the future I intend on sharing this stuggle on my blog.

    • Anita M. Schimizzi, Ph.D. says:

      Leanne,
      I am sorry to hear about your son’s struggles in school. Bullying can become especially complex where there is a large power differential between bully and victim. It can be helpful to look carefully at the dynamics at play and see where intervention can happen. Is there a liaison at the school that can faciliate a more harmonious relationship between school professional and student? Are there skills that both can learn to manage problematic situations as they arise? How can students be empowered to advocate for themselves in a productive and healthy way? These are all areas to explore.

      Hopefully, your son receives some great support this semester. And I wish you both the best as he transitions back to school for the latter part of the year. Oh, and FYI…I will be posting on an anti-bullying program later in the month that you may find interesting.

  3. Pernilla says:

    I’m dying to hear from other parents of children suffering from school refusal. My husband and I are at the end of our tethers with our 16 year old son, who has been suffering from SF since grade 2, on and off, at various degrees. No one seems to really be able to tackle the problem and the school is at a loss as to why he is absent so often. To make matters worse he refuses to communicate with us when he’s ‘low’. We have just started seeing a psychiatrist but our son has only been once and refused to go today, our second appointment. How do other people cope? Is there any light at the end of the tunnel? To Leanne, what is the RAP program?

  4. Peter Jones says:

    Why does it occur to so few people that school refusal is completely rational and healthy? Schools are not, generally, nice places for children. They are forced to do lots of things they hate and lose all control over their learning choices. They are powerless, like prisoners. If they are really enjoying something, they have to stop it according to the clock. If they find a loving, supportive adult who they want to spend time with and learn from, that adult is taken away next year according to the time-table. If I behaved towards an adult as schools behave towards their charges, I wouldn’t have a single friend. You would show me the door immediately.

    • Kiri says:

      Exactly! Exactly exactly! However, it’s important to distinguish between refusing to go to school because it sucks, and refusing to go to school out of inappropriate fear. The former requires a new school (or, in some cases, home or alternate schooling), and the latter requires treatment for anxiety. (Of course, a third cause of school refusal is *appropriate* fear due to bullying, but I think we as a society are getting a lot better at addressing that issue.)

  5. Dana Kucharski says:

    I am actually a parent of a kindergardener who is exhibiting “SCHOOL REFUSAL”. My husband and I have always known that he has issues with social aspects but starting school was a mess. When we finally had him going to school with no major issues, his teacher decided to call off alot and he had a sub and we went downhill from there. I have never in my life seen a child go pale with the mention of going to school. I have 3 other children who go to the same school without any problems. We are seeing a psychiatrist who is treating him with Vistaril but they keep stating that he “needs” to be in class now but I do not think that they understand the depth of this anxiety. And the school is not helping at all, actually they are trying to get us to do home schooling. I am so lost!!!!

    • Anita M. Schimizzi, Ph.D. says:

      Dana,

      Thank you for commenting on your experiences with your son. It sounds like you have all been through a lot this year. Kudos to you and your husband for doing everything you can to support him and for continuing to reach out for support.

      In reading your comments, I have a couple of thoughts. It is true that medication can help calm the nervous system and ease some of the physical sensations of anxiety. It does not resolve the underlying causes of the anxiety, however. I am wondering if you and your husband have taken your son to see a therapist (e.g., psychologist, LCSW) that specializes in childhood anxiety. Someone who is well-versed in this area could do a more in-depth investigation into the heart of the matter. A solid therapist can address specific triggers/worries, teach social and coping skills, and provide much needed support as your son works through his anxiety. A therapist can also offer mom and dad much needed support along with concrete ways of helping their child cope with anxiety.

      Remember, you and your husband know your son best. The more that you can convey your knowledge and understanding of your son to those who work with him, the better equipped they will be in meeting his needs based on who he really is rather than who they expect/want him to be. I also encourage you to continue being open to trying new ways of meeting your son where he is and thinking outside the box if necessary. There are other comments on this post that may be of use to you, parents that have and continue to go through the challenges of school anxiety.

      Readers, anyone have some words for Dana and her husband that could be useful?

      Warm regards,
      Anita

  6. mandi says:

    This is very similar about my child. I am a parent of a teen girl. She hates the school that she goes to. She is always fighting, has a really bad ATTITUDE,hardly talks, always talking back to the teachers, bad grades and everything. She has a problem with her anxiety and she has low self esteem. I don’t know what to do. She can’t trust anyone except her one good friend at school. She can’t talk to anyone with out getting nervous. She also locks herself away in her room and never wants to go to school. She has had a recent problem with bulling. She has been bullid since fifth grade and nvr told me. I don’t know what to do. She has sto eating and everythin:0

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