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School Phobia: Truancy or Refusal?

Lydia refuses to get ready for school in the morning. Tommy is constantly coming up with various excuses to miss school. Jonathan pleads with his mom saying "I just can't go." Their plaintive excuses include morning stomach aches, nausea once they get to homeroom, or simply an inability to get moving in the morning.
For Lydia, she started avoiding school following a period of familial stress that caused her to fear separation from her mother. In Tommy's case, he became wary of returning to class after following a prolonged absence due to illness. Jonathan's truancy was connected to his fear of being bullied, an unfortunate experience he had in the previous year. In all three cases, the longer they refuse to go to school, the more difficult it becomes to catch up with school work and the worse the anxiety and socio emotional issues become. Their ability to function independently is compromised and family tensions spike as parents start to feel more and more frustrated and lost as to how to reestablish a normal school routine for their child.
Fortunately, there are several ways in which parents, teachers, and mental health professionals can collaborate to facilitate a child's relief from underlying issues that may lead to school refusal.  
Here are a few suggestions:
  • Set up an appointment with a mental health professional that can help identify a clear diagnosis, sources, and recommendations for treatment of school refusal .
  • Set aside time to process, with your child, any negative experiences such as bullying, test anxiety, and school related fears that may be driving their phobia.
  • If children seem anxious to be separated from parents while at school, set aside special quality time during the week to spend with the child, or create a way for them to be reminded of your presence while at school by giving them a special note in their lunch box or a special key chain they can wear on their back pack.
  • Avoid providing "rewards" for staying home such as video games or special attention. Structure the homebound child with constructive, school oriented activities leaving designated play time and leisure for after the school time period is over.
  • Be firm and steadfast in your resolve; make it clear to your child that they are expected to try to attend school, and praise them for their brave efforts to follow through on this.
  • When dropping off your child at school, resist from unnecessary lingering or prolonged good byes, so as to expedite the transition process.
  • Teens do not respond to external pressure as well as younger children. In the case of teens, strong emotional support from parents and peers, forming goals and inspiring initiative may help encourage a return to school.
  • Address teens' deeper underlying issues such as anxiety and/or depression in individual and group therapy before enforcing a strict return to school policy.
  •  Request that a counselor or administrative staff person meet you when dropping off your child and escort the child into school, in an effort to provide more accountability and support.
If you have concerns that your child or teen may be exhibiting school refusal due to a variety of anxiety related causes, consult your educational and health professionals to see what further steps can be taken to enable your child to do their best. A combination of individual and/or group therapy can help address the anxiety and/ or socio-emotional obstacles preventing the child from attending school readily. Play therapy for younger, less verbally oriented children helps to reenact anxiety-provoking situations and master them. Interpersonally oriented individual therapy as well as group therapy can be extremely helpful for adolescents to counteract feelings of low self-esteem, isolation, and inadequacy.