Winter 2023

Peace of Mind – School Refusal

Also referred to as school avoidance, school refusal happens when a young person does everything in their power to avoid going to school. They might be trying to avoid the school bus, interactions with peers, or a teacher they aren’t getting along with. Sometimes they suffer from separation anxiety and don’t want to leave the confines of their home and family.

Is school refusal the same as school phobia?

Things get a little murky when discussing school refusal and school phobia. Some mental health experts use the terms interchangeably, suggesting a continuum stretching from mild anxiety to extreme fear. Others distinguish the two terms with school refusal affecting about 25% of students and school phobia affecting less than 5%. In other words, school phobia is less common than flat out refusing to go to school and is deeply rooted in a student’s fear of school. However, there is consensus when it comes to one common element in both: anxiety. Whether it is school refusal or school phobia, students who don’t attend school are feeling some kind of anxiety. While some may be able to express the cause of their anxiety, others feel powerless to identify what is keeping them from going to school.

Symptoms of school refusal

Besides the obvious symptom of short- and long-term absence of a student from school, here are the most common symptoms of school refusal:

  • Negative thoughts expressed about school or the idea of attending school.
  • “What if” statements like ‘what if I don’t fit in’ or ‘what if I fail’ or ‘what if I get bullied.’
  • Physical symptoms like dizziness, headaches, muscle tension, bowel issues, racing heartbeat, or trembling at the thought or idea of attending school.
  • Prolonged and extreme emotions like anger, tantrums, anxiety, fear, embarrassment, loneliness, sadness, or shame.
  • Catastrophic thinking.
  • Separation anxiety.
  • Constant complaining.
  • Failing to submit assignments and complete homework.
  • Skipping classes (for those who attend).

There are also some common causes of school refusal:

  • Transitions – like moving homes, shifting from elementary to secondary school, changing from summer vacation to a new grade/school year.
  • Family dynamics – things like parental separation/divorce, sibling quarrels, mental illness, abuse, alcoholism/drug addiction, financial instability, food instability, homelessness, a sick family member, a death in the family.
  • Problems at school – bullying, peer rejection, isolation. Also learning disabilities (i.e., dyslexia).

School refusal and school phobia share all these characteristics. However, when school refusal becomes much more intense, mental health professionals may start calling the condition school phobia or scolionophobia—an extreme and irrational fear of school. This is when school refusal and the fear of school becomes so intense that the student feels virtually powerless.


There is no formal diagnosis for school refusal or school phobia in the mental health realm. Most professionals see the condition as an extension or variation of an anxiety disorder. If a student is dealing with school refusal, there are some straight forward steps a guidance counsellor can take in consultation with the student’s parent/guardian and the school team. They include:

  • Work with the parent/guardian and the school team on a ‘return to school’ plan. The plan should specifically address the student’s concerns/fears about attending school. The counsellor should make sure teachers are aware of the plan so that all stakeholders are on the same page regarding the situation.
  • Assess the plan on a continual basis. Make sure the plan is working for the student and make any modifications necessary to improve the plan.
  • Make the guidance office a place for the student to check in if they are feeling anxious or uncomfortable.

Encourage students to:

  • See the benefits of school attendance (relationship building, working toward future goals like work or further schooling, more stability at home).
  • Keep a journal of their thoughts and feelings.
  • Practice self-reflection and mindfulness as coping mechanisms for returning to school.

What if we’re dealing with school phobia?

If school refusal cannot be addressed through these strategies, a student might need more intensive mental health support. This is when we move toward the realm of school phobia or scolionophobia. In these rarer instances, guidance counsellors can suggest:

  • Seeking a mental health referral through a family doctor. A mental health professional can use techniques like Cognitive Behavioural Therapy (employing talk therapy to help students address unhelpful or untrue thoughts) or Exposure Therapy (slowly and safely addressing the fear of school in a therapeutic setting).
  • In some cases, for example if a student is suffering from diagnosed anxiety or depression, medication may be helpful to bring them some stability.


School refusal is a real test of a guidance counsellor’s sense of empathy. Instead of simplifying the issue (“What am I supposed to do? The kid just won’t come to school!) it is important to understand that school refusal is complex and requires understanding and compassion. This complexity is addressed as a guidance counsellor works with the student and their family to find the root of the issue (anxiety? fear?) that is keeping the student from attending school. In many ways, school refusal is a normal reaction to life’s challenges. Helping a student address these challenges can teach them an important life lesson and get them back into the school community.

By: Sean Dolan