The 2020–2021 school year put unparalleled demands on students and teachers. Along with the move to remote learning, student programming and interventions shifted into the digital world. And with that move, support for student mental health has bubbled up as an even greater concern for parents, students, and teachers at The University of Chicago Laboratory Schools, where I’ve been the high school counselor for the past three years.The school moved to remote learning in March 2020 and changed to hybrid learning in March 2021. During this time, some student behaviors started to change. One change has been the manifestation of school refusal, which is defined as emotional distress or anxiety centered on the refusal to attend school. Researchers describe this behavior as typically occurring in the first two years of high school with increases in school absences, anxiety or depression, and physical ailments. School transitions, poor emotional regulation, and low self-confidence could lead to some of these behaviors. The national prevalence of school refusal has been estimated to range from 1% to 5% of students.
In the 2019–2020 year, our counselors and administrators noticed that they were spending a significant amount of time tracking down and supporting students, and they saw an uptick in medical leaves. Some of these students exhibited behaviors that matched the characteristics of school refusal, including struggling to enter the classroom at the start of the day because they felt anxious about attending class, making frequent prolonged visits to the nurse, or being in other school spaces when they were supposed to be in class. Now, after the shift to remote learning, we’ve seen this issue present in different behaviors, including not turning on video cameras during synchronous class sessions, not completing or submitting assignments, not meeting with teachers during office hours or with school support staff, or not responding to requests for video conferences. We identified eight students (1.3% of the high school population) who experienced school refusal in a digital environment.
So why focus on such a small group of students? As anxiety, depression, and mental health concerns continue to rise and schools transition from remote to hybrid and in-person learning, we need to be tracking school refusal behaviors. We know from the research that there are dangers to students who exhibit prolonged school refusal—such as a lack of normal development, specifically in the areas of independence, separation from parents, and development of peer relationships. Intervening early can help avoid long-term consequences like academic underachievement, employment difficulties, self-esteem issues, and poor peer relationships. The key for our school—in-person and even more amid remote learning during the pandemic—has been understanding what lies under the behaviors, with increased attention to those students who may have anxiety.
Our Approach
Our approach to targeting school refusal concerns has remained constant amid the pandemic. On a weekly basis, the 16 members of the learning and counseling team, which includes school counselors, learning coordinators, and college counselors, meet with administration and the high school nurse. In this teaming structure, the group discusses common issues, such as academic difficulties or medical concerns, to identify strategies to help and support students. And it’s also important to communicate with different groups, such as teachers, parents, and outside health providers, to fully support these students.Understanding School Refusal: A Handbook for Professionals in Education, Health and Social Care offers a helpful framework that we generally use in our department. This handbook uses a systems approach, specifically a joint effort from the school and family to support the student. It puts the child at the center and supports families and schools working together while maintaining their own boundaries. It focuses on context and how the student interacts in both settings. The aim is to help foster communication, clarify how problems occur, identify goals, and take steps toward change.
This context-focused approach illustrates how a problem shows up in student behaviors. Focusing on why has a tendency to create blame. “If the school only did X, the student would attend classes”—this example is common and rarely gets to the root of the issue. In our approach, no one (school, parent, or student) is the cause of a student’s refusal; rather each has an influence on the others. One scenario this past year included a student who refused to attend school because they felt stressed and overwhelmed, but they wanted to attend extracurriculars because they enjoyed clubs and sports. By working with the student as well as their teachers and parents, we began to understand the stressors affecting the student, and together we built a plan to move to a “return to school.”
The root of school refusal most often is a student’s anxiety. Commonly, when anxiety increases, a natural response is for the student to avoid the anxiety-provoking situation. However, the opposite strategy is needed to reduce discomfort. Anxiety tends to decrease the more a student experiences familiar but stressful situations. In our counseling department, our goal is to create spaces for students to experience or anticipate these moments. For example, I’ll meet with a student who has a panic attack because they didn’t prepare for a class presentation. We’ll collaborate with outside medical or mental health providers to clarify what medical needs exist and explore strategies for the student to manage their anxiety in certain contexts.
The Process
This year, I worked with a ninth grade student who enrolled in our school during remote learning and refused to turn on her camera in most synchronous classes. Teachers brought this issue to me in September, and I took it to our structured team meeting. We planned to work with the parent, the dean, and the student. As a team, we learned that the student was allowed to have her camera off in her old school and felt disconnected to students at our school. We clarified school norms, communicated with teachers, and collaborated to help the student find more opportunities for connection in the school. In late October, teachers reported that the student kept her camera on more consistently but has struggled to feel connected to school during the remote year. During the year, the student and I moved from weekly to monthly check-ins.Most often, a school counselor or other support staff takes the lead in the process of helping students who are demonstrating signs of school refusal. However, teachers, school leaders, school staff, families, and others all have an impact on helping these students. Parents and guardians play a critical role in helping students address school refusal. Often, parents provide the school team with insights into student stressors. They also give the school support team permission to communicate with any outside providers, including physicians or therapists. Parent participation in workshops around student anxiety or stress can be useful to build connections between family and school, while giving parents tools to work with their children. In 2019–2020, our department started hosting parent workshops about stress and other factors impacting adolescents, and these have continued into this remote year.
Teachers are also key players at the school. While teachers do not offer therapeutic support, they offer relational support and can identify student emotions and triggers. Teachers can be instrumental in helping anxious students manage their emotions, regardless of whether a student is experiencing school refusal.
Key Takeaways
At our school, we tend to measure student progress with teacher feedback, class attendance, or work completion. However, there are other ways to measure improvement. Formal scales can be used to measure changes in school refusal, such as the School Refusal Assessment Scale, developed by Christopher Kearney and Wendy Silverman in 1993 and revised in 2002. Student and parent interviews or surveys can also be used to signal progress. In 2021–2022, I hope to use scales or parent surveys to measure student progress for school refusal. As a team, we’re continuing our work to understand this issue and to better support students who are struggling. Here’s what we’ve learned since we began using our systems approach.Behaviors change when situations do. School refusal is much less visible during a pandemic. It can look like a student just not showing up for classes or completing work. So it’s important to look for themes of students not participating, being present, or completing work across classes.
Context is important. Setting the space for family and people from the school to communicate is helpful to spark change. Sometimes we talk about fears and anticipating difficulties before they happen.
Be proactive. Early identification of school-refusing students and clarifying anxiety as the root issue are key. Identifying students in the ninth grade has helped us communicate with teachers as these children progress through school, and we can better anticipate what supports will be needed.
Raise cultural awareness. “Migrant Parents of Adolescents with School Refusal: A Qualitative Study of Parental Distress and Cultural Barriers in Access to Care,” a 2020 Frontiers in Psychiatry article, focused on school refusal with migrant populations in Paris. This study found that mistrust in the school system and culture differences impacted school refusal. Students coming from other countries may struggle to find the balance between the cultures of family and school. Exploring the cultural expectations of different students and their families can build trust and help make changes to support students.
This school year, of the eight students who struggled with school refusal, five were still struggling to improve in the second semester. The transition to hybrid and to fully in-person learning will surely bring changes in student behaviors. We plan to be proactive and notice how school refusal and other behaviors arise.