Now that it’s November, and the school year is several months old, most families have—to their great relief—settled back into some kind of daily routine after a more freewheeling summer. However, there are a few families facing a very difficult challenge: a child or teen who refuses to go to school, or routinely has trouble staying at school. School refusal, as this is known, puts a major strain on parents and caregivers, but it is treatable with proper care and patience.

UNDERSTANDING SCHOOL REFUSAL

First of all, school refusal is not truancy, where young people ditch school to do something more appealing. It’s a form of emotional distress, often based on anxiety, and requires treatment, not punishment. School refusal typically involves visible sign of anxiety, that can even start the night before a school day. Children may complain of stomach aches, headaches, nausea, dizziness, fatigue or a general sense of not feeling well. There are many reasons for this distress, such as separation anxiety, social problems, bullying, an undiagnosed learning difficulty, to name just a few. Whatever the reason, avoiding school gives a child short-term relief, but given the academic and social importance of attending school, this situation requires a long-term solution.

TREATING SCHOOL REFUSAL

Treatment involves addressing the reasons for the child’s anxiety, while also forming a plan for their return to school. Assessing and treating the psychological aspects usually requires the help of a therapist or even a physician. While that aspect of treatment is ongoing, parents, school administrators and teachers can cooperate on a return strategy.

The foundation of a school-return plan is empathetic, but firm support for the child, and the creation of a routine. Every family is different and will require an individual approach, but I can outline the general principle. Essentially, you need to help your child feel more comfortable going to (and staying at) school, while at the same time, creating sense of discomfort at home.  To be clear, I don’t mean feeding your kid only stale bread, or turning the thermostat down to 10° Celsius. Instead, the idea is ensuring days at home aren’t fun. That means no sleeping in, no TV or videogames, regular time set aside for home study, and so on. By comparison, school should start to seem more appealing.

MAKING A RETURN-TO-SCHOOL PLAN

Many kids benefit from a graduated return program. This approach varies with the age of the child, and how long they’ve been out, but has a high rate of success. For example, it may be possible to start with an hour in the morning, and then gradually increasing that time. Or if kids are too anxious to go to class, they can spend time in the  library or the office. It’s also essential to deal with the social aspects of lengthy school absence. With younger children, that might mean playdates to maintain social ties with schoolmates. For many older kids, a big source of anxiety is the idea of explaining their absence. To combat this, I always train teens on how to handle awkward questions. It’s one of the small things that can really help reduce anxiety, and increase comfort.

Finally, I’ve seen how difficult school refusal can be on parents, where one child’s difficulty creates a domino effect through your whole work and family life. I know it can stretch you to your limits, but patience and empathy are absolutely crucial. Try to remember what it was like when you had to return to work after a long absence, such as parental leave, and had to cope with many changes, new faces and reconnecting with colleagues.   

Without question, school refusal is a serious issue, and one that can rapidly worsen. But the good news is that it’s very treatable. When the child, parents, school and mental-health professionals all work together, most young people are able to return to school, and resume normal lives.

Your Therapy is a safe, welcoming, counselling therapy practice that offers confidential mental health assessment and treatment in the Greater Toronto Area. Thanks for reading and, as always, please feel free to reach out with questions about mental health therapy in Toronto.

Anu Chahauver is the Director & Social Worker at Your Therapy, providing individual, couple and family therapy.