School Refusal and School Anxiety

When Going to School Becomes a Daily Struggle

Occasional difficult mornings are common. However, when distress, physical complaints, lateness, or refusal to attend school becomes a pattern, a child may need additional support.

School refusal is not always defiance or a lack of motivation. It may be connected to anxiety, bullying, friendship difficulties, academic pressure, learning challenges, separation concerns, depression, perfectionism, or fear of making mistakes.

Parents may notice:

• Crying, arguing, or refusing to get ready

• Frequent stomachaches, headaches, or nausea

• Difficulty sleeping before school days

• Increased anxiety on Sunday evenings

• Repeated visits to the school nurse

• Frequent absences, tardiness, or requests to go home

• Panic, anger, or emotional outbursts before school

• Fear of tests, assignments, teachers, or classmates

• Declining grades or unfinished schoolwork

• Avoiding friends, activities, or extracurricular programs

How Therapy Can Help

Our therapists work with children, teens, and parents to better understand what is making school feel overwhelming. Treatment is individualized according to the child’s age, circumstances, and specific needs.

Therapy may focus on:

• Identifying the source of school-related distress

• Managing anxiety and physical symptoms

• Developing coping and emotional-regulation skills

• Building confidence and problem-solving abilities

• Reducing avoidance patterns

• Improving communication between children and parents

• Creating manageable steps toward consistent attendance

• Supporting parents through difficult school mornings

With written authorization, therapists may collaborate with schools, pediatricians, and other professionals involved in the child’s care when clinically appropriate.