Systematic Literature Review on School Refusal Behaviour
DOI:
https://doi.org/10.55829/8pftjm89Keywords:
School refusal, school phobia, anxiety, cognitive-behavioral therapy, systematic reviewAbstract
School refusal behavior (SRB) is when a child doesn't want to go to school because they are upset, not because they are skipping school. This affects 1-5% of school-aged children and makes it hard for them to do well in school and stay mentally healthy. This paper reviews existing research and synthesizes evidence from 25 high-quality studies, utilizing PRISMA guidelines to ascertain prevalence, risk factors, interventions, and outcomes. The main findings show that anxiety disorders and family dynamics are the main causes, and cognitive-behavioral therapy (CBT) is the most effective treatment, with success rates of 60–80%. There are still gaps in longitudinal data and samples from different cultures. For teachers and doctors, this means that early screening and support systems that work together are important. This review emphasizes the necessity for customized, evidence-informed approaches to alleviate enduring effects on academic performance and mental well-being.
References
[1] Benarous, X., Hassler, C., Falissard, B., Consoli, A., & Cohen, D. (2022). School refusal and psychiatric disorders: A systematic review. European Child & Adolescent Psychiatry, 31(5), 683–697. https://doi.org/10.1007/s00787-021-01735-9
[2] Bitsika, V., Sharpley, C. F., & Bell, R. (2022). The association between bullying experiences and school refusal behaviour among adolescents. Child Psychiatry & Human Development, 53(4), 623–635. https://doi.org/10.1007/s10578-021-01143-7
[3] Bronfenbrenner, U. (1979). The ecology of human development: Experiments by nature and design. Harvard University Press.
[4] Bronfenbrenner, U., & Morris, P. A. (2006). The bioecological model of human development. In W. Damon & R. M. Lerner (Eds.), Handbook of child psychology (6th ed., pp. 793–828). Wiley.
[5] Elliott, J. G., & Place, M. (2019). School refusal: Developments in conceptualisation and treatment. Routledge.
[6] Fernández-Sogorb, A., Gonzálvez, C., Sanmartín, R., Vicent, M., & García-Fernández, J. M. (2020). School refusal behavior profiles and their relationship with social anxiety. Frontiers in Psychology, 11, 560. https://doi.org/10.3389/fpsyg.2020.00560
[7] Filippello, P., Buzzai, C., & Costa, S. (2020). School refusal and academic motivation: The role of psychological well-being and school climate. Educational Psychology, 40(5), 588–605. https://doi.org/10.1080/01443410.2019.1699925
[8] Gillen-O’Neel, C. (2021). Sense of belonging and school attendance among adolescents. Journal of Adolescence, 88, 1–10. https://doi.org/10.1016/j.adolescence.2021.02.001
[9] Gonzálvez, C., Díaz-Herrero, Á., Sanmartín, R., Vicent, M., & García-Fernández, J. M. (2019). School refusal behavior: Latent profile analysis and relationship with school anxiety. Psychiatry Research, 274, 1–8. https://doi.org/10.1016/j.psychres.2019.02.017
[10] Gonzálvez, C., Vicent, M., Sanmartín, R., García-Fernández, J. M., & Inglés, C. J. (2023). Profiles of school refusal behavior and their relationship with psychological distress. Current Psychology, 42(10), 8041–8052. https://doi.org/10.1007/s12144-021-02369-7
[11] Gonzálvez, C., Vicent, M., Sanmartín, R., García-Fernández, J. M., & Inglés, C. J. (2023). Profiles of school refusal behavior and their relationship with psychological distress. Current Psychology, 42(10), 8041–8052.
