School Refusal

School Refusal

There can be various causes of school refusal including school phobia. It is a symptom related to social anxiety disorder, depressive disorders, anxiety disorders and oppositional defiant disorder. Children may refuse school to avoid riding the school bus, going to gym class, using the school bathroom, avoiding bullies, reading aloud, or interacting with teachers or other children. Often the child will stay home and avoid these negative situations. This situation is often reinforced behaviorally as by staying home, the child can play games, watch TV, or spend extra time with parents, all positive experiences. The child may complain of headaches, stomach aches, sore throats, or even actual symptoms like diarrhea or vomiting.

Treatment of School Refusal

As there are many causes of school refusal including anxiety, depression, and oppositional behavior, there is no one simple treatment. In cases involving anxiety and depression, Cognitive-behavioral therapy (CBT) can help children better identify negative thoughts and their behaviors. Medications for anxiety or depression may also be helpful in lessening the fears and worries about school, as well as improving mood symptoms. In cases of oppositional behaviors, ruling out oppositional defiant disorder and ADHD are particularly warranted as well as consideration of medications.

Sometimes parents may also benefit from Parent-Child Interaction Therapy (PCIT) where parents are taught ways to improve the relationship between the parents and their children. In cases of school refusal, PCIT may help by developing strategies to encourage their child to attend school by creating positive reinforcement for attending school.