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Practitioner Review: School Refusal: Issues of Conceptualisation, Assessment, and Treatment
Abstract
Developments in the assessment and treatment of school refusal have often been hampered by a failure to recognise its essentially heterogeneous nature. This paper provides a review of major conceptual complexities that have helped to undermine developments in clinical practice. In particular, it considers the distinction between school refusal and truancy, and school phobia and separation anxiety. Common approaches to the assessment and treatment of school refusal are outlined. Although behavioural and cognitive behavioural approaches are now widely accepted as central to treatment, it is increasingly recognised that individually tailored programmes, utilising a range of approaches, are most likely to prove successful. An approach focusing upon the functions, rather than the symptoms, of school refusal is advocated as having most promise for assessment and the subsequent formulation of individual prescriptive treatment.
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“The TR youth's preference for more appealing activities outside of school (Elliott, 1999;Havik et al., 2015a;Kearney, 2008c) may well stem from the lack of interest in schoolwork, which is likely associated with the educational difficulties frequently associated with TR.”
From Differentiation between school attendance problems: why and how? (2019) · cites this paper as Elliott, 1999
In the citing paper
“Defiance of school authority has been associated with TR (Elliott, 1999)”
From Differentiation between school attendance problems: why and how? (2019) · cites this paper as Elliott, 1999
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Sorted by citations
Esch, P., Bocquet, V., Pull, C. B., Couffignal, S., Lehnert, T., Graas, M., Fond‐Harmant, L., & Ansseau, M. (2014) · BMC Psychiatry · doi:10.1186/s12888-014-0237-4 · Cited by 426
Differentiation between school attendance problems: why and how?
Heyne, D., Gren-Landell, M., Melvin, G., & Gentle-Genitty, C. (2019) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2018.03.006 · Cited by 339
“Truants have been referred to as youth kept at home because of their benefit to parents (Berry & Lizardi, 1985; Elliott, 1999), even though this phenomenon had already been referred to as school withdrawal.”
BackgroundFamily therapy and systemic interventions for child‐focused problems: the current evidence base
Carr, A. (2018) · Journal of Family Therapy · doi:10.1111/1467-6427.12226 · Cited by 312
“Systematic reviews have concluded that behavioural family therapy leads to recovery for more than two-thirds of cases, and this improvement rate is significantly higher than that found for individual therapy (Elliott, 1999; Heyne et al. 2013; Kearney and Sheldon, 2017; King and Bernstein, 2001; King et al., 2000; Pina…”
ResultThe role of anxiety symptoms in school performance in a community sample of children and adolescents
Mazzone, L., Ducci, F., Scoto, M. C., Passaniti, E., D'Arrigo, V. G., & Vitiello, B. (2007) · BMC Public Health · doi:10.1186/1471-2458-7-347 · Cited by 245
School factors associated with school refusal- and truancy-related reasons for school non-attendance
Havik, T., Bru, E., & Ertesvåg, S. K. (2015) · Social Psychology of Education · doi:10.1007/s11218-015-9293-y · Cited by 319
“2013), whereas truancy is believed to be related to anti-school sentiments and antisocial characteristics such as finding school boring and seeking more rewarding activities outside school (Reid 2012; Fremont 2003; Kearney 2008b; Kearney and Silverman 1993; Elliott 1999).”
Background
Metadata
- Authors
- Elliott, J. G.
- Affiliations
- University of Sunderland (GB)
- Corresponding author
- Elliott, Julian G.
- Venue
- Journal of Child Psychology and Psychiatry
- Publisher
- Wiley
- Published
- 1999-10
- Volume
- 40
- Issue
- 7
- Pages
- 1001-1012
- ISSN
- 0021-9630 (ISSN-L)
- 1469-7610
- OpenAlex
- W2144495956
- Cited by
- 128
- References
- 0
- Citations by year
- 2026: 6 · 2025: 3 · 2024: 5 · 2023: 7 · 2022: 3 · 2021: 2 · 2020: 6 · 2019: 4 · 2018: 7 · 2017: 2 · 2016: 2 · 2015: 11 · 2014: 9 · 2013: 9 · 2012: 5
- FWCI
- 12.01
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Child Psychology and Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Education › Youth Substance Use and School Attendance
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › School Health and Nursing Education
- Keywords
- school refusal, truancy, school anxiety, separation anxiety, conceptualization, assessment, treatment, cognitive behavioral therapy, behavioral approach, personalized treatment
- MeSH terms
- Adolescent, Anxiety Disorders, Behavior Therapy, Child, Female, Humans, Male, Phobic Disorders, Student Dropouts, Cognitive Behavioral Therapy
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