[12] Grazia, V., Cavioni, V., Grazzani, I., & Ornaghi, V. (2024). School climate, emotional regulation, and school refusal behaviour in adolescents. Children, 11(3), 299. https://doi.org/10.3390/children11030299
[13] Heyne, D. (2022). Developmental issues associated with adolescent school refusal and cognitive behavioral therapy. Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie, 50(6), 471–494. https://doi.org/10.1024/1422-4917/a000890
[14] Heyne, D., & King, N. J. (2021). Treatment approaches for school refusal behaviour. Clinical Child and Family Psychology Review, 24(3), 456–473. https://doi.org/10.1007/s10567-021-00342-7
[15] Heyne, D., Gren-Landell, M., Melvin, G., & Gentle-Genitty, C. (2019). Differentiation between school attendance problems: Why and how? Cognitive and Behavioral Practice, 26(1), 8–34. https://doi.org/10.1016/j.cbpra.2018.03.006
[16] Ingul, J. M., Havik, T., & Heyne, D. (2019). Emerging school refusal: Patterns and predictors. School Mental Health, 11(4), 762–774. https://doi.org/10.1007/s12310-019-09328-0
[17] Karlberg, M., et al. (2022). School climate and student absenteeism: The mediating role of school refusal behaviour. Children, 9(4), 1–13. https://doi.org/10.3390/children9040516
[18] Karthika, G., & Devi, M. G. (2020). School refusal: Psychosocial distress or psychiatric disorder? Telangana Journal of Psychiatry, 6(1), 14–18.
[19] Kearney, C. A. (2008). School absenteeism and school refusal behavior in youth: A contemporary review. Clinical Psychology Review, 28(3), 451–471. https://doi.org/10.1016/j.cpr.2007.07.012
[20] Kearney, C. A. (2016). Managing school absenteeism at multiple tiers: An evidence-based and practical guide for professionals. Oxford University Press.
[21] Kearney, C. A. (2019). Helping school refusing children and their parents: A guide for school-based professionals (2nd ed.). Oxford University Press.
[22] Kearney, C. A., & Albano, A. M. (2004). The functional profiles of school refusal behavior. Behavior Modification, 28(1), 147–161. https://doi.org/10.1177/0145445503259263
[23] Kearney, C. A., & Albano, A. M. (2018). When children refuse school: A cognitive-behavioral therapy approach (2nd ed.). Oxford University Press.
[24] Kearney, C. A., & Graczyk, P. (2014). A response to intervention model to promote school attendance and decrease school absenteeism. Child & Youth Care Forum, 43(1), 1–25. https://doi.org/10.1007/s10566-013-9222-1
[25] Kim, S., & Gentle-Genitty, C. (2020). School attendance and belongingness among adolescents. Children and Youth Services Review, 118, 105377. https://doi.org/10.1016/j.childyouth.2020.105377
[26] Leduc, K., et al. (2022). Psychological factors associated with school refusal behaviour in adolescents. Journal of School Psychology, 90, 1–15. https://doi.org/10.1016/j.jsp.2021.11.002
[27] Maeda, N. (2019). School-based behavioural consultation for school refusal behaviour. International Journal of Psychological Studies, 11(1), 40–49. https://doi.org/10.5539/ijps.v11n1p40
[28] Mondal, A. (2022). Changes in Indian culture and increasing school phobia among children. International Journal of Home Science, 8(3), 205–207.
[29] Nayak, A., Sangoi, B., & Nachane, H. (2018). School refusal behavior in Indian children: Analysis of clinical profile and psychopathology. Indian Journal of Pediatrics, 85(12), 1073–1078. https://doi.org/10.1007/s12098-018-2686-4
[30] Ochi, M., et al. (2020). Bullying victimization and school refusal among adolescents. Journal of Adolescent Health, 66(2), 234–240. https://doi.org/10.1016/j.jadohealth.2019.08.006
[31] Prabhuswamy, M. (2018). To go or not to go: School refusal and its clinical correlates. Journal of Paediatrics and Child Health, 54(10), 1117–1120. https://doi.org/10.1111/jpc.14124
[32] Seçer, İ., & Ulaş, S. (2020). Psychological adjustment problems associated with school refusal behaviour. Journal of Child and Family Studies, 29(10), 2827–2838. https://doi.org/10.1007/s10826-020-01747-3
[33] Tekin, U., & Aydın, B. (2022). Risk factors related to school refusal behaviour in adolescents. Education Sciences, 12(5), 322. https://doi.org/10.3390/educsci12050322
[34] Ulaş, S., & Seçer, İ. (2024). A systematic review of school refusal. Current Psychology, 43, 19407–19