School Refusal

So let's get real for a second. Every school morning you wake up hoping "this is going to be a good day." Your morning is wrecked when your kid wakes up and doesn't want to go to school. These are the mornings you fear. Parents of school refusal kids know what I am talking about. Your day depends on how your kid wakes up. If your kid is good, you're good. If your kid is bad, you're stuck. What do you do? Do you try forcing your kid in the car, take away his/her iPad "forever," go to work and leave him/her at home..... School Refusal parents, you need help!

Join us for School Refusal as we help you step back, determine the reasons for your child's school refusal behaviors, and start to develop a step-by-step parenting plan to encourage your child to go to school stay all day, everyday.


Randy Floyd, LSCSW, Founder, Clinical Level Therapist

Randy is the founder of Midwest Anxiety. He is a Licensed Specialist Clinical Social Worker who is an optimist and passionate about helping people focus on what they can do rather than what they can't do. Randy believes building a strong therapeutic relationship and tapping into a person's strengths are the most essential components of the therapeutic experience. Randy is passionate about changing the way we do mental health. He is focused on making mental health normal, a positive experience. He is also adamant about doing mental health differently. Randy believes the "old ways" suggest mental health is for the "broken" or "mentally ill." Randy believes that "Everyone Struggles." Sure. Some people struggle more than others, but everyone struggles with something. With this belief, Randy is focused on providing a wide range of programs and services to help people be mentally well ;) Go give Randy a fist bump on Twitter, Facebook, Instagram, and YouTube.

Class Recording

Level of School Refusal.png


  1. Negotiations about school attendance the night before, morning of, or during school.

  2. Tardy or absentee from school.

  3. Pattern of physical complaints (headaches, stomachaches, nausea, etc) prior to or during school.

What are the Reasons for School Refusal behaviors?

  1. To stay away from objects or situations at school that makes your child feel unpleasant physical symptoms.

  2. To stay away from social or evaluative situations at school that are painful to your child (Social Anxiety Disorder).

  3. To receive attention from a parent or a significant other (Separation Anxiety Disorder).

  4. To obtain tangible rewards outside of school that make skipping school more fun than staying in school. Home is more fun!

Reason 1: "School makes me feel bad."

Caleb is a 7-year-old boy who gets up in the morning and immediately starts to cry and say, "I don't want to go to school." Although his parents can get Caleb ready for school, their son sulks during the car ride, complains of having a stomachache, and sobs when he sees the school playground. Caleb's mother says she has a hard time getting her son to go into the school building and that she sometimes drives him home when he seems so distraught. Caleb seems fine once home but sulks as well during the evening before school.

Like Caleb, one reason why children show school refusal behaviors is to get away from the distress they feel when at school.  This distress may be due to specific things such as the school bus or walking from one part of the school to another.  In some cases, children cannot say what is bothering them.  Children just indicate that are distressed and they don't like it.  We may not know what is causing the distress.  The goal is to find ways to reduce the distress not find what is causing the distress.

What is distress?

Distress is generally characterized by the anxiety, worry, uneasiness, apprehensiveness or dread about school.  It is shown in different ways in children including crying cling, tantrums, withdrawal, verbal statements asking to stay home.......

Distress is made up of three parts: thoughts, feelings, and behaviors.

Thoughts: Worries about bad things happening, sometimes just general thought of "I don't like school" (especially in younger children).  When distressed, your child does not have clear thoughts.

Feelings: Uncomfortable physical feelings such as aches, trembling, "butterflies," shortness of breath. The focus is on how your child "feels." I "feel" bad.  Don't always know what is causing the feelings, just that the child is feeling bad.  The goal is we have to teach your child to ways to control uncomfortable feelings and despite the feelings move forward with full time school attendance.

Behaviors: Avoiding places that cause distress, asking for reassurance, seeking accomodations.

Ways to reduce distress in your child:

  • Understanding what distress is: the "thinking," "feeling," and "doing" parts of distress

  • Teach your child ways to control uncomfortable feelings (focus on breathing) and despite the feelings move forward with full time school attendance.

  • Dealing with the "thinking" part of distress or what to do when your child says he/she doesn't want to go to school.

  • Managing the "doing" part of distress by gradually reintroducing your child to school and increasing his/her time in the classroom.

“I Feel Bad.”

