School Refusal and Anxiety: Keeping Your Anxious Child in School through Coordinated Interventions

Presenter: Brian Chu, Ph.D.
View this webinar by clicking here
View the webinar’s corresponding slide presentation here
School Refusal behavior is one of the most vexing and impairing problem behaviors that affect childhood. Dr. Chu discussed anxiety-based sources of school refusal, its associated impairment, and recommended intervention strategies. He emphasized behavioral interventions and collaborative work among child, parent and school.


  1. slrcpa46 says:

    The webinar was great. I already knew most of this information having dealt with it for 3 years, but it really reinforced some things for me.

    My son started refusing to go to school in January of 6th grade. He went to 7th grade for 5 months. He is now in 8th grade and he has not been to school at all this year. He has a tutor come to the house and he sees no friends. We tried a program like the RU clinic and they said that they could not help him. They rec. partial hos pitalization,but we tried it before and it was BAD!

    • Dr. Chu says:

      I’m glad the talk reinforced some of the strategies you liked and I’m sorry therapy hasn’t worked sufficiently for you. I would encourage you to try again as multiple attempts can have different impact at different times. Your son may be more open to returning to a qualified outpatient CBT program after going to partial hospitalization. And the lessons may mean something different now that he’s been to partial hospitalization and also since he’s missed so much school. Don’t give up!

  2. KelleyT says:

    The parents and school have been working together and just can’t seem to break through the anxiety on a consistent basis. The child sees a counselor outside of school and we have many accommodations in place at school. What else can we do?

    • Dr. Chu says:

      In response to many of these questions, I must encourage families to re-assess their therapy if it’s not working. The first thing you want to ask in these cases is, “is my therapist truly behavioral?” In order for our approach to work, the therapist has to be willing and prepared to enact behavioral exercises IN SESSION. We can’t just count on designing a hierarchy and a reward plan and expect the school and families to implement this on their own. At our clinic we do active exposures IN SESSION. So, if a child has fears of speaking in public (as a relatively simple example), we arrange a series of social exposures in therapy. That can include giving speeches in front of a group at the clinic, it can include wandering around on campus and starting up conversations with novel college students, it could mean calling up a fellow classmate from the therapy room. Don’t underestimate the power of these simple experiments. Giving the youth practice at tolerating distress in session makes it more likely they will try these assignments at home. Ask yourself – does my therapist ever leave the therapy room with my child? Do they ever involve other people to make the exercises more “real?” If not, they may not be enacting exercises that are “real enough.”

  3. KelleyT says:

    In reference to our 16 year old son with severe anxiety and depression with school refusal in 10th grade public school. He’s in an alternative school. Internal stressors are preventing him from wanting to go to school. Says “He doesn’t like himself” What therapeutic progam would you suggest with our son who has so many issues on the same spectrum? OCD, tourettes, trichotillomania, anxiety. Most of what was mentioned on this webinar describes our son perfectly

  4. KelleyT says:

    Is home schooling, private school or theraputic day school better for my 8 year old than public school? He has Tourette’s plus, adhd and other comorbid disorders.

    • Dr. Chu says:

      Another great website for more information on evidence-based treatments (like cognitive behavioral therapy) is http://www.effectivechildtherapy.com.

      It is the official website of the Division of Child and Adolescent Clinical Psychology of APA and gives lots of great education about a variety of childhood problems and effective treatments.

  5. patty says:

    I dont know where to start. I wish I could find the right personnel to help my daughter who has social anxiety and school phobia. we have tried partial hospital program but that did not teach her anything. She currently visits with a therapist who has no idea who my daughter is or how to help her. The school is hounding me to get her to school. She is so afraid but we can’t pinpoint exactly what it is that is freightening her. She interprets everything in her mind as being “against her” or “they dont like me” or “I’m stupid” HEr confidence level has drastically gone down hill and probably is experiencing depression also. Are there special schools for kids with anxiety?

    • Dr. Chu says:

      Where to start to find the right services? Well, this website here has some very good resources for families with children with TS. Take a look and also look for similar organizations near you.

      For general behavioral therapy, go to http://www.abct.org. This is the website for the Association for Behavioral and Cognitive Therapies. It has a therapist directory that can get you started.

      Google also works: google school refusal, CBT, and behavior therapy. That might get you started.

      And of course, if you are near central NJ, we provide services for anxious and depressed youth who are school refusing and we also have a TS clinic for youth with specific concerns regarding TS.