What measures help prevent and reduce school refusal?

Although little research has yet been conducted into programmes specifically aimed at preventing school refusal, research into school absenteeism and the factors underlying school refusal does provide some starting points for prevention.

Early identification appears to be important

Early identification appears to be important in this regard. The longer students are absent, the more difficult it becomes to return to school. Early signs include regularly arriving late, missing lessons, going home early, or experiencing tension and physical complaints related to school, such as stomach aches or headaches. Absenteeism can reinforce itself: repeated absence increases the likelihood of prolonged absence. By systematically monitoring attendance, schools can identify emerging absenteeism in good time and provide appropriate support.

School refusal is associated with factors at the level of the school, the family and the student. At school level, a safe school climate, positive teacher–student relationships and support from teachers are associated with less school refusal. Negative social experiences, such as bullying, loneliness and a perceived lack of support, increase the risk. At family level, factors including parents’ mental health problems, performance pressure, conflicts between parents and the school, and unhealthy sleep habits are associated with school refusal. At individual level, anxiety, depressive symptoms, somatic complaints, sleep problems, a negative self-image and limited problem-solving skills are more common among students who refuse to attend school. Neurodivergent students, such as students with autism or ADHD, are also at increased risk, especially when they are bullied.

Involving the student, parents and school

Because school refusal is associated with multiple factors, an approach involving the student, parents and school seems appropriate. However, research into such comprehensive approaches is largely lacking. Most studies focus on cognitive behavioural therapy. This treatment, in which students learn to cope with anxiety about school through gradual exposure, generally leads to improved school attendance, although not every student benefits from it. The initial results for Acceptance and Commitment Therapy are promising, but the evidence is still limited.

Research warns both against prolonged avoidance of school and against a forced full return without a gradual build-up. Both can hinder recovery. A gradual return, tailored to the student’s capacity, best aligns with current knowledge about the treatment of anxiety and avoidant behaviour.

This is a summary. You can read the full article by Kennisrotonde here.