Parents and teachers will ask a child a lot questions about what is bothering the child about school but come away with little information.  Part of the reason for this is that the child is focusing a lot on how he feels inside.  For whatever reason, school has become associated with uncomfortable physical feelings, and your child may be upset mostly with those feelings.  

Reason 2: “I’m nervous about what other people think of me at school."

Raven is a 13-year old girl who has problems attending school because she is nervous in different social and performance situations at school.  Raven has skipped several classes already this year and has three full-day absences.  She says she is shy, feels uncomfortable talking to other kids at school, and does not like speaking before others or going to gym class.  In particular, she has been skipping classes where she has to take tests or give oral presentations, and her teachers complain that Raven will not answer questions in class.

Anxious Thoughts + Anxious Feelings = Anxious Behaviors (School Refusal)


Children who are distressed about social and performance situations at school seem most bothered by their thoughts that something bad will happen at school.  The goal is to help you child think more "realistically" in social and performance situations.  Notice I didn't say more think more "positively."  Have your child take a step back and distiquish between possibility and probability of something "bad" happening.  When we think more realistically, we understand that the chance of bad things happening is actually small and we often feel less distressed. 

Examples of Negative Thoughts

  • They assume something bad is happening when actually it is not.

  • They assume terrible things will happen when terrible things are not likely to happen.

  • They assume what other people are thinking about them even though they cannot know. This is called "mind reading."

  • They jump to conclusions from just one event or make "mountains out of molehills" by assuming that the consequences of their acts will be extremely terrible.

  • They assume they will be embarrassed and that the embarrassment will be horrible.

  • They see situations as only perfect or terrible and not somewhere in between.

  • They focus much more on the negative than the positive side of things.

  • They blame themselves for things that are not within their control.

Encourage your child to use the STOP method to change the thoughts

  • S: Am I SCARED or nervous about a certain social or performance situation?

  • T: What THOUGHTS am I having in this situation?

  • O: What OTHER, more realistic thoughts can I have?

  • P: PRAISE myself for thinking more realistic thoughts.

Questions to Ask to Have "Other" More Realistic Thoughts

  • Am I 100% sure this will happen (or is happening)?

  • Can I really know what that person thinks of me?

  • What's the worst thing that can really happen?

  • Have I ever been in this situation before, and was it really that bad?

  • How many times has this terrible thing actually happened?

  • Am I the only person that has ever had to deal with this situation?

  • So what if I'm not perfect in this situation?

  • Is this really my fault?


Everyone feels uncomfortable from time to time- that's part of being human!  Talk with your child about this. The goal is to control the distress and move forward by going to school regardless of the feelings.  I find that children aren't too motivated to "relax" when they are in physical distress.  At this point, your goal is to normalize the feelings and name them as "anxiety."  "For anxiety not to win, YOU (not we) have to push through the feelings and they will get better the more you do it."


Your child may be missing some or most of the school day because of social and performance situations at school.  The most important part at the beginning is to get your child in the school building for part or all of the school day.

  • Find out what classes (times of the day) your child doesn't want to go to school and then build your plan around that. Then you can gradually increase the amount of time spent in school.

  • If you are not capable of transporting your child for only parts of the school day, set up plan that your child will go to "safe" area (defined by your child) during the missed classes.

  • It is important to have your child practice the feared social or performance situations outside of the school day.  Then as your child becomes comfortable, the classes missed due to social or performance anxiety should be added back in gradually. 

Reason 3: “I don’t like being away from my parents.”

Sam is an 8-year-old boy who has problems attending school because he would much rather be with his mother at home.  Sam often refuses to go to school in the morning, although his mom (Emily) can sometimes get him to go into the school building.  Sam says he likes school but often misses his mother.  Whenever he is at school, Sam tries to call Emily and has even run out of the school building twice to try to go home.  Lately, Emily has been eating lunch with Sam in the school cafeteria to get him to go to school with less fuss.

Refusing School for Attention

Some children seek alot of attention from one or both parents and are defiant about going to school because they would rather stay home.  Many of these children are not distressed about school.

To change your child's attention-seeking behavior and help improve his school attendance, focus on:

  • Setting up a regular morning routine.

  • Pay attention to appropriate behaviors and ignoring inappropriate behaviors.

  • Setting up formal rewards for going to school without a “meltdown.”

  • Setting up consequences for going to school with a “meltdown.”

  • Dealing with excessive telephone calls and texts.

