Understanding School Refusal in Teens

August 8th, 2025

Getting your teen back into the school routine after a long summer break can be one of the most challenging times of the year for parents. While some kids struggle with the usual adjustment period, others experience deeper emotional distress that leads to frequent absences or outright refusal to attend school. This behavior is commonly referred to as school refusal—and when it becomes persistent, it's often called school avoidance.

The million-dollar question is, what should you do when your teen doesn't want to go to school?

In this blog, we’ll break down what school refusal is, its reasons, ways to identify it, and practical strategies to support your child. Keep reading to discover effective treatment options to help your teen feel safe and supported in returning to the classroom.

What is School Refusal?

As parents, we know how hard it can be to shift from a relaxing summer break mindset to the structure of early mornings, long workdays, and packed schedules. That same transition can be just as overwhelming for kids. While some children ease into the school year with minimal bumps, others experience intense anxiety and it becomes easier to avoid school altogether to relieve stress.

To better understand this response, think about the body’s fight-flight-freeze reaction—our instinctive way of protecting ourselves from perceived threats. For some children, school itself can feel like a threat. Their behaviors might reflect this:

Fight: Acting out in class or at home before school
Flight: Skipping school or frequently asking to stay home
Freeze: Withdrawing, shutting down, or refusing to engage at school

Avoiding school often provides immediate relief from anxiety—but only in the short term. As Psychology Today contributor Alison Escalante, M.D., explains, “Parents and children don't understand that staying home from school doesn't help. It makes it harder to return to school, to keep up academically, and potentially feel socially disconnected from peers and teachers.”

The more a child stays home, the more their anxiety grows—and over time, that anxiety can evolve into depression. Additionally, this short-term relief response prevents teens from developing the coping skills they need to manage stress in healthy, sustainable ways.

Why Kids Refuse to Go to School

School refusal isn’t just about being stubborn or lazy—it’s often a sign that something deeper is going on. When a child consistently avoids school, it’s usually because they’re trying to escape something that feels overwhelming, frightening, or emotionally distressing. If your teen refuses to go to school, here are some common reasons as to why.

Common reasons kids refuse to go to school include:

Separation anxiety – Especially common in younger children, who may fear being away from their parents or home environment.
Social anxiety – Worrying about peer interactions, bullying, or embarrassment in social situations.
Academic pressure – Fear of failure, struggling with learning difficulties, or feeling behind can cause intense school-related stress.
Mental health issues – Conditions like anxiety, depression, or trauma can make attending school feel impossible.
Sensory issues or neurodivergence – Kids with autism, ADHD, or sensory processing challenges may find the school environment overwhelming.
Bullying or peer conflict – Ongoing issues with classmates can lead to dread and avoidance.
Change in routine or life events – Family changes like divorce, moving, or grief can disrupt a child’s ability to cope with school demands.

Understanding the why behind school refusal is the first step to helping your child. With the right support, coping strategies, and professional help when needed, most children can return to school feeling safer and more confident.

Identifying School Refusal

So, how do you identify school refusal? Most of us will answer well when our child refuses to go to school or skips. However, school refusal can manifest in several behavioral ways. According to clinical psychologist Julia Martin Burch, Ph.D., school refusal can appear in several behavioral forms, including:

Difficulty getting to school on time
Frequent requests to leave early
Repeated absences or skipped classes
Emotional outbursts or meltdowns before school

In many cases, school refusal also shows up as physical symptoms—also known as psychosomatic complaints. These may include:

Headaches
Stomachaches
Nausea or fatigue
Dizziness or muscle pain

These symptoms are often real and distressing to the child, even when no medical cause can be found. They are the body’s way of expressing emotional overwhelm—especially anxiety—without having the words to explain it.

You might also notice increased clinginess, irritability on school mornings, or frequent visits to the school nurse. These are all common signs that a child may be struggling with school-related stress or anxiety.

What Should I Do If My Child Won’t Go To School?

Understanding your child's school refusal/avoidance is critical to addressing the issue and finding ways to support them. According to Julia Martin Burch, Ph.D. below is a list of strategies parents can use to combat school refusal:

