Functional outcome of adolescents with ‘school refusal’
Abstract
There is limited information about the outcome of young people with school refusal. We aimed to describe the functional outcomes of persons with school refusal presenting to a child and adolescent psychiatric unit. Young people assessed or treated for school refusal between 1994 and 1998 at the Rivendell Unit, Sydney, Australia, were identified. Information was gathered from the medical records, mailed questionnaires and follow-up telephone interviews. Of 192 patients eligible for inclusion in the study, outcome information was available for 118 (61%); 83 had improved functional outcomes (employment and/or education) at 6 months after treatment and 89 at 3 years after treatment. Dysthymia or comorbid diagnoses were associated with poorer functional outcomes 6 months after treatment/assessment, but not at 3 years. The longer term functional outcomes for those treated for school refusal, apart from those with social phobia or academic difficulties, were favourable. Diagnoses of social phobia and learning difficulties were predictive of poorer functional outcomes 3 years after treatment. Longer or more intensive treatment of those with social phobia may improve outcome.
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Prognosis may relate to a degree to specific diagnostic type in this population.
“Prognosis may relate to a degree to specific diagnostic type in this population as well (Layne et al., 2003; McShane et al., 2004).”
From Reconciling Contemporary Approaches to School Attendance and School Absenteeism: Toward Promotion and Nimble Response, Global Policy Review and Implementation, and Future Adaptability (Part 1) (2019) · cites this paper as McShane et al., 2004
Cites
Diagnostic and Statistical Manual of Mental Disorders
Williams, J. B. W., & First, M. B. (2013) · Oxford University Press eBooks · doi:10.1093/acrefore/9780199975839.013.104 · Cited by 109,841 · see citing works
Weissman, M. M., Orvaschel, H., & PADIAN, N. S. (1980) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-198012000-00005 · Cited by 894 · see citing works
KOVACS, M. (1996) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199606000-00010 · Cited by 441 · see citing works
School Refusal in Children and Adolescents: A Review of the Past 10 Years
KING, N. J., & BERNSTEIN, G. A. (2001) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-200102000-00014 · Cited by 310 · see citing works
Characteristics of adolescents with school refusal
Mcshane, G., Walter, G., & Rey, J. M. (2001) · Australian & New Zealand Journal of Psychiatry · doi:10.1046/j.1440-1614.2001.00955.x · Cited by 199 · see citing works
Self-citationThe behavioural treatment of school refusal—A comparative study
Blagg, N., & Yule, W. (1984) · Behaviour Research and Therapy · doi:10.1016/0005-7967(84)90100-1 · Cited by 155 · see citing works
Absence from School and Mental Health
Berg, I. (1992) · British Journal of Psychiatry · doi:10.1192/bjp.161.2.154 · Cited by 148 · see citing works
Practitioner review: School refusal: Issues of conceptualisation, assessment, and treatment
Elliott, J. G. (1999) · Journal of Child Psychology and Psychiatry · doi:10.1111/1469-7610.00519 · Cited by 128 · cited 2× · see citing works
“K E Y WO R D S anxiety disorders, depressive disorders, outcome, school refusal ‘ S C H O O L R E F U S A L’ IS a problem affecting approximately 1–2% of school-aged children and 5% of clinic-referred children and adolescents (Elliott, 1999; King, Ollendick, & Tongue, 1995).”
BackgroundSchool Refusal: Assessment and Treatment
King, N. J., Ollendick, T. H., & Tonge, B. J. (1995) · Medical Entomology and Zoology · Cited by 102 · see citing works
Berg, I., & Jackson, A. (1985) · The British Journal of Psychiatry · doi:10.1192/bjp.147.4.366 · Cited by 83 · see citing works
School Refusal: a 15–20-year Follow-up Study of 35 Swedish Urban Children
Flakierska, N., Lindström, M., & Gillberg, C. (1988) · The British Journal of Psychiatry · doi:10.1192/bjp.152.6.834 · Cited by 52 · see citing works
A FOLLOW‐UP STUDY OF SCHOOL PHOBIC ADOLESCENTS ADMITTED TO AN IN‐PATIENT UNIT *
Berg, I. (1970) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.1970.tb01011.x · Cited by 50 · see citing works
A 5- to 10-year followup of hospitalized school phobic children and adolescents.
