School Refusal: A Sydney Psychologist's Guide for Parents When Your Child Won't Go to School
Updated: Sep 2
By Bradley Bowen, Clinical Psychologist and Clinic Director, Sydney Children's Practice
As parents, few things feel as worrying as a child who simply cannot get to school. The morning stomach aches, the tears at the front gate, the door that will not open, the teenager who pulls the doona over their head and will not move. If this sounds like your home, please know two things straight away. You are not alone, and this is not a sign that you have done something wrong.
School refusal is something we see often in our clinics, and it is far more common than most families realise. It can be distressing and exhausting for everyone, but with understanding and the right support, most children and young people are able to return to school. This guide explains what school refusal is, why it happens, and the practical steps you can take, including how things work here in New South Wales and when it may help to speak with a psychologist.
What is school refusal?
School refusal is when a child or adolescent finds it very difficult, or feels unable, to attend school because of significant emotional distress. It is sometimes called "school can't", a phrase many families and clinicians prefer because it captures the truth of what is happening. Your child is not choosing to be difficult. Their nervous system is responding to something that feels overwhelming.
This is an important distinction. School refusal is not the same as wagging or truancy, and treating it as simple misbehaviour usually makes things harder rather than better.
School refusal vs truancy: what is the difference?
School refusal ("school can't") | Truancy ("wagging") | |
What is driving it | Anxiety, fear or distress | Boredom, preference for being elsewhere |
Does the child want to avoid school work? | Often wants to attend but cannot manage it | Usually chooses to skip school |
Where is the child? | Typically at home, with parents aware | Often hidden from parents |
The emotion involved | Worry, panic, dread, low mood | Generally little distress about missing school |
When you understand school refusal as a stress response rather than a behaviour problem, it changes how you respond, and that shift is often the first step towards helping your child.
Signs of school refusal to look out for
School refusal can build slowly or appear quite suddenly. The signs are not the same for every child, but these are some of the most common ones parents and carers notice.
Physical signs
Frequent stomach aches, headaches, nausea or feeling unwell, especially on Sunday nights and weekday mornings
Complaints that often ease on weekends or during school holidays
Trouble sleeping or changes in appetite
Emotional and behavioural signs
Tears, panic, anger or pleading in the lead-up to school
Clinginess, or not wanting to be apart from you
Reluctance to talk about school, or becoming upset when it is mentioned
Pattern signs
A creeping increase in late arrivals or days missed
Long visits to the school sick bay
Difficulty that seems tied to specific days, subjects or events
If you are noticing several of these, it is worth paying attention early. The longer school refusal continues, the harder the return can become, so gentle action now is genuinely helpful. If the nerves are milder and come and go, our post on school anxiety looks at when worry is a normal part of school life and when it is worth seeking help.
What causes school refusal?
There is rarely a single cause. Most of the time, school refusal grows from a combination of factors that have built up over time. Some of the more common contributors we see include:
Anxiety, including separation anxiety in younger children and social anxiety in older ones. Our guide to anxiety in children explains the different types and what to look for
Bullying or peer conflict, or feeling that they do not belong
Learning difficulties that make the school day feel hard or embarrassing, which an educational assessment can help identify
Sensory or environmental factors, such as noise, crowds or busy classrooms
Transitions, like starting school, changing schools or moving into high school
Family stress or change, such as illness, separation or a recent loss
It can help to think of school refusal as the visible tip of something larger underneath. The behaviour you see in the morning is usually the result of feelings your child may not yet have the words to explain.
School refusal by age: younger children and teenagers
While the underlying distress is similar, school refusal can look quite different depending on your child's age, and the support that helps often differs too.
Younger children
In primary-aged children, school refusal is frequently tied to separation anxiety, the worry of being away from a parent or carer. It can also appear during the first weeks of school, after holidays, or when a routine changes. Younger children may not say "I feel anxious". Instead, you might see tummy aches, clinginess, or tears that seem to come from nowhere.
