Anxiety & School Refusal

Photo of an empty school desk chair representing a chair that’s empty if a child missed school due to anxiety. When your teen is struggling to be present in school, anxiety treatment in Columbia, mo may help them. In teen therapy, you can help your …

Maybe it happens suddenly or perhaps it starts out slowly with your child only occasionally refusing to go to school giving you a different reason for the refusal each time.  Regardless, you’re left with a child who refuses to attend school.  Perhaps the school is calling you about the unexcused absences or even talking about disciplinary action.  You want your child to go to school, but no matter what you try (explaining the importance, threatening punishment, offering to reward the child for attending) they insist they can’t attend class.  What do you do?

Is this school refusal or truancy?

If your child is skipping school to avoid feeling negative emotions, is still willing to do school work, and expresses a great deal of anxiety (which may look like agitation or a “meltdown” particularly in younger kids) you may want to consult a professional to help you determine the root cause.

How can counseling help a child overcome anxiety about school?

A therapist will tailor anxiety treatment to meet the needs of your individual child after talking to the parents, the student, and in many instances their teacher or school counselor.  However, here are some very general steps your counselor may take to help your child overcome their fears and confidently return to class full time:

  1. A full assessment includes ruling out any reason your child may have to fear attending school.  It is particularly important to rule out trauma such as bullying, abuse, or a major change in the student’s life if the school refusal is sudden.  Does the student have a good reason to be afraid of going to school?  Does something specific in the school environment feel unsafe?  Or perhaps the student is afraid something will happen at home if they are at school.  For instance, a child may be afraid that a sick caregiver will pass away if they’re separated or that something will happen to their home if they’ve recently experienced a house fire.  This is why it’s critical that your therapist first gathers as much information as possible about what is going on before determining a course of treatment.

  2. Teach coping skills for dealing with negative emotions.  How we do this depends on your child’s age.  We may teach a younger child coping skills through games and play.  On the other hand, an older student may be encouraged to mindfully observe cues in their body, discuss their feelings or even complete a worksheet.  I personally teach children as young as preschool all the way through adults breathing and mindfulness techniques that can be calming when one experiences anxiety, sadness, or distress of any kind. Teaching coping skills is often one of the first steps we take so that when we’re exploring the emotions later in treatment your child has the tools to cope with those feelings without becoming overwhelmed.  Clients often feel some relief even at this point.

  3. Teach the child to recognize and express their difficult emotions.  In many children, this is a scary step.  I’ve worked with many people who can only say they feel “good” or “bad.”  I use a variety of games, books, discussions, and play to help children learn to accurately state how they are feeling.  We try to do this in a nonthreatening way that includes expressing both positive and negative feelings.

  4. Gradually increase your child’s confidence through exposure.  Sometimes this step takes place at the same time the others are happening or we move through the steps quickly, but ultimately we know that most individuals feeling anxiety need some sort of anxiety.  Your therapist will individualize exposure exercises for your unique child and their specific situation but will build up from things they feel less scary to the situation they are most worried about facing.  Examples of exposure exercises a therapist might suggest for school refusal could be as simple as talking about school, walking through the school when school isn’t in session, meeting with teachers or school counselors individually, attending a preferred or smaller class first, attending full classes with an accommodation that the teacher won’t call on your student and eventually moving to full participation.

How can the school help an anxious student?

Students in study group reading books and taking notes. When your teen is anxious, it can be heard to know how to help. However, with the help of a skilled anxiety therapist in therapy, they can breathe once again. Try counseling for teens with anxi…

It’s been my experience that our local schools are happy to work with parents, students and even me as the outside therapist to help your child be successful.  I’ve spoken to teachers, school counselors and even a principle on the phone about students.  There are also times where having a meeting between the parents, school counselor, possibly an IEP coordinator and outside therapist can be helpful.  Your teachers are the experts on how your child behaves in the classroom.  Your outside therapist may be the best equipped to speak about the impact of your child’s anxiety.  And most importantly, you (and your student) are the expert on your child as a whole.  I encourage everyone to work together.  This is another one of those situations where there is no “one size fits all” approach and your child’s unique personality and fears need to be taken into account.  That said, your school guidance counselor and teachers are likely to have suggestions based on what they know about their school, what they’ve seen of your child and what they’ve seen work for other students in the past.

When the anxiety is severe, the school may consider offering short term accommodations such as preferential seating, not requiring that the student speak in class or even shortened days for a short period of time.  The school may want to evaluate if the child qualifies to a 504 plan or IEP, particularly if the anxiety continues over a long period of time or there are other concerns as well.

Counseling for Your Anxious Student

Call Aspire Counseling today at 573-328-2288 or e-mail us today to discuss how counseling may be able to help your child overcome their fears related to school.

Other resources on our site you may find helpful:

Adolescent Anxiety

Identifying Anxiety in Children and Teens

Test Anxiety in Older Students

The 6 Levels of Validation for Teenagers for Better Communication

Learn more about how Aspire Counseling helps children and teenagers.

 About the Author

Photo of a teenager getting on the bus. He looks confident and represents a teenager who has attended counseling for child/teen anxiety with one of our Missouri therapists. Begin anxiety treatment in Columbia, MO for teens soon!

Jessica Tappana, LCSW is the founder, director and a therapist at Aspire Counseling in Columbia, MO.  She began Aspire Counseling in May 2017 to provide quality, evidence based counseling services to individuals in the Mid Missouri area looking for healing from trauma, grief, anxiety and overwhelming stress.  The practice now has multiple therapists and serves all ages from early childhood through retirement. Aspire Counseling is LGBTQ friendly and welcoming to people from all walks of life.  Jessica is proud of the care that is taken at Aspire to match each client with a therapist who is uniquely suited to meet that client’s needs based on personality, training, specialty and experience. If you’re interested in finding help for your child and finding peace for your entire family, you will find a safe space at Aspire Counseling.

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