Phobic school refusers
As the name suggests, this group has often had a long history of school refusal with varying degrees of success in re-engagement, and is characterised by older students. This group rarely makes an attempt to get to school and parents rarely try to motivate them on a consistent basis. Parents will often report bouts of yelling and screaming but rarely is there a systematic and consistent approach. This group can be quite complacent knowing that the family has been worn down and will only lash out when forced to make change.
Families of this group are often burnt out and can present as unmotivated, sceptical or resistant. These families require as much (if not more) support than their child as they too need to learn to overcome their anxiety and remain strong in the face of adversity.
Case example
Some years ago I met the parents of a 14-year-old boy (Charles), who had been referred to me by child protection services, for assistance in getting their son back to school. The parents informed me that they worked long hours and had three sons all of whom had, at some point in their education, refused to attend school. They described their many attempts to get their eldest son back to school and spoke of the frustration, anger and heartache they felt when, after much intervention by professionals, school and parents, they were only able to get him back to school for the fourth term of Year 10. At the time of referral they informed me that their eldest son was in his early twenties and unemployed. He had lost contact with most of his friends and tended to stay in his room playing computer games and watching TV. Not surprisingly there was some question of whether this son suffered with depression.
To add to their despair, their middle son also disengaged from school. The parents admitted to making only a half-hearted attempt at getting him back to school given the turmoil the family had experienced with their eldest son. As with his older brother, this son was also unemployed and very much confined to the family home. Their middle son was in his late teens at the time of referral.
It was of no surprise to me that their youngest son, Charles, had followed his elder brothers’ footsteps given that he had watched his parents take the path of least resistance particularly with his middle brother. When I met with Charles, he presented as a respectful and quiet young man who was genuinely distressed when we discussed a possible return to school. Charles admitted to disliking school and feeling out of place when he attended. He understandably preferred to be at home with his two older brothers, who would occasionally include him in one of their computer games.
Charles had scarcely attended school since the start of secondary school with periods of nonattendance reported in primary school. His parents admitted to leaving for work without even attempting to get him out of bed as they were fed up with the arguments, which were ultimately fruitless.
There is no doubt that Charles’s anxiety about going to school was very real but we must remember that Charles had not really been expected to attend school for some time. By the time I met Charles and his parents, the fear of going to school had become so great that avoidance was the only solution. Or to use an old adage: ‘Charles had come off the horse and had never really been expected to get back on’. Hence he had forgotten how to ‘ride’.
It was only with the involvement of his school, extensive education of his parents about anxiety/fear/avoidance and clear expectations of Charles that we were able to slowly get him back to limited school hours.
Sadly, Charles and his family moved away before we were able to complete his return to school. I often wonder what happened to Charles and his brothers and use their story in presentations as an example of what happens when issues are not addressed in their infancy and parents become despondent. In this case, what started as a problem with one child became a scourge for an entire family. As with all phobias, the longer we take to begin the exposure process the more difficult it becomes to challenge and successfully eradicate the phobia.
Why do children refuse to go to school?
Children refuse to go to school for many reasons. It is important, where possible, that we try to identify the factors that lead to the disengagement. The factors discussed in this chapter are in no way exhaustive, but may help narrow down the possible causes.
Fearing the loss of a parent
We often see this fear occur when a child has been separated from a parent (or parents) due to hospitalisation or when one parent has left the family home for an extended period of time and then returns (i.e., to serve in the military). As our natural instincts are to remain close to our parents, as they are directly responsible for our survival, we cling to that parent once they return for fear that they will leave again. In the nonclinically anxious child, this fear of loss passes as the child slowly comes to realise that the parent is no longer at risk of leaving. However, for the clinically anxious child this fear remains and affects their ability to engage in normal daily activities that require separation from that parent. Family breakdown can also create this fear of loss as the child fears that their remaining parent will also leave.
Needing to protect a parent
Children also need to know that their parents are safe. If a child has witnessed or heard family violence, their fear for the abused parent will escalate. Remaining at home, especially if the abuser is at home during school hours (due to unemployment or shift work), is one way to minimise the threat. The child, in effect, takes on the role of protector. Alternatively, the child may stay at home in the belief that they can help a sick or grieving parent; therefore, becoming the parent’s nurse or counsellor. For example, a child may stay at home to keep mum company after parents have separated because they have seen mum cry when she is alone but perk up when she sees the child.
Jealousy
School refusal can be brought on by jealousy. This is especially true if another sibling is at home for health reasons and is seen to be having fun while they recuperate. A good example of this might be: a sibling being at home with chickenpox and mum taking time off work to care for the sick child. The child attending school then discovers that mum has been baking goodies and playing with the sick child while the well child is expected to go to school. Becoming ‘sick and anxious’ is a nice way of joining in on the fun. Similarly visitors from interstate or overseas can trigger the desire to spend more time at home with them, especially if parents or older siblings have taken time off work.
Family dysfunction
Dysfunction within the family could include parents arguing, older siblings or parents with mental health or physical ailments, an unemployed parent who is lonely, or a pet that is sick. Whether real or perceived the child believes that remaining at home will help alleviate these issues; therefore, the child will create symptoms that facilitate their carer role.
Transition
Any change from old and comfortable to new and challenging can produce very high levels of anxiety particularly for the clinically anxious child. For example, moving to a new school and leaving behind well-known teachers, friends and surroundings can produce such turmoil and distress that the child cannot bring themselves to start anew. This is why appropriate care must be taken when children are involved in a major life transition. Where possible, the child should be encouraged to visit their new school several times and be provided with buddies who will communicate on a regular basis to help the child integrate more easily once they move to their new school. Letters of welcome, video calls from students and teachers can make