Weiss, M., & Burke, A. (1970) · American Journal of Orthopsychiatry · doi:10.1111/j.1939-0025.1970.tb00724.x · Cited by 18 · see citing works
Prior, M. (1998) · Clinical Psychologist · doi:10.1080/13284209808521032 · Cited by 2 · see citing works
Flagged first, then by citations
3 of the 17 references couldn’t be matched to a known paper.
Cited by
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School absenteeism and school refusal behavior in youth: A contemporary review
Kearney, C. A. (2008) · Clinical Psychology Review · doi:10.1016/j.cpr.2007.07.012 · Cited by 906 · see citing works
Esch, P., Bocquet, V. G., 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 369 · see citing works
Practitioner Review: School refusal: developments in conceptualisation and treatment since 2000
Elliott, J. G., & Place, M. (2019) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12848 · Cited by 162 · see citing works
Kearney, C. A., Gonzálvez, C., Graczyk, P. A., & Fornander, M. J. (2019) · Frontiers in Psychology · doi:10.3389/fpsyg.2019.02222 · Cited by 130 · see citing works
Hochadel, J., Frölich, J., Wiater, A., Lehmkuhl, G., & Fricke-Oerkermann, L. (2014) · Psychopathology · doi:10.1159/000345403 · Cited by 71 · see citing works
Social Anxiety and the School Environment of Adolescents
Blöte, A. W., Miers, A. C., Heyne, D. A., & Westenberg, P. M. (2015) · Springer eBooks · doi:10.1007/978-3-319-16703-9_7 · Cited by 70 · see citing works
Maynard, B. R., Brendel, K. E., Bulanda, J. J., Heyne, D., Thompson, A., & Pigott, T. (2015) · Campbell Systematic Reviews · doi:10.4073/csr.2015.12 · Cited by 62 · see citing works
Heyne, D., Sauter, F. M., Ollendick, T., van Widenfelt, B. V., & Westenberg, P. (2013) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-013-0160-0 · Cited by 55 · see citing works
School Avoidance From the Point of View of Child and Adolescent Psychiatry
Knollmann, M., Knoll, S., Reißner, V., Metzelaars, J., & Hebebrand, J. (2010) · Deutsches Ärzteblatt international · doi:10.3238/arztebl.2010.0043 · Cited by 61 · see citing works
McKay-Brown, L., Mcgrath, R., Dalton, L., Graham, L., Smith, A., Ring, J., & Eyre, K. (2019) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2018.08.003 · Cited by 46 · see citing works
Youth mental ill health and secondary school completion in Australia: time to act
Bowman, S., McKinstry, C., & McGorry, P. D. (2016) · Early Intervention in Psychiatry · doi:10.1111/eip.12357 · Cited by 54 · see citing works
Chu, B. C., Guarino, D., Mele, C., O’Connell, J., & Coto, P. (2019) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2018.09.001 · Cited by 51 · see citing works
Brouwer-Borghuis, M. L., Heyne, D., Sauter, F. M., & Scholte, R. H. J. (2019) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2018.08.001 · Cited by 47 · see citing works
Development and Validation of the School Refusal Evaluation Scale1 for Adolescents
Gallé-Tessonneau, M., & Gana, K. (2018) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsy061 · Cited by 46 · see citing works
Out of school: a phenomenological exploration of extended non-attendance
Baker, M., & Bishop, F. L. (2015) · Educational Psychology in Practice · doi:10.1080/02667363.2015.1065473 · Cited by 46 · see citing works
Heyne, D. (2022) · Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie · doi:10.1024/1422-4917/a000881 · Cited by 25 · see citing works
Bitsika, V., Sharpley, C. F., & Heyne, D. A. (2021) · International Journal of Disability Development and Education · doi:10.1080/1034912x.2021.1969544 · Cited by 24 · see citing works
Benoit, L., Barreteau, S., & Moro, M. R. (2014) · Neuropsychiatrie de l Enfance et de l Adolescence · doi:10.1016/j.neurenf.2014.05.001 · Cited by 24 · see citing works
Behind the SCREEN: identifying school refusal themes and sub-themes
Gallé-Tessonneau, M., & Heyne, D. (2020) · Emotional and Behavioral Difficulties · doi:10.1080/13632752.2020.1733309 · Cited by 14 · see citing works