Behavioral Modification System

Consequences: Your child will “owe” you time.  Owing you time can include anything from chores to writing you a letter how your child will handle the situation differently next time.  Your child does not do anything “fun” (watch TV, video games, play with toys, etc) until ALL the time is owed back.  The goal of this is for your child to determine that he/she is giving self consequence and he/she does not have consequence if makes good choice.  It is very important to keep track of time in minutes and seconds and consequence be for exactly that amount of time.

Rewards:  Give "Random Rewards." A “Random Reward” is any reward you give your child when he/she doesn’t expect it.  Give Random Rewards to reinforce positive behaviors (i.e. putting shoes on without your help, smiling, etc.)  The main point of a Random Reward is to reward them randomly when they least expect it.  For example, “Wow you did such an awesome job this morning, lets celebrate and go get ice cream.” Rewards are not to be given on a schedule of “you do this, you get this.”

Setting a Regular Morning Routine

Morning routines are generally a disaster for school refusal children.  The school refusal child may be "calling the shots," and everyone else in the family is reacting to what he/she does in the morning.  You may be "giving in,"working with," yelling, negotiating, bribing, or constantly bugging your child to go to school.  In the meantime he/she is still resisting to going to school.  You are reacting to what your child is doing and, in doing so, giving him/her a lot of attention that reinforces the school refusal behaviors.  We have to change this.  We have to set up the morning so that your child is responding to your rules and to what you say, and not the other way around.  We have to set up a clear and predictable morning routine that your child is expect to follow each day. 


  • Simple commands. Tell your child exactly what you want him/her to do. The goal is not to let the all content make it complicated on moving through the morning.

  • Set boundaries. You have to get good at which behaviors/statements to ignore and which ones to attend to.

  • Direct eye contact. When speaking to your child or giving a command.


Separation Anxiety Disorder is a psychological condition in which an individual has excessive anxiety regarding separation from home or from people to whom the individual has a strong emotional attachment (like a mother). Separation anxiety is often characterized by some of the following symptoms: persistent, excessive worrying about losing the subject of attachment, persistent, excessive worrying that some event will lead to separation from a major attachment, excessive fear about being alone without subject of attachment, persistent reluctance or refusal to go to sleep without being near a major attachment figure (like a mother), recurrent nightmares about separation, difficulties with drop off at activities (school, birthday parties, sporting events).

Note: It is highly encouraged the child, parents, and school agree to the specifics of this protocol prior to initiation.  It is important that child separate from parent by choice rather than a teacher, counselor, principal, etc. intervening by pulling, carrying, distracting child.

1.       Determine how long you will allow for complete separation (typical drop-off) from child (at least 2 weeks).

2.       Discuss with your child in confident (non-negotiating) voice that complete separation will occur within established time.  It is important for child to see that parent is calm, confident, and in control.

3.       Give child choice to determine gradual plan for separation such that child chooses specific places in school to separate.  Always begin separating at classroom and then move backwards from classroom.  For example:     

Aug. 23 - 26: Drop off at classroom

Aug. 27 - 31:  Drop off at school office

Sept. 1 – 4:  Drop off at front door

Sept. 5:  Drop off at curb

The important part is to establish that you will determine when complete separation will occur and the child can choose how it happens.  It is very important for the child to understand that once you drop off at a certain point from the classroom that you will not move closer to the classroom again.

4.     At drop off point you will say one (only one) good bye.  You will then become non-negotiating and not talk to your child, no eye contact again.  If you need balance, stand against a wall.  You will wait for the child to separate from you.  This is very important, as you want the child to begin learning and have confidence that he/she can separate from you.  You have to be prepared that the first several times that it may take an extended period of time for your child to separate.  It is important that you not give in early if you want child to learn that you are not going to give in.  If you stay strong, separation will occur but you have to wait it out.

5.     Establish for every second your child is late to class, your child will have to stay after school or have to “owe” you at home for the amount of time your child is late to class. It works best if the school will allow your child to stay after school for the time he/she is late.  If staying after school is not an option, then when your child gets home they have “owe” you for every second they were late.  Owing you time can include anything from chores to writing you a letter how separation will be different the next drop off.  The child does not do anything “fun” (watch TV, video games, play with toys, etc) until ALL the time is owed back.  The goal of this is for your child to determine that he/she is giving self consequence and he/she does not have consequence if not late.  It is very important to keep track of time in minutes and seconds and consequence be for exactly that amount of time.

