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School Anxiety and School Refusal

School anxiety and refusal refer to a complex set of emotional and behavioral challenges that some children and adolescents experience related to attending school.

What is School Anxiety and School Refusal?

School anxiety and refusal refer to a complex set of emotional and behavioral challenges that some children and adolescents experience related to attending school. School anxiety can manifest as heightened stress, worry, or fear associated with various aspects of the school environment. This may include academic pressures, social interactions, performance expectations, or specific situations such as tests or presentations.

School refusal, on the other hand, occurs when a child or adolescent consistently avoids attending school, leading to prolonged absences. This behavior is often driven by underlying anxiety or fear, and the refusal can result from a variety of factors, such as bullying, academic difficulties, social anxiety, or even separation anxiety.

Various factors contribute to school anxiety and refusal, including individual temperament, learning difficulties, social pressures, and family dynamics. Identifying the root causes is essential for effective intervention. Parents, teachers, and mental health professionals play crucial roles in supporting the child. Creating a positive and supportive school environment, addressing underlying issues, and implementing strategies to manage anxiety are key components of intervention.

Treatment for School Anxiety and School Refusal

Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy (CBT) combined with Exposure and Response Prevention (ERP) is a highly effective approach for treating school anxiety and school refusal, helping children and adolescents overcome their fears and return to school with confidence. At Light On Anxiety, our specialized therapists offer compassionate and evidence-based care tailored to the unique needs of students struggling with school-related anxiety.

In CBT sessions, clients learn to:

  • Identify and challenge maladaptive thought patterns and beliefs related to school
  • Develop coping strategies to manage anxiety and distress.
  • Gradually confront and tolerate feared situations through ERP exercises.

ERP involves exposing students to anxiety-provoking aspects of the school environment while refraining from avoidance behaviors or rituals. By learning to cope with their anxiety and confront their fears, students can regain their confidence and resume their academic and social activities. 


At Light On Anxiety, our team of psychiatric providers collaborates closely with students and their families to assess their unique needs and develop personalized medication regimens.

Our approach to medication management prioritizes safety, efficacy, and collaboration with students and their families to ensure they receive the most appropriate treatment for their symptoms while minimizing potential side effects.

Integrating CBT + Medication

At Light On Anxiety, we offer integrated treatment plans that address both the psychological and physiological aspects of the difficulties. Our therapists and psychiatric providers work closely together with students and their families to tailor treatment plans to their individual needs and preferences.

  • CBT and ERP help students develop coping skills, challenge negative thoughts, and confront their fears,.
  • Medication management targets symptoms of anxiety and depression, providing additional support and relief.

Through this combined approach, we empower students to overcome school-related anxiety, improve their academic performance, and foster a positive and successful school experience.

Your Unique Path to Freedom From School Anxiety and Refusal

Our goal is to create a treatment plan that aligns with your needs and preferences, recognizing that each individual’s journey is unique.

What are the symptoms of School Anxiety and School Refusal?

School anxiety and refusal can manifest through a range of symptoms, impacting a child’s emotional well-being, behavior, and academic performance:

Persistent physical symptoms like stomachaches, headaches, nausea, or fatigue, particularly on school mornings.

Heightened levels of anxiety, fear, or irritability related to the idea of attending school.

Actively avoiding or refusing to attend school, often leading to extended absences.

A noticeable decline in academic performance or engagement due to anxiety-related challenges.

Difficulty separating from caregivers, especially in the morning or when faced with the prospect of attending school.

Withdrawal from social interactions with peers, leading to increased feelings of loneliness or exclusion.

Difficulty falling asleep or experiencing frequent nightmares related to school-related stressors.

Noticeable changes in behavior, such as increased irritability, mood swings, or a reluctance to discuss school-related topics.

Excessive worry about academic performance or fear of not meeting perceived expectations, leading to heightened anxiety.

Engaging in rituals or negotiations to avoid attending school, such as prolonged morning routines or repeated requests to stay home.

FAQs about School Anxiety and School Refusal

Forcing an anxious child to attend school may exacerbate their anxiety and worsen the situation. Instead, it’s advisable to work collaboratively with the child, school staff, and mental health professionals to understand the root causes of their anxiety and implement supportive strategies to gradually ease their transition back to school.

School refusal is not a specific disorder but rather a behavioral manifestation often associated with underlying anxiety, depression, or other emotional difficulties in children and adolescents.

Yes, anxiety can significantly impact a person’s desire to attend school. The fear of social interactions, academic pressures, or specific situations like tests can contribute to school avoidance behaviors.

The trajectory of school refusal can vary. While some children may naturally outgrow school refusal as they mature and develop coping mechanisms, others may require ongoing support and intervention to address underlying anxieties. Early identification and appropriate strategies can contribute to improved outcomes over time.

There could be various reasons why your child no longer wants to go to school. It might be linked to academic challenges, social difficulties, bullying, or anxiety about specific situations. Open communication with your child, involving teachers and potentially seeking guidance from a mental health professional, can help identify the underlying issues and implement strategies to support their well-being and successful engagement with school. Understanding the specific reasons behind their reluctance is crucial for addressing the situation effectively.

More About Treatment for Anxiety

What is CBT & ERP for OCD?

Light On Anxiety CEO Dr Debra Kissen describes how CBT & ERP helps clients move past OCD and other anxiety disorders.

Learn more about how we can create a custom individual treatment plan to fit your goals.

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