School Refusal

School refusal is more than just “not wanting to go to school.” For many children and teens, it reflects deeper emotional, behavioral, or social struggles that require thoughtful, compassionate support. At Etheridge Psychology in Cary, NC, we help families understand and respond to school refusal in a way that prioritizes healing, safety, and long-term change.

Whether your child is overwhelmed by anxiety, withdrawing due to depression, ditching school to avoid conflict or pressure, or being influenced by peers who are also disengaged from school, we approach each case with openness and care.

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What Does School Refusal Look Like?

 

School refusal can show up in many ways, including:

• Panic attacks, meltdowns, or physical symptoms before school

• Frequent absences, tardiness, or skipping specific classes

• Refusing to get ready, leave the house, or attend school altogether

• Sudden changes in mood or energy related to school days

• Sneaking out or ditching school without parental knowledge

• Resistance to school paired with peer conflict, bullying, or isolation

• Involvement with peers who encourage rule-breaking or substance use

• Declining grades, loss of motivation, or disciplinary issues

 

School refusal is often misunderstood as defiance or laziness, but in reality, it is usually a signal that something important is going on beneath the surface.

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Common Causes of School Refusal

 

At Etheridge Psychology, our therapists work with children and teens experiencing school refusal due to a wide range of factors, such as:

• Generalized anxiety or school-related panic

• Depression or low energy/motivation

• Bullying, harassment, or trauma at school

• Learning differences, ADHD, or sensory overwhelm

• Fear of failure or academic pressure

• Identity-based stress (e.g., related to being LGBTQ+, neurodivergent, or “different” from peers)

• Negative peer influences or social pressure

• Substance use or risky behaviors

• Family conflict or major life transitions

 

Our Approach

 

We do not believe in quick fixes or punishment-based approaches. Instead, we help children, teens, and families explore what is really driving the avoidance and create a plan to move forward with support, clarity, and compassion.

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Our therapists draw from evidence-based practices such as:

• Cognitive Behavioral Therapy (CBT) and DBT-informed skills

• Trauma-informed and attachment-based therapy

• Support for substance use or co-occurring behavioral concerns

• Parent coaching and family communication support

• Collaboration with schools for appropriate accommodations

• LGBTQ+ affirming and neurodiversity-affirming care

 

Supporting Kids/Teens and Their Families

 

Whether your child is terrified to walk into the building or actively rejecting school rules and expectations, our job is to understand the “why” behind the behavior—and help you move toward a healthier, more hopeful place.

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We also recognize that school refusal impacts the entire family. Caregivers often feel stuck, exhausted, or unsure how to help. Our team supports parents with strategies, insight, and nonjudgmental guidance every step of the way.