Mcshane, G., Bazzano, C., Walter, G., & Barton, G. (2007) · Clinical Child Psychology and Psychiatry · doi:10.1177/1359104507071090 · Cited by 20 · see citing works
Self-citationHeyne, D. (2022) · Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie · doi:10.1024/1422-4917/a000899 · Cited by 19 · see citing works
Beidas, R. S., Crawley, S. A., Mychailyszyn, M. P., Comer, J. S., & Kendall, P. C. (2000) · University of Zagreb University Computing Centre (SRCE) · Cited by 18 · see citing works
Havik, T., & Ingul, J. M. (2022) · Frontiers in Education · doi:10.3389/feduc.2022.895983 · Cited by 17 · see citing works
Jans, T., & Warnke, A. (2004) · Monatsschrift Kinderheilkunde · doi:10.1007/s00112-004-1049-2 · Cited by 15 · see citing works
Trajectories of school refusal: sequence analysis using retrospective parent reports
Benoit, L., Peng, É. C. S., Flouriot, J., DiGiovanni, M. J., Bonifas, N., Rouquette, A., Martin, A., & Falissard, B. (2024) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-024-02419-5 · Cited by 12 · see citing works
The impact of parental and individual factors on school refusal: a multiple-mediation model
Hughes, P. M., Ostrout, T. L., & Lewis, S. F. (2020) · Journal of Family Studies · doi:10.1080/13229400.2020.1842232 · Cited by 12 · see citing works
Havik, T., & Ingul, J. M. (2021) · Frontiers in Education · doi:10.3389/feduc.2021.720014 · Cited by 9 · see citing works
School Refusal in Adolescence: Personality Traits and Their Influence on Treatment Outcome
de Groot, C., Heyne, D., & Boon, A. (2023) · Journal of Emotional & Behavioral Disorders · doi:10.1177/10634266231151903 · Cited by 7 · see citing works
Melvin, G. A., & Gordon, M. S. (2018) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2018.07.005 · Cited by 10 · see citing works
Zugaj, L., Gotheil, N., Delpech, S., Jung, C., & Delmas, C. (2016) · Neuropsychiatrie de l Enfance et de l Adolescence · doi:10.1016/j.neurenf.2016.01.002 · Cited by 9 · see citing works
School Refusal And Home Education
Wray, A., & THOMAS, A. (2013) · DOAJ (DOAJ: Directory of Open Access Journals) · Cited by 9 · see citing works
Gallé-Tessonneau, M., & Dahéron, L. (2020) · Neuropsychiatrie de l Enfance et de l Adolescence · doi:10.1016/j.neurenf.2020.06.002 · Cited by 8 · see citing works
Treatment of school refusal in an adolescent with comorbid anxiety and chronic medical illness
Rohrig, S. N., & Puliafico, A. C. (2018) · Evidence-Based Practice in Child and Adolescent Mental Health · doi:10.1080/23794925.2018.1447855 · Cited by 7 · see citing works
Ratnamohan, L., McInnis, P., Kotzé, B., Koncz, R., Cunich, M. M., & Heyne, D. A. (2025) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/00048674251332727 · Cited by 6 · see citing works
Knollmann, M., Waltz, E., Reissner, V., Neumann, U., & Hebebrand, J. (2022) · Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie · doi:10.1024/1422-4917/a000884 · Cited by 4 · see citing works
A Description of School Refusal Behavior in Adolescents Prior to Acute Care Admission
Rohrig, S. N., Bennett, S. M., Desai, P., Zendegui, E., & Chiu, A. W. (2023) · Journal of Emotional and Behavioral Disorders · doi:10.1177/10634266231187369 · Cited by 4 · see citing works
Melvin, G. A., & Tonge, B. J. (2012) · Wiley eBooks · doi:10.1002/9781118156391.ebcp001024 · Cited by 3 · see citing works
Wang, Y., Afzal, K. I., Yuan, C., Fan, J., He, J., Li, X.-H., Wang, B.-B., Feng, Y.-Y., Shao, H.-Y., Zhou, D., et al. (2026) · BJPsych Open · doi:10.1192/bjo.2026.10980 · Cited by 2 · see citing works
Orm, S., Tien, I. S., Wood, J. J., & Fjermestad, K. W. (2024) · Discover Psychology · doi:10.1007/s44202-024-00303-6 · Cited by 2 · see citing works
La phobie scolaire, définition et symptomatologie
Baranger, É. (2012) · Soins Pédiatrie/Puériculture · doi:10.1016/j.spp.2012.05.001 · Cited by 2 · see citing works
Higham, M., & Demkowicz, O. (2021) · British Journal of Special Education · doi:10.1111/1467-8578.12391 · Cited by 2 · see citing works
