Sage Thrive Today Blog Student Mental Health School Refusal: 8 Effective Intervention Strategies
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School Refusal: 8 Effective Intervention Strategies

School refusal impacts between 2 and 5% of students.1 This anxiety-based mental health issue ranges from mild separation anxiety to more severe cases of anxiety or depression that can cause young adolescents to miss weeks or months of school each year. School-based counseling can provide effective interventions that help students improve attendance and enjoy learning again.

School professionals and parents/guardians need to work together in proactively addressing the issue of school refusal. An effective means to help the child make it out the front door and into the classroom is to consistently employ supportive home and school-based interventions.

Pushing Creates Resistance

It is important to keep in mind that school refusal is a mental health issue that goes beyond childhood tantrums or adolescent defiance. Because the root cause is anxiety, addressing that issue by restoring a feeling of safety while maintaining clear expectations and accountabilities will best guide the student back into a productive educational experience.

The ideal team to effect change may include teachers, family, an adolescent therapist, and any specialist working with the child outside of school. A unified message is critical. Parents, guardians, and school professionals should be aligned in implementing some or all of the following interventions:

1. Assess and Collaborate.

A comprehensive medical and psychological evaluation will identify the underlying causes of school refusal. A multi-disciplinary school meeting including parents/guardians will ensure a unified decision on how to address those issues and assign responsible roles.

2. Address Underlying Causes.

Strategies to reduce anxiety and foster confidence include cognitive behavioral therapy, relaxation training, and systemic desensitization. School-based mental health clinicians can coordinate care with outside providers and agencies as needed.

3. Plan A Successful Re-Entry.

The student’s support team should work together to create a suitable re-entry plan. This might involve arriving early, planned breaks, involvement of a student aide, etc. Having the student participate in creating a step-by-step plan for a successful day will offer them a feeling of greater control and safety during the transition.

4. Establish Routine and Structure.

Predictable home and school routines reduce anxiety. Avoid over-scheduling and establish regular bedtime and morning routines. A safe launch pad at school might be part of this routine, allowing the child to report to an emotionally neutral place like a counselor’s office at the start of their school day.

5. Implement Incremental Consequences.

Not every child will immediately embrace the new routine. Making the stay-at-home experience less comfortable is the motivating counterpoint to making school more comfortable. Appropriate consequences for continued refusal involve limiting or removing daily pleasurable privileges, like access to television, cell phones, or video games.

6. Encourage Healthy Habits.

Sleep deprivation and inactivity contribute to anxiety and depression. Encourage the student to get adequate sleep, exercise regularly, and eat a healthy diet. Address the child’s concerns early in the evening rather than continuing a cycle of conflict in the mornings to reduce anxiety-related insomnia.

7. Support Social Involvement.

Help the student develop and maintain social relationships that provide motivation to attend school. Social skills training, team activities, and group therapy can help students develop trust, compassion, and healthy friendships. An assigned peer buddy for recess, lunch, and unstructured time before and after school may bridge the gap.

8. Maintain Team Communication.

The student’s support team should continue to collaborate regarding progress and new challenges on a daily basis. Once the child is attending school regularly, make clear to the student that resources and counseling are always available if he or she needs help. If multiple tardy days or absences occur in the future, the team should come together again to create a new action plan.

mom and teenage daughter visiting physiotherapist

Support Creates Motivation

If students do not receive the support that enables them to express their feelings of anxiety, school refusal or avoidance can become increasingly entrenched, resulting in social isolation and education gaps. By coming together to identify and address the root causes, parents, educators, and Sage Thrive clinicians can fuel students’ motivation to overcome their fears and successfully return to school in a safe and supportive environment.

If you would like to know more about how Sage Thrive partners with school districts and educators to prevent and treat school refusal or avoidance behaviors through comprehensive school-based counseling programs, call or contact us for additional resources and information.




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