Understanding School Refusal (page 3)

By — NYU Child Study Center
Updated on Apr 22, 2014

Concluding remarks

When children like Rebecca and Nicholas refuse school, immediate intervention is necessary not only because school attendance is mandated by law, but also to address negative social, psychological and academic consequences to the youth and family. If not identified and treated, school refusal behavior has severe short- and long-term consequences. Some of the short-term consequences of school refusal behavior include significant child stress, deteriorating school performance, social isolation, and family tension and conflict. Some of the longer term consequences include decreased probability of attending college, impaired social functioning impacting personal and professional goals, and increased risk of substance abuse, anxiety and depression in adulthood. Furthermore, the longer the youth refuses to attend school, the greater the risk of these problems developing. Taken together, it is essential that children, parents, mental health professionals, and school officials act collectively to further understand school refusal. It remains a prevalent and potentially grave problem that is under-investigated regarding empirically-based assessment and treatment.

A version of this article by these authors appeared previously in School Nurse News, September 2001.

About the Authors

Nicole Setzer, a licensed clinical psychologist and Clinical Coordinator of the Institute for the Study Adolescent Anxiety and Mood Disorders at the NYU Child Study Center. She specializes in working with both anxious and depressed children and their families. Dr. Setzer works as a cognitive behavioral therapist on the NIMH funded research project for the Treatment of Adolescent Depression (TADS).

Amanda Salzhauer, MSW is a Certified Social Worker and leads cognitive behavioral therapy groups for teenagers and young adults with Social Phobia at the Institute for the Study of Child and Adolescent and Mood Disorders at the NYU Child Study Center,


1. Kearney, C.A. & Albano, A.M. (2000). Therapist's guide for the prospective treatment of school refusal behavior. San Antonio, TX: The Psychological Corporation.

2. Kearney, C.A. & Silverman, W.K. (1993). Measuring the function of school refusal behavior: The School Refusal Assessment Scale. Journal of Clinical Child Psychology, 22, 85-86.

Related Books

Your Defiant Child R.A. Barkely & C.M. Benton Guilford Press 1998

When Children Refuse School: A Cognitive-Behavioral Therapy Approach -- Parent Workbook C.A. Kearney & A.M. Albano The Psychological Corporation 2000

Helping Your Anxious Child R.M. Rapee, S.H. Spence, V. Cobham & A. Wignall New Harbinger Publications 2000

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About the NYU Child Study Center

The New York University Child Study Center is dedicated to increasing the awareness of child and adolescent psychiatric disorders and improving the research necessary to advance the prevention, identification, and treatment of these disorders on a national scale. The Center offers expert psychiatric services for children, adolescents, young adults, and families with emphasis on early diagnosis and intervention. The Center's mission is to bridge the gap between science and practice, integrating the finest research with patient care and state-of-the-art training utilizing the resources of the New York University School of Medicine. The Child Study Center was founded in 1997 and established as the Department of Child and Adolescent Psychiatry within the NYU School of Medicine in 2006. For more information, please call us at (212) 263-6622 or visit us at

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