Signposts for School Refusal Interventions, Based on the Views of Stakeholders
Open accessAbstract
School refusal (SR) signals a young person's difficulty attending school. It jeopardizes their development, often contributes to distress for parents, and places an extra burden on school personnel. Reviews of empirical studies indicate that intervention for SR helps to increase school attendance, but not for all youths. This practice-based manuscript aims to support practitioners and organisations addressing the needs of youths and families affected by SR. Specifically, we present 14 signposts for the development and delivery of intervention for SR. The signposts represent important conditions for effective intervention based on key findings from the Knowing What Works project in the Netherlands. During that project, 76 professionals shared their views about the important elements in SR interventions they delivered, and 39 youths and 86 parents shared their views about the helpful elements in SR interventions in which they participated. These 201 stakeholders were variously associated with 21 SR interventions across 9 of the 12 Dutch provinces, most situated in mainstream or special education settings. Their responses informed the development of the 14 signposts presented here, supported by the extant literature on SR intervention. We describe the essence of each signpost and conclude with suggestions for using the signposts and evaluating their utility.
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Comparatively less attention is given to the working elements that underpin successful returns or improvement of school attendance.
“Comparatively less attention is given to the working elements that underpin successful returns or improvement of school attendance (e.g., Halligan and Cryer, 2022;Heyne and Brouwer-Borghuis, 2022).”
From Their voices matter: student and professional perspectives on overcoming school attendance problems in the context of social, emotional, and behavioral difficulties (2025) · cites this paper as Heyne and Brouwer-Borghuis, 2022
Youth who meet criteria for conduct disorder often avoid school, either because they are excluded for defiant behavior or because they resist authority.
“Youth who meet criteria for conduct disorder often avoid school, either because they are excluded for defiant behavior or because they resist authority”
From “So That You Can Feel Well”: Perspectives of Students with Social, Emotional and Behavioral Difficulties on Factors that Support School Attendance (2025) · cites this paper as Heyne et al., 2022
The “School Refusal and Its Impact” section distinguishes school refusal from school exclusion, but does not discuss conduct disorder or why youths with that diagnosis might miss school. Searches for conduct disorder, defiant behavior, resistance to authority, and school exclusion found no passage addressing the claimed relationship. (LLM, conf=0.75)
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“Intervention efforts should strategically address symptoms that impede progress toward increased school attendance (1, 71, 72).”
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“Research indicates that between one-third and two-thirds of young people with absenteeism do not respond to interventions (Heyne, 2022), this could be explained by adolescent developmental challenges such as increased academic and social demands, and higher rates of social anxiety and depressive…”
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“The parents’ positive experiences with the B2S intervention reflect key elements of effective SAPs interventions identified by Heyne and Brouwer-Borghuis ( 2022), including adopting an integrated approach, gaining a comprehensive understanding of the problem, and fostering strong, supportive…”
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“The multi-professional team has the opportunity to address different aspects of the child’s and their family’s situation simultaneously, which studies have found beneficial (Boaler & Bond, 2023; Heyne & Brouwer-Borghuis, 2022; Kearney & Graczyk, 2020; Keppens & Spruyt, 2020).”
A qualitative meta-synthesis of adolescents’ perceptions of school attendance problems
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“Notably, these levers converge with stakeholder-derived ‘ sign-posts ’ for EBSA intervention, particularly the emphasis on lowering initial barriers to engagement through the provision of safe, structured, and relationally supportive environments (45).”
Self-citationZahriyanti, Musrizal, Ikhwani, & Ikbal, M. (2026) · Al Qodiri Jurnal Pendidikan Sosial dan Keagamaan · doi:10.53515/alqodiri.v24i2.188
Gonzálvez, C., Pérez-Marco, M., Fuster, A., Sanmmartín, R., Sunay, C., Caparello, C., Çimen, F., Filipello, P., Meduri, C. F., Seçer, I., et al. (2026) · Continuing education · doi:10.5334/cie.238
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“Additional studies have underscored the importance of skill application in interest-driven, participatory, and individualized activities (Halligan & Cryer, 2022, Hejl et al., 2024, Heyne & Brouwer-Borghuis, 2022).”
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Involving Parents in the Management and Treatment of Youth Anxiety
Trent, E. S., Tan, S. X. L., Cheng, J. S., & Storch, E. A. (2025) · Current Psychiatry Reports · doi:10.1007/s11920-025-01614-8
Ruan, L., Ren, Y., Zeng, H., Zhang, C.-N., & He, L. (2024) · Journal of psychological researches · doi:10.30564/jpr.v6i3.6982
“School refusal, a worldwide public health challenge, affects approximately 1%–7% of school-age adolescents [3, 4] .”
- Authors
- Heyne, D., & Brouwer-Borghuis, M.
- Affiliations
- Leiden University (NL)
- Corresponding author
- Heyne, David
- Venue
- Continuity in Education
- Publisher
- Ubiquity Press, Ltd.
- Published
- 2022
- Volume
- 3
- Issue
- 1
- Pages
- 25-40
- ISSN
- 2631-9179 (ISSN-L)
- PMC
- PMC11104337
- OpenAlex
- W4285256723
- Cited by
- 28
- References
- 67
- Citations by year
- 2026: 10 · 2025: 10 · 2024: 5 · 2023: 1 · 2022: 2
- FWCI
- 9.71
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by
- Locations
- Continuity in Education (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Leiden Repository (Leiden University) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, cc-by)
- Funders
- Indian National Science Academy
- Nederlandse Organisatie voor Wetenschappelijk Onderzoek (405-18-640)
- Topics
- Social Sciences › Education › Youth Substance Use and School Attendance
- Health Sciences › Health Professions › Speech and Hearing › School Health and Nursing Education
- Social Sciences › Education › Early Childhood Education and Development
- Keywords
- school refusal, school refusal intervention, stakeholder perspectives, intervention design, school attendance, special education, mainstream education, intervention effectiveness, practice-based research
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