Teenagers
In adolescents, school refusal more often connects to social anxiety, friendship difficulties, academic pressure, or the demands of high school. The move into Year 7 is a common turning point. Teenagers may be more likely to withdraw, spend long hours in their room, or describe feeling that they simply cannot face it. Because teens are also seeking more independence, it is important to work with them rather than around them.
When school refusal is linked to autism or ADHD
For neurodivergent children, including autistic children and those with ADHD, school can carry extra demands that build towards "school can't".
Autistic children may experience sensory overload, find unpredictability difficult, or reach a point of autistic burnout after holding themselves together all day. Some children also find everyday demands overwhelming, which can drive avoidance. Children with ADHD may struggle with the sustained focus, organisation and sitting still that a school day requires, and the resulting frustration or overwhelm can show up as not wanting to go at all.
If your child is neurodivergent, the goal is not simply to "get them back in the classroom". It is to understand what is making the environment hard and to put the right supports and adjustments in place. Where it would help to understand your child's profile more fully, an ADHD assessment or autism assessment can give you and your child's school a clearer picture to work from.
What you can do at home: a step-by-step plan
When you are in the thick of it, a long list of tips can feel overwhelming. Here is a calmer, ordered way to approach things.
Step 1: Rule out any medical concerns. Start with a visit to your GP to check that physical symptoms such as stomach aches or headaches do not have a medical cause. This also gives you a helpful first point of contact.
Step 2: Stay calm and acknowledge the feelings. Try to remain steady, even when mornings are hard. Let your child know you can see they are finding this difficult, while gently holding the expectation that school is where they are heading. You might say, "I know this feels really hard right now, and I am here to help you with it." If big feelings are a regular part of your mornings, our posts on emotion coaching at home and helping children manage big emotions set out practical strategies you can use straight away.
Step 3: Get curious about the triggers. Without pressure, try to map out what tends to make things harder. Is it a particular subject, a certain person, the bus, the noise, the lunchtime? Patterns give you and your child's support team something concrete to work with.
Step 4: Connect with the school early. Reach out to your child's teacher, year adviser or the school counsellor. Schools deal with this more often than you might think, and a shared plan works far better than parents and schools pulling in different directions.
Step 5: Build a gradual return, one step at a time. Rather than expecting a full day straight away, it often helps to break the return into smaller, manageable steps. This is sometimes called a return ladder, and we explain how it works further below.
Step 6: Review and adjust. Progress with school refusal is rarely a straight line. Expect some harder days, celebrate small wins, and keep adjusting the plan as you go.
How do you deal with school refusal at school?
Working closely with your child's school is one of the most important parts of turning things around. In a NSW school, helpful people to contact include your child's class teacher (primary) or year adviser (high school), the school counsellor or psychologist, and the deputy principal or a wellbeing leader.
A supportive school plan might include a reduced or staggered timetable to begin with, a safe place and a trusted adult your child can go to, flexibility around tasks while they rebuild confidence, and reasonable adjustments for a child with additional or neurodivergent needs. The aim is to make school feel safe and achievable again, step by step.
What is the best treatment for school refusal? What seeing a psychologist involves
When distress is significant or has been going on for a while, therapy for children and adolescents can make a real difference. Families sometimes worry that seeing a psychologist means something is seriously wrong, but it is simply a way of understanding what is happening and building a plan together.
In our experience, two evidence-based approaches are often helpful. Cognitive Behavioural Therapy (CBT) helps children and teenagers understand the link between their thoughts, feelings and behaviour, and learn practical ways to manage worry. Graded exposure is a gentle, step-by-step way of helping a child face what they have been avoiding, at a pace they can manage, so that confidence grows with each success.
A graded return, or return ladder, is a good example. If walking through the school gate feels impossible, the first rung might be driving past the school. The next might be walking around the grounds on a weekend, then attending for fifteen minutes, then one lesson, and so on. Each small step that goes well makes the next one feel more possible.
A first appointment usually focuses on understanding your child and your family, and what has been happening. From there, we work collaboratively with you, your child, and where helpful their school, to create a plan tailored to your child's individual needs. Parents play an important part throughout, and progress is reviewed and adjusted along the way. Every child is different, so timeframes vary, but many families find that having a clear plan and steady support brings real relief.
