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What To Do About Teen Anxiety and School Refusal

Teen School Refusal | Paradigm Malibu

Many teens experience anxiety about attending school. They may have anxious thoughts and feelings about school for a variety of reasons, including social and academic ones. When anxiety becomes more and more pronounced, some teens may begin to refuse to go to school. School refusal can easily result when teens are feeling overwhelmed or intimidated by the events happening in their classes and/or among friends. This article will provide parents with suggestions on how to best support their teen when anxiety begins to interfere with school attendance.

Teen School Refusal


Teen school refusal may seem like a typical problem parents face. However, it is considered to be more than just refusing to go to school every once in awhile. When a child or teen doesn’t want to go to school because of anxiety or other emotional concerns and does so on a regular basis, it is termed by experts as school refusal. School refusal is different than truancy, as the following definitions suggest:


School Refusal:  School refusal is a term that is used to describe a child’s experience of missing school due to emotional distress. At one point, school refusal was called school phobia. However, the term changed to reflect the fact that a child may not be afraid of school, but that there may great deal of stress or anxiety related to attending school.


Truancy: Truancy isn’t typically a result of anxiety. Instead, a teen may not care about school or may not even have a good reason not to go.


Teens may experience anxiety about school and refuse to go for a variety of reasons. According to the Anxiety and Depression Association of America, approximately 2-5% of children and teens experience anxiety-related school refusal. Teens might also refuse to go when making a transition into middle or high school.


Anxiety and Other Causes of School Refusal


If a teen is refusing to go to school and if there is an emotional reason behind it, parents might begin by uncovering the source of a teen’s anxiety or emotional distress. Reasons why a teen won’t go to school include:

  • facing a bully
  • not understanding a subject/failing
  • rejection from peers
  • the presence of an anxiety disorder or other psychological disorder
  • family conflicts or problems at home
  • physical illness


Another issue that can keep teens at home is a somatic symptom. This means that a teen may be experiencing a psychological issue (anxiety, depression, etc.) but it is showing up as a stomachache, headache, or bodily aches. Frequently, these aches can occur the night before school or the morning of school, and seem to not occur on the days when there is no school. Sadly, some parents might remain focused on the physical symptom without making the connection and supporting their teen with the anxiety or psychological problem.

Getting Help for Teen Anxiety


If you notice that there is a pattern of somatic symptoms or if anxiety is getting in the way of your teen’s attendance to school, getting professional mental health assistance may be useful. If your teen began seeing a therapist on a regular basis, this can provide your teen with tools and techniques to manage the anxiety. Furthermore, in some cases, a teen can take medication that might help ease anxiety in order to return to regular day to day functioning.


The benefits to getting professional help with teen anxiety include:

  • a teen has someone to talk to privately about their emotional distress
  • parents feel supported in assisting their teen
  • a teen may learn more about anxiety and how to manage it
  • a mental health professional can provide referrals if there are additional needs not being met through therapy
  • if the source of anxiety is a family one, a mental health provider may be able to offer family therapy or provide a referral
  • a mental health provider can conduct an assessment for any possible psychological concerns that may be affecting a teen’s school performance
  • a mental health provider may be able to uncover a learning disorder, which may be contributing to the school refusal
  • a mental health provider may be able to make a referral to a psychiatrist for the right medication, if needed.


Tips for Parents


In addition to getting mental health support, parents may want to consider the following tips:


Talk to your teen about what’s going on. It’s important to hear your teen out. What are the emotional triggers and the sources of anxiety? By understanding your teen, you can provide help that more accurately addresses their needs.


Talk to your teen’s teacher and school counselor. Parents can arrange a meeting with teachers and other school personnel to discuss how to best support their teen. This meeting might also be a place for school staff to share their concerns as well as a teen’s strengths. At this meeting, a teacher may suggest ways to support a teen in the classroom. School staff may be able to come up with a plan for supporting a teen.


Establish a support system. If your teen is worried about a particular class, facing a bully, or not being accepted by peers, you might consider creating a support system that a teen can access at school. Knowing that they can go to the school counselor or even sit in the principal’s office to take a break may be a source of relief.


Look for what’s positive about school. Encourage your teen to attend school by highlighting the positive. This isn’t to dismiss the anxiety or source of emotional distress, but looking at the positive can help your teen see the benefits of going to school that they might not see when focused on anxiety. For instance, your adolescent might enjoy being with friends or appreciate learning about a particular subject.


These are suggestions for supporting your teen when they refuse to go to school as a result of anxiety or emotional distress. As suggested above, it may be best to also seek the support of a mental health provider.

Dr. Nalin is a Licensed Clinical Psychologist, and Founder and Executive Director of Paradigm Treatment Centers, who has been a respected leader in the field of adolescent mental health for more than 20 years. He received his undergraduate degree from the University of Southern California, his Master’s degree from Loyola Marymount University, his Doctoral degree from Pacific University’s APA approved Clinical Psychology program, and completed his training at the University of California, San Diego’s APA approved psychology internship program.

Dr. Nalin has provided training and mentoring to students entering the field of psychology at institutions of learning including Pepperdine University’s Graduate School of Education and Psychology, UCSD, Pacific University, and Santa Monica College. He was also instrumental in the development of the treatment component of Los Angeles County’s first Juvenile Drug Court, which now serves as a national model.

Dr. Nalin has appeared as an expert on shows ranging from CBS News and Larry King, to CNN, The Today Show and MTV. He was also featured in an Anti-Drug Campaign for the Office of National Drug Control Policy (ONDCP).

Dr. Nalin is a Diplomate of the National Institute of Sports Professionals and a Certified Sports Psychologist as well as a Certified Chemical Dependency Intervention Specialist. He lectures and conducts workshops nationally on the issues of teen mental health, substance abuse prevention, and innovative adolescence treatment.

In 2017 Dr. Nalin was awarded The Sigmund Freud Foundation and Sigmund Freud University’s Distinguished Achievement Award in recognition of his work with youth in the field of mental health over the course of his career.

2 responses to “What To Do About Teen Anxiety and School Refusal

  1. Hi,
    My son is turning 15 and is in ninth grade. He refuses to go to school. He has OCD, depression, ADD, and mild dyslexia. He won’t tell us why he is not going but he did mention it is too much work and can’t keep up with English. He was bullied but told them off and said why are you picking on a scrawny ninth grAder w your pack of wolves . Very smart … lots of obstacles
    Taking meds for depression and ADD. When things are too stressful he shuts down . He seem to need a lot of
    Down time. Strengths are math and drama. Very insightful and deep thinker. Aware of his feelings and can articulate . He doesn’t want yo talk about it. He tells me to F off and I’m the reason why the universe is exploding. I’m a teacher . I don’t know what to do . We have tried CBT. But he doesn’t practice it. Very spacey kid. He told us something happened at school that we would think is a little thing of why he is not going to school. He also wants straight As but realizes it’s not going to happen so he is giving up. He won’t talk to us to find a solution . I don’t think on line schools would be good . He doesn’t seem to have executive functioning . He won’t leave the house .

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