Step in Quickly: When children begin missing school, they fall behind on assignments and miss out on important social experiences. Over time, this can make school avoidance even harder to manage. That’s why it’s important to act early. Watch for warning signs—such as trouble getting to school on time or wanting to leave before the day ends—as these can signal growing anxiety or school refusal.
Help Identify Issues: Gently talk with your child about why they're avoiding school, as you want them to be open and honest about the issue. You can ask questions like "What is making school feel hard?" Are they struggling socially or being bullied? Are you afraid of having a panic attack in the classroom? Are they worried about academic performance or experiencing separation anxiety?
Communicate and Collaborate: Collaboration with your child's school can be essential in combating school avoidance. Remembering you cannot handle the issue alone is key, and establishing a support system is vital. Utilize the school guidance counselor, psychologist, or social worker to share information about why your child struggles to attend school. This can help create a plan with your child and the school to identify ways to help address what they are avoiding at school.
Be Firm About School: It’s important to balance empathy with consistency. Acknowledge and validate your child’s physical symptoms of anxiety—such as stomachaches, headaches, or fatigue—without reinforcing avoidance. Let them know you understand how uncomfortable it feels, but also reassure them that they are safe and capable of getting through the school day. By being supportive yet firm about attendance, you help your child build resilience and learn that anxiety can be managed—not avoided.
Make Staying Home Boring: Assess the home environment. Are there things that make staying at home more appealing, and how can we make the home environment less attractive? This can start by restricting access to screen time (cell phone, TV, iPad, etc.) and limiting sleeping/lounging in bed unless they're sick. The day should still have a routine as if they were in the school environment, asking the school to send assignments that need to be completed or even asking for a home tutor. Make clear expectations that if they do not attend school, all electronic devices will be taken, or home Wi-Fi will be turned off.
Therapy for Teens: Apart from working with the school counselor, Individual therapy outside of school can help your child better understand and manage the emotions behind their school refusal. Working with a licensed therapist gives teens a safe space to explore anxiety, depression, social fears, or academic stressors that may be driving their avoidance. Therapists can also teach evidence-based coping strategies—like cognitive behavioral techniques and mindfulness practices—that empower teens to face challenges with more confidence.
PHP/IOP Program: If weekly therapy alone isn't enough, a higher level of care may be necessary. Partial Hospitalization Program (PHP program) and Intensive Outpatient Programs (IOP Program) offer structured, multi-day treatment that address the root causes of school refusal—such as severe anxiety, depression, or trauma. These programs provide teens with therapeutic support, skill-building, and peer connection while allowing them to remain in their home environment. PHP/IOP can be a crucial step in helping teens stabilize, build confidence, and successfully reintegrate into school life.

What is the Treatment for School Refusal?

Treating school refusal can be challenging for families, but support from licensed mental health professionals—especially those who specialize in child and adolescent anxiety—can make a significant difference. These clinicians can help your child re-engage with school in a structured, compassionate, and clinically informed way.

Cognitive Behavioral Therapy

According to the Child Mind Institute, one of the most effective treatments for school refusal is Cognitive Behavioral Therapy (CBT). CBT helps children recognize and manage anxious thoughts, while teaching practical coping strategies to handle distressing emotions and fears about school.

Exposure Therapy

Another powerful approach is Exposure Therapy, a CBT-based method that gradually introduces children to anxiety-inducing situations—like attending class or entering the school building. The goal is to slowly increase tolerance to these stressors, helping the child progress from attending a single class to a full day of school over time.

Dialectical Behavior Therapy

In addition, Dialectical Behavior Therapy (DBT) is another effective treatment for school refusal—especially when other mental health conditions are present. DBT teaches mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness skills. This approach is particularly helpful when school refusal is connected to deeper emotional or relational challenges, including family conflict or co-occurring psychiatric concerns.

Outpatient Mental Health Program (PHP/IOP Program)

As mentioned in the previous section, enrolling your teen in a PHP program or IOP program is another highly effective treatment method that does not interfere with their academic life. Partial Hospitalization Programs (PHP) and Intensive Outpatient Programs (IOP) provide a higher level of care for teens who need more support than weekly therapy can offer. These programs are designed to address the underlying mental health conditions—such as anxiety, depression, or trauma—that often fuel school refusal behaviors.

Both PHP and IOP offer structured, therapeutic environments that include:

Individual and group therapy
Psychiatric support and medication management (if needed)
Skills training in emotional regulation, distress tolerance, and coping strategies
Family therapy to improve communication and support systems at home

No matter the approach, early intervention and a personalized treatment plan are key to helping your child return to school with confidence and resilience. By giving teens the tools to manage their anxiety, improve their mental health, and rebuild their confidence, PHP and IOP can be a crucial step in breaking the cycle of school refusal and setting them up for long-term success.

Find a Teen Therapist Near You

Find the best teen therapy for your child at Clarity Clinic! If your teen is struggling with school refusal, anxiety, or signs of depression, getting professional help is a critical next step. At Clarity Clinic, we specialize in teen mental health treatment and offer a range of evidence-based options—including therapy for teens, teen IOP, and teen PHP programs—designed to support your child’s emotional and academic success.

Whether your teen refuses to go to school, shows clear signs of school avoidance, or you're unsure why your child won’t go to school, our licensed teen therapists can help uncover the root cause and develop a personalized treatment plan. Explore our mental health clinic locations throughout Chicago.

We offer:

In-person and online therapy for teens
Access to experienced teen therapists near you
Comprehensive mental health care through our PHP programs and IOP programs
Support for conditions like school refusal, depression, anxiety, and more

Don’t wait to get your child the support they need. Find compassionate, expert-led teen therapy at Clarity Clinic and help your teen take the next step toward healing. Click the button below to explore our therapist options and schedule a consultation.

Find a Therapist for your Teen

Related Readings:

- PHP/IOP for Teens: Questions Parents Should Ask Before Choosing a program

- Anxiety in Teens: Key Signs to Watch for at School

- Teen IOP: How Do Intensive Outpatient Treatment Programs Work?