School Refusal: When Your Child Doesn’t Want to Go to School Due to Depression

It is not uncommon for a child or teen with depression to avoid or refuse to go to school. Inability or reluctance to wake up and get dressed in the morning, frequent visits to the school nurse, skipping class, or frequent complaints of physical pain and sickness such as headaches, stomach aches, nausea, or diarrhea can all be signs of school refusal. Anxiety and defiance may be present, as well. The Director of Child Programs at Compass Health Center, Lee Dal Pra, AM, LCSW, says, “It’s so important to have self-compassion. It’s a painful process for parents, caregivers, and everyone.” As a parent, it is hard to know what to do. The behavior can be disruptive to the family and it’s heart-wrenching to see your child in pain and unable to manage school. One of the most important steps in dealing with school refusal is to understand why your child is having difficulty getting to school in the first place. School refusal is often a manifestation of an illness like depression or anxiety, but it can also be the result of bullying or issues with friends or family members.

If your child is avoiding or refusing to go to school, talk to your child’s therapist. He can help develop strategies to help resolve the situation, such as addressing your child’s sleeping habits so that he is ready for school in the morning. If it is an issue of bullying, the school should be involved in order to mediate the situation between the bully and your child. If the school refusal is rooted in family problems, family therapy may be helpful. Regardless of the reason for school refusal, it is probably a good idea to get your child’s school involved. The school may have ideas about how to help. However, with more people involved, communication is key. Make sure releases are signed so that the school can work with you and your child’s therapist seamlessly—resulting in a consistent approach that is supportive and, ultimately, effective. Everyone’s situation is different, and therefore, blanket advice on this topic is not fitting. However, there are a few tips that we have found helpful.

• Avoid engaging in a power struggle. When your child is refusing to go to school, try to avoid getting upset. This can escalate the situation and cause both you and your child stress—which is not a helpful headspace for a child already having trouble going to and/or staying in school.
• Validate how they must be feeling. Think about what would be helpful to you if you were in your child’s shoes. It would probably feel pretty comforting to know that your mom or dad understands that you are in pain and that getting to school is hard.
• Reinforce the plan. Remind your child of the plan in place. If part of the plan is using skills learned in therapy, ask your child’s therapist to teach you the skills so you can help. Review those skills with your child each day until they integrate them regularly. Ask your child if it’s okay for teachers to be cued in so they can support your child when needed.
• Establish a safe space. Often when a child is experiencing emotional difficulty in school, there is a fear of visibly “losing control” in front of their classmates. This may be why they are avoiding school. One way to make the school day feel safer for your child is to ask the school to establish a safe place where they can go to collect themselves such as a social worker’s or nurse’s office.
• Practice patience. Be firm on the idea of going to school and also understand that overcoming school refusal may take time.
• Reward and praise improvement. Make sure to point out the moments when your child is using their skills or making even the smallest steps in the right direction. Remember, when you are depressed, you see failure in everything. Positivity is very powerful.

Chronic school refusal may mean a therapeutic school environment is needed for your child. Talk to your child’s school if you believe this step is necessary, as it can sometimes be challenging to get the school’s buy-in. IDEA/IDIEA (Federal law) requires that a school must provide children with the least restrictive educational environment. For a child exhibiting chronic school refusal, this means that every available school intervention must be exhausted before a school district will fund a therapeutic school placement. If you have the resources, you may decide to initiate the process on your own. If you choose to do this, you can talk to your child’s pediatrician or therapist, who may have some suggestions for you. You can also contact the National Association of Therapeutic Schools and Programs (www.natsap.org) to find a school or hire an educational consultant who specializes in therapeutic schools. The Independent Educational Consultant Association (www.iecaonline.com) is a good resource to help you find a consultant in your area. For more information download our Family Handbook .