Getting professional help in Sydney
If you would like support, there are a few practical things worth knowing.
A good starting point is often your GP, who can check in on your child's health and talk with you about a GP Mental Health Treatment Plan. Where eligible, this can provide Medicare rebates towards psychology sessions. Eligibility and the number of rebated sessions are set by Medicare, so it is best to ask your GP what applies to your family. Some private health funds may also offer rebates for psychology, depending on your level of cover, so it is worth checking with your fund.
You do not always need a referral to see a psychologist for therapy, though a GP referral is needed to access Medicare rebates. Your child's school counsellor and the NSW school counselling service can also be a valuable source of support.
At Sydney Children's Practice, we work with children, adolescents and families across Sydney's Inner West, with clinics in Glebe and Stanmore. You can meet our psychologists to see who might be the right fit for your family, and we are always happy to talk through your concerns and whether further support might help.
What happens if a child refuses to go to school in Australia?
Understandably, some parents worry about the legal side of school attendance. In New South Wales, school-aged children are expected to attend regularly, and schools work with families to support attendance rather than to punish struggling children. The system's first response to school refusal is support, including help from teachers, school counsellors and wellbeing staff. If your child is finding school very difficult, reaching out early to the school and to your GP is the most helpful path.
Looking after yourself as a parent
Supporting a child through school refusal can take a real toll on parents and carers. The early mornings, the worry, the juggling with work, and sometimes the judgement from others can leave you depleted. Please be gentle with yourself. Looking after your own wellbeing is not a luxury, it is part of helping your child, because children take their cues from the calm adults around them. Lean on your partner, family or friends, and reach out for support for yourself if you need it. Our parent support sessions can also be a helpful place to feel understood and to learn practical strategies.
When to seek help sooner
Most school refusal can be worked through gradually, but some situations call for prompt support. If your child talks about not wanting to be here, mentions self-harm, or you are worried about their immediate safety, please seek help straight away. You can speak with your GP, contact Kids Helpline on 1800 55 1800, or in an emergency call 000. Reaching out is always the right thing to do.
Frequently asked questions
How do you deal with school refusal?
Start by staying calm and acknowledging your child's feelings, rule out any medical concerns with your GP, work out what is triggering the distress, and connect with the school early. From there, a gradual, step-by-step return, with support from a psychologist if needed, is usually the most effective approach.
What is the most common age for school refusal?
School refusal can happen at any age, but it is often seen around key transitions, such as starting school, returning after holidays, and the move into high school.
What is the best treatment for school refusal?
Evidence-based approaches such as Cognitive Behavioural Therapy and graded exposure are commonly used and can be very effective. The best plan is one tailored to your individual child, developed with you and, where helpful, their school.
How long does it take for a child to return to school?
Every child and situation is different, so there is no set timeframe. Some children return within weeks, while others need a longer, more gradual approach. Acting early and having steady, consistent support tends to help.
Do I need a referral to see a psychologist?
You do not need a referral to book therapy with a psychologist. A GP referral and a Mental Health Treatment Plan are needed if you would like to access Medicare rebates. Ask your GP what applies to your family.
You do not have to work this out on your own
If your child is struggling to get to school, support is available, and things can get better. With understanding, patience and the right plan, most children and young people find their way back.
The team at Sydney Children's Practice provides warm, evidence-based psychological support for children, adolescents and families across Sydney's Inner West, with clinics in Glebe and Stanmore. If you would like to talk things through or explore whether further support might help, we would love to hear from you. You can meet the team or get in touch through our website, or call us on 02 9564 3758. We are here to help.
Bradley Bowen, MPsych (Clinical Psychology), BA (Hons I), BSc, AMusA, MAPS is a Board-registered Clinical Psychologist and Clinic Director of Sydney Children’s Practice. He has worked with children, adolescents, and families for over 25 years and has been practising as a Clinical Psychologist since 2011. Bradley has a particular interest in supporting neurodivergent children, including those with ADHD and Autism, and works using evidence-based approaches such as CBT, ACT, and Mindfulness.
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