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School refusal Some strategies for parents dealing with this growing issue

Psychotherapist Bronagh Starrs says there are simple things parents can do for their child who might be struggling with school attendance.

“HOW CAN WE stop our child having panic attacks?” and “How can we get them back to school?” are the two most common questions concerned parents ask me.

If you’re reading this and looking for answers too, then the first thing I will tell you is that you’re asking the wrong questions.

There’s something much bigger at stake in your child’s life than panic and the issue of school attendance. A deep sense of inadequacy and discomfort shapes their lives.

These children and young people essentially have little or no faith in themselves and the world… and that is the core issue. In my experience, I have found that school-based anxiety is merely a symptom of this phenomenon.

Anxiety in children

In today’s world, we are seeing epidemic levels of children and teenagers who are highly self-critical, very intense, gripped by anxiety and struggling to attend school or even leave their bedrooms. The world is a threatening place and they are fearful of so many bad things happening, troubled by how they have messed up and feeling panicky about how they’ll not be able to handle future situations.

As they focus their attention for hours at a time on what did or could go wrong, they become worked up, endlessly stressing themselves out.

This is where oxytocin, a comfort chemical, comes into play. These kids become oxytocin addicts. Life becomes more bearable and manageable when they live within a comfort zone — often, a ‘comfort parent’ is recruited into the zone.

Parents often tell me they are very close to their children and that they talk a lot. I reframe this somewhat for them: “It’s not that you’re very close, it’s that he/she is highly dependent on you.” In these cases, the default strategies parents use take the form of reassurance and the building up of the young person’s confidence — neither of which works in my experience.

As inhibitive children and adolescents reach the edge of their comfort zones and the threat feels more tangible, their brain’s flight or fight system becomes activated. This is triggered when we perceive that our safety and survival are at stake. It is a heightened stress response which sends the kid into extreme panic, resulting in various types of meltdown including tearful collapses, rage attacks and numbing out.

On the first morning of each new academic term, many inhibitive children and adolescents become hyper-stressed, knowing they have to face another term of academic pressure and social unease. The stress from being out of their comfort zone is a grim reality staring them in the face — no longer on the horizon but happening right now. The thought of putting on the dreaded uniform and walking through the front door of the school building — and having to do it repeatedly until the next school break — pushes many over the edge. Sometimes they manage the first few weeks or even months… but all too often, they grind to a halt. It can be overwhelming for parents who suddenly find their once easygoing child going through such a tough time. 

Some tips for worried parents

Here are the three questions I invite parents to reflect on when anxiety that is impairing development and functioning has taken hold of a child or teenager:

How do I enable the comfort zone?

Anxious kids need to feel comfort, and parents do what they can to facilitate this. However, these parenting strategies tend to merely be short-term oxytocin generators which lack transformative potential, for example, reassuring hugs and treats to cheer her up.

The more the child struggles the more the parents step in to compensate, reassure, encourage and indulge. Whilst attempting to be as supportive as possible, it’s useful to realise that continual recycling through this fixed relational theme is not only unhelpful but also reinforces dependency.

What happens at the edge of the comfort zone?

When the integrity of the young person’s comfort zone comes under real or perceived threat (“I have to go to school. I don’t want my mum to go to work. What if something bad happens? What if the burglars come? What if I fail?”) that’s where we see the anxiety symptoms emerge: OCD, panic attacks, eating disorders, meltdowns, tics, pulling hair, scratching, self-harm, suicidal process.

There’s a lot of cortisol flowing in these moments… and in a way, the production of cortisol is contagious. Your job is to bring that cortisol down. I promise you there will be very little, if any progress whilst stress chemicals are at overwhelming levels. So one of the first things to consider is how to explore options for lowering cortisol. There are abundant suggestions and resources online, tapping is one simple start:

The Tapping Solution / YouTube

Focus on lowering your own cortisol (challenging I know, as a parent your cortisol levels are through the roof if your child is struggling with school-based anxiety) and then support your child to do the same.


When children are overwhelmed, they are in a state of emotional dysregulation. Practice empathy — start to imagine the world from your child or teenager’s perspective. I mean, from the inside out. Imagine the level of threat she experiences, the dread she feels leaving her comfort zone, the oppression of the world she inhabits. I’m going to suggest that you spend about 10 minutes each day for a couple of weeks simply stepping into her shoes and being her. Then write a paragraph or two afterwards about what the experiment was like and what struck you. 

The next task is to develop an ear for the emotional. When she communicates with you, learn to fire up your emotional radar and identify feelings. Try listening out for feelings she’s naming or describing, and you’ll get to the heart of her experience more directly.

Sometimes she’ll clearly state them and other times she’ll hint at them. Often their communication to you is full of feelings. It’s so easy to miss them because, as parents, you are focused on trying to take away her suffering and make everything better. Mirroring her feelings back to her will help to ground and settle her. Offering solutions, trying to be positive and attempting to fix all have their place, but they are premature if your daughter is still off-balance.

You have to focus on helping your child find calm. A really effective way to do this is to let her know that you recognise her feeling world. This is empathy and is a great way of creating comfort. It will offer a bridge to reconnection with you again. She’ll feel met and much less isolated and alone in her struggle. Then after you’ve communicated your empathy you simply state that you’re there to support her. You don’t have to qualify your support, just name it. This mirroring and naming of support seems awfully simple, but it can be powerfully effective.

How can I expand the comfort zone?

There is usually quite a contrast between where you would like your child to be and where she actually is. You can support her to reach the desired end point with a step-by-step approach. Your child may need to go through a whole bunch of levels of comfort zone expansion in order to get to a place of much healthier functioning.

How to begin is to focus on Level One… just starting with baby steps. Once Level One has been mastered, we move to Level Two and so on. Expanding the comfort zone in slow, steady degrees is how this will be done. When you arise each morning, after attending to your cortisol-lowering strategies and focusing on empathic attunement of your child’s experience, ask yourself this… “Is there one thing I could start doing today that would help and one thing I could stop doing that would help?” Consider introducing sleep hygiene, screen boundaries, good nutrition, fresh air, concentration, tolerable socialising and creative activities into your child’s life gradually.

Keep focused on the baby steps and your child will hopefully be in much better shape physically and psychologically. You might find then that school doesn’t seem like such an impossible prospect.

Bronagh Starrs maintains a private practice in Omagh, Northern Ireland as a consultant psychotherapist, clinical supervisor, writer and trainer. She is Creator and Programme Director of the MSc Adolescent Psychotherapy in Dublin Counselling & Therapy Centre in partnership with University of Northampton. Bronagh teaches and presents internationally on the developmental phenomena and therapeutic dynamics of contemporary adolescence. Her first book Adolescent Psychotherapy — A Radical Relational Approach (Routledge, 2019) has received international acclaim. Bronagh is running a workshop for parents entitled “Parenting Strategies for Anxious Teens” on Monday 8 April in the Croke Park Hotel, Dublin. More at

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