Zubeidat, I., Freire, J. C. S., & Parra, A. F. (2006) · Cuadernos de medicina psicosomática y psiquiatria de enlace · Cited by 2 · see citing works
School refusal behavior: The relationship between functions and symptom sets
Hendron, M. (2020) · Digital Scholarship - UNLV (University of Nevada Reno) · doi:10.34917/2327179 · Cited by 2 · see citing works
Ozsagir, S. A., Abanoz, E., Bozok, B. K., Kapan, O. G., Ince, N., & Çiçek, A. U. (2026) · Interdisciplinary Medical Journal · doi:10.17944/interdiscip.1803809 · Cited by 1 · see citing works
Waleed, Z. I. D. (2021) · Psychology and Education Journal · doi:10.17762/pae.v58i2.1549 · Cited by 1 · see citing works
Functional analysis of school refusal: An exploratory study in the Indian context
Yadav, A. S., Rajendra, K. M., Sravanti, L., Kommu, J. V. S., Seshadri, S. P., & Girimaji, S. C. (2024) · Industrial Psychiatry Journal · doi:10.4103/ipj.ipj_133_24 · Cited by 1 · see citing works
Haight, C. (2020) · Digital Scholarship - UNLV (University of Nevada Reno) · doi:10.34917/2476192 · Cited by 1 · see citing works
Using a Dual-Factor Model to Understand the Mental Health of Students with School Refusal Behavior
Maupin, Z. D. (2021) · Chapman University Digital Commons (Chapman University) · doi:10.36837/chapman.000266 · Cited by 1 · see citing works
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Öner, Ö., Ergüder, T., Cakir, B., & Erol, N. (2012)
Functional outcomes in school refusal
Bonavitacola, L. (2015) · doi:10.7282/t3nk3h06
Leal, D., Marques, J. M. D. A., Vaz, P., Pereira, S., & Matos, A. (2015)
School Refusal Behavior: A Phenomenological Study of Latino/a Children's Experiences
Angelo, M.-A. (2011) · Digital Commons - DU (University of Denver)
Listening to the stories of parents whose children have experienced school non-attendance
Burrows, H. M. (2020) · White Rose eTheses Online (University of Leeds, The University of Sheffield, University of York)
Jaemwimol, K., Punyapas, S., Pornnoppadol, C., & Chantaratin, S. (2021) · Chiang Mai Medical Journal - เชียงใหม่เวชสาร · doi:10.12982/cmumedj.2021.23
(2020) · Dunod eBooks · doi:10.3917/dunod.galle.2020.01.0253
Gelişimi Tipik Seyreden Çocuklarda Okul Reddi, Anksiyete ve Duygu Düzenleme Güçlükleri
Ulaş, S. (2023) · Özgür Yayınları eBooks · doi:10.58830/ozgur.pub170.c845
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Gülaçtı, F., & Çiftçi, Z. (2023) · Özgür Yayınları eBooks · doi:10.58830/ozgur.pub170.c841
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Gencer, S., & Ateş, Ö. T. (2023) · Özgür Yayınları eBooks · doi:10.58830/ozgur.pub170.c837
Zubeidat, I., Dallasheh, W., Khalil, A. A., & Masri, A. (2024) · International Journal of Inclusive Education · doi:10.1080/13603116.2024.2303155
School refusal behavior in children and adolescents: a concept analysis
Wang, L., Li, X., Li, X., Lei, M., Hong, L., & Xue, B. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1954084
- Authors
- Mcshane, G., Walter, G., & Rey, J. M.
- Affiliations
- Central Sydney Area Health Service, Australia
- Rivendell Unit, Australia
- The University of Sydney (AU)
- Venue
- Clinical Child Psychology and Psychiatry
- Publisher
- SAGE Publications
- Published
- 2004-01
- Volume
- 9
- Issue
- 1
- Pages
- 53-60
- ISSN
- 1359-1045 (ISSN-L)
- 1461-7021
- OpenAlex
- W2054469301
- Cited by
- 61
- References
- 17
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 4 · 2023: 5 · 2022: 4 · 2021: 6 · 2020: 7 · 2019: 1 · 2018: 7 · 2017: 1 · 2016: 2 · 2015: 5 · 2014: 2 · 2013: 3 · 2012: 3
- FWCI
- 6.91
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Child Psychology and Psychiatry (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 › Health Professions › Speech and Hearing › School Health and Nursing Education
- Keywords
- school refusal, functional outcome, adolescents, child and adolescent psychiatry, social anxiety disorder, dysthymia, comorbidities, learning difficulties, long-term follow-up, treatment outcome predictors
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