Lauren Pellizzi LLC

Specialized OCD & Anxiety Treatment

Anxiety Therapy Red Bank

Areas of Specialty

anxiety school refusal

​​Anxiety-based school refusal is a phenomenon that affects between 5 and 28% of children at some point during their education.  It occurs when a child or adolescent experiences a very high level of anxiety/distress when s/he is asked to attend school.  This anxiety results in active avoidance of school (i.e., refuses to attend) or marked distress when s/he is forced to attend.  Children with school refusal may complain of physical symptoms shortly before it's time to leave for school or repeatedly ask to visit the school nurse. If the child is allowed to stay home, the symptoms quickly disappear, only to reappear the next morning. In some cases a child may refuse to leave the house, get on the school bus, or leave the car when dropping them off.

School refusal often occurs or worsens following a stressful event, such as a death or illness in the family, divorce or separation, or illness in the child or adolescent that has resulted in an accumulation of missed schoolwork. School refusal is not a diagnosis, it is a symptom, and is associated with many mental health disorders, including:

  • Separation Anxiety Disorder
  • Social Phobia
  • Panic Disorder
  • Specific Phobias (including a phobia of vomiting)
  • Adjustment Disorder
  • Somatoform Disorder
  • Obsessive Compulsive Disorder​
School Refusal Treatment
anxiety school refusal

I offer a comprehensive treatment program for school refusal, which consists of four main components:

  • Specialized assessment of the school refusal 
    • ​I provide assessment of the nature of the anxious avoidance, the underlying function(s) of the school refusal, and diagnostic clarification.
  • Child-focused behavioral treatment
    • ​Consists of psychoeducation, coping skills training, and direct exposure (in a controlled, gradual format) to situations that the child/adolescent fears.
  • Parent management training
    • Parents are educated regarding evidence-based skills and techniques that can be utilized (many of which are counterintuitive) to help reduce the child’s experience of anxiety and to improve school attendance
  • School consultation
    • ​The school consultation component consists of a school meeting to discuss specific methods and accommodations that the school personnel can utilize to assist the child in his/her rapid reintegration into school. 
Anxiety-Based School Refusal