School refusal: What you can do to help

On the way to school when our daughter was in grade 3 she read out a diary entry from her new favourite book series, Dork Diaries. This particular entry was all about how to make fake vomit. Apparently you need split pea soup, porridge, chunks of cheese and raw egg. And don’t forget to warm it up on the stove. Just hearing that read aloud was enough to make me feel sick. This was all a ploy by Nikki Maxwell, the diary writer, to get the day off school. 

Pulling a sickie for a day off school here and there is something lots of kids give a red hot go, some with success, others not so much. Then there’s those who ‘wag’ where they’re not at school and their parents think otherwise. Some kids refuse to go to school once in a while if there’s a difficult issue or challenge waiting for them but this is short lived. 

School refusal is different. It’s a serious condition and it affects the whole family. What’s often misunderstood about school refusers is that many want to be at school but just can’t face it. They end up being absent from school on an ongoing basis which can perpetuate the problem for them. The more school they miss and the less they see of their friends, the harder it is to go back. Around half of school refusers are found to have an underlying anxiety disorder such as separation anxiety, generalised anxiety or phobias to name a few, others can experience fear below the threshold for an anxiety diagnosis. 

What factors can influence school refusal?

There is no one particular cause for school refusal, it can stem from a complex interaction of multiple factors including but not limited to:

• stressful life events
• major transitions such as starting primary or secondary school
• moving or other big change
• fear of harm coming to a parent
• illness in the family
• separation and divorce
• academic problems
• overprotective parenting
• friendship difficulties 
• separation anxiety

What are some of the signs of school refusal?

• Complaining of not feeling well before it’s time to leave for school
• Separation anxiety 
• Lots of visits to the school nurse if at school
• Easily upset and teary
• Headaches, nausea, diarrhoea
• Withdrawal from class activities 
• Withdrawal from friends
• Missing half of school or less over previous month
• Difficulty concentrating

How to respond to school refusal

A review of eight scientific studies of treatment for school refusal found that children and adolescents who receive psychosocial treatment; that is, treatment that addresses the impact of their environment as well as supporting them psychologically, improves school attendance. It’s imperative parents of school refusers seek help for their child early. The longer school refusal continues, the harder the pattern of avoidance is to break. Here’s how you can help.

1.         Recognise it for what it is

If you suspect your child is a school refuser then you’re well on the way to getting them the help they need. School refusal can become an entrenched pattern, recognition is the first step to making positive change. 

2.         Make an appointment with your GP

Your GP is a wonderful first port of call if you are concerned about school refusal. Your GP is in a position to begin supporting you immediately and refer your child onto a health professional, most likely a psychologist, who can support you both to understand and manage the underlying causes of school refusal, and build within your child the knowledge, skills and courage to get back to school. 

3.         Open a conversation 

Talk with your child about the thoughts they’re having about school and what stands in the way of them going each day but strike while the iron’s cold. These conversations are always best started at a time when you’re both relaxed and calm and have the time and space to have a good talk. Part of this conversation is helping you to understand some of the factors that have contributed to school refusal in the first place. 

4.         Parent like a cat and a dog

In our book ‘Anxious Kids’ we write about the parenting styles that are helpful depending on the situation at hand. When parenting like a cat, you’re adopting a more firm but fair approach. The dog approach to parenting brings more warmth and nurturance. School refusers need both. They need your empathy, to let them know you understand it’s hard for them to go to school (dog), but they also need you to be firm and to continue to reinforce the message that school is important and that attendance is expected. Of course, depending on where your child is at with their school refusal you will temper these to fit the circumstances. 

5.         Help your child develop the willingness to tolerate discomfort

For school refusers the idea of going to school can cause a lot of distress and many will want to wait until they feel completely relaxed and calm about going to school to actually get back to their classes. Teaching your school refuser to tolerate discomfort is a way to help them get back to school sooner. Having the recognition of what makes them feel fearful and avoidant is helpful, and with the help of a professional your child will, over time, begin to learn that putting into practice the skills of mindfulness, breathing will help them remain more relaxed in the lead up to school. Also, a willingness to tolerate any residual discomfort and still go to school is an important step to work towards. We want our kids to know that they can feel unhappy, annoyed, frustrated, scared and uncertain, and still do the things that matter. In this case, going to school. 

6.         Stepladder their way back to school full-time

School refusal can cause a lot of distress for parents and child, and when it comes to getting back to school, a stepladder approach can work well. This approach requires input from the child’s psychologist or other health professional, to ensure that the approach is a good fit for your child’s needs. In essence, this approach is about moving your child in the direction of what matters, going to school, but doing so in a way that is incremental. The child’s input here is important too. 

7.         Keep communication lines open with the school

Inform the school about your child’s progress and the steps you’re putting into place to support their transition back to school. Keep these lines of communication open and ongoing. 

8.         Look after yourself

Parenting a school refuser can be distressing for parents and other family members. It can be disruptive and the uncertainty about how long it will continue for and what the future holds can prompt a whole host of difficult thoughts and feelings for parents. Talk to someone you trust about how you’re feeling and be sure to look after your own mental health. Exercise is excellent and will help, as will engaging in your own mindfulness practice as well as creating opportunities for your family to have fun together when school refusal is not a factor.