The child who would not go to school

Specialist CBT therapy for anxiety, OCD, depression and more in West London

A child who cannot get to school, leaves early, arrives only after a difficult morning, or becomes distressed at the thought of attendance can leave a family feeling frightened and stuck. The phrase “school refusal” can sound blaming. Many families prefer to talk about school attendance difficulty because it keeps attention on what may be making attendance hard rather than treating the child as the problem. There is no single explanation. Anxiety may be relevant for some children, but attendance difficulty can also involve bullying, learning needs, neurodivergence, sensory demands, physical illness, disability, friendship problems, bereavement, family stress, a difficult journey, safety concerns, a recent move, conflict at school, sleep or a combination of factors. A blog cannot diagnose a child, decide the cause, judge parenting or tell a family that a child should simply be made to attend. Physical symptoms such as stomach pain, headaches, dizziness, fatigue, changes in eating or sleep, and panic like sensations can have many causes. They should not automatically be attributed to anxiety. Parents or carers may need to seek medical advice where symptoms are new, severe, changing or concerning. It can help to start with a careful picture: when did attendance become hard; which parts of the day are most difficult; what has changed; what does the child say, show or avoid; what does school observe; what support already exists; and what feels safe enough to discuss? This information can support a conversation with the school, GP, school nurse, special educational needs team, local authority attendance service or another appropriate professional. If a child may be at risk, is disclosing harm, is being harmed, is missing, is experiencing abuse, is unable to stay safe or there is an immediate safeguarding concern, urgent safeguarding or emergency support is more important than following advice in an article. It is also important not to encourage a child to undertake exposure based tasks, confront a feared situation, or reduce a safety behaviour without an appropriate assessment and coordinated support. Where CBT based support is appropriate, it is assessment led and adapted to the child, family, school context, safeguarding needs and professional scope. It may involve work with relevant adults and services, with consent and clear roles. It cannot guarantee attendance, replace educational, medical or safeguarding advice, or decide what a school should provide. For related information, see <a href="/therapy/anxiety/">anxiety support</a>, <a href="/guides/anxiety and depression guide/">the anxiety and depression guide</a> and <a href="/support/understand myself/">support options</a>. If someone is in immediate danger or cannot be kept safe, seek urgent appropriate help.