6.)    Give “Random Rewards” when your child is being brave, separating from you.  A “Random Reward” is any reward you give your child when he/she doesn’t expect it.  Pick out all the things that you want your child to do on his/her own (i.e. walking into school without holding your hand, smiling, etc.)  The main point of a Random Reward is to reward them randomly when they least expect it.  Maybe randomly reward when you pick up your child from school, “Wow you did such an awesome job this morning, lets celebrate and go get an ice cream.” Rewards are not to be given on a schedule of “you do this, you get this.”

Phone Calls During School Day

There are several different ways to handle phone calls/texts during the school day.  Your child needs to know your expectation.

  1. No phone calls/texts during the school day. Encourage your child to connect with his/her teachers, counselor, etc.

  2. Limit phone calls/texts to a specific number. Once your child reaches that number you will not answer. Gradually reduce number of phone calls/texts over time.

  3. Allow your child to call/text you when needed. Your child will "owe" you the time after school for the time spent on phone calls/texts during the school day.

Reason 4: “Being at home is more fun than going to school.”

Maya is a 16-year-old girl who has been skipping afternoon classes to hang out with her friends outside of school.  Although Maya does go to school in the morning, she often meets up with her friends Callie and Nita in the middle of the day for lunch.  Many times the teens eat lunch off the school campus and then "ditch" the rest of the day to go to a local mall or spend time at Callie's house.  Maya is not distressed about school but complains sometimes that school is boring.  She tried to hide her absences from her parents., but the principal recently informed Maya's mother that her daughter has now missed at least seven afternoons of school.

Enjoys doing these things more than school

  • Hang out with friends

  • Enjoy sleeping late

  • Watch television/play video games

  • Riding bicycle

  • Shopping

  • Drugs

  • Shoplifting

  • Destroy Property

Many of these children are not particularly distressed about school.

Things to Change

  1. Must make sure that you and school staff know exactly where your child is at all times of the day. This will require you working closely with the school.

  2. Have to change all the fun things your child gets to do when she/he is out of school. Change to your child is getting reward for going to school and is receiving consequence for not going to school.

  3. Have your child check in at various times of day with school officials to maintain school attendance rather than ditching school.

  4. Require your child keep an attendance log to be assigned by each teacher.

  5. Get in the habit of your child checking in with you more during non school hours.

  6. Have regular meetings with your child to school preparation and attendance.

School Refusal Expectations

  1. Parents will give clear expectation to child that he is to participate in school activities with his assigned class allday, every day. There will not be any pulling, tugging, carrying child to car, classroom, etc.

  2. Randomly Reward positive behaviors.

  3. For every second that child is not in his seat in class, he/she will owe that time prior to getting any privileges (T.V.,video games, sports practices, sports games, eating dinner out, etc)

  4. Child will owe missed time by completing missed schoolwork and other academic work assigned by parents or school.

  5. If child refuses to go to school, he will follow same schedule at home as he would in class (only eat during eatingtimes at school, sitting at kitchen table to complete school work, only restroom breaks when restroom breaks at school)

  6. Parents will call school and report child as unexcused if refuses to go to school.

  7. If child refuses to go to school, he will pick up his schoolwork in his classroom or office after school. School work will not be forwarded to parents.

  8. Child is to self-advocate if he is not able to manage expectations.

  9. Parents and school will provide minimal negotiating or accommodations without child self-advocating.

What's Next?

  1. Nothing. Just let it ride and see how it goes ;)

  2. Take some more classes.

  3. Need more help than just a class? Try the The Feel Good Community or Individual Therapy.

  4. Stay connected with us on Facebook, Twitter, Instagram, and YouTube.


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Limits and Restrictions:

The materials distributed are provided with the understanding that the author and presenters are not engaged in rendering professional services. This is a psychoeducational class and information in the presentations or group discussions by the presenters, facilitators, or participants should not be considered to be medical, psychological, legal, financial, or spiritual counsel. The presentations and written materials are not intended to provide medical, psychological, legal, financial, or spiritual services or counseling. If expert assistance or counseling is needed, the services of a competent professional should be sought. Any opinions, finding, recommendations or conclusions expressed by the author(s) or speaker(s) do not necessarily reflect the views of Midwest Anxiety, LLC.