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School Refusal

School refusal defined

School refusal is a problem associated with separation anxiety and social anxiety in which a child regularly refuses to go to school or has problems staying at school.
The first symptoms that appear during school refusal are physical, they include: nausea, diarrhea, headaches, lightheadedness, and stomach aches. School refusal also takes the form of tantrums, separation anxiety, and avoidance. School refusal often occurs  during times of transition, such as entering high school or middle school.
School refusal is not the same as truancy because in school refusal, a child stays home with the knowledge of their family, despite their parents trying to enforce attendance. Unlike truant individuals, people with school refusal do not display behaviors such as lying, cheating, or destroying property.
To treat school refusal, the first step is to have your child with school refusal take a comprehensive diagnostic assessment to determine further treatment. Treatment for school refusal often includes cognitive behavioral therapy, which helps individuals face their anxieties, and exposure therapy, which gradually reintroduces them to a school environment. Wilderness therapy programs have also proven to be effective in assisting the recovery of teens with school refusal.

Trails Carolina and School Refusal

school refusalFor teens with school refusal, Trails Carolina offers a multi-dimensional wilderness therapy program for individuals ages 10-17. For children and teens with school refusal issues, going through a wilderness therapy program like Trails Carolina provides a transformative experience that offers time for self reflection and change through the  experience of being in nature.
For students with school refusal, Trails Carolina has a well-trained, caring staff prepared to treat whatever is causing teens to experience school refusal.  Trails Carolina involves the family of our students at every step. We have weekly calls with parents, family therapy sessions and weekly exchanges of letters with families for our students. These therapy techniques assist in working out the issues that caused school refusal in the first place.


A 2003 Duke University study found school refusal to be strongly associated with depression, and separation anxiety disorder. After surveying a sample of 4500 9-16 year old children, researchers found that difficulties in peer relationships, sleep difficulties, somatic complaints and specific fears had different associations with school refusal.
In a 1990 study about school refusal, conducted by the National Institute of Mental Health, 63 children and adolescents with school refusal were referred to outpatient anxiety disorder clinics.
There, individuals were assessed on personality and diagnostic variables, as well as whether school refusal ran in their family. Results displayed two groups of individuals with school refusal – those with separation anxiety and those with a phobia of school. Phobic school refusers began experiencing school refusal at a later age and had more severe school refusal than those with separation anxiety-related school refusal.

Contemporary Articles

An article in the New York Times details the experiences of Dr. Perri Klass with school refusal. She describes school refusal as a symptom that needs to be treated as soon as parents can get help. She discusses the anxiety which creates school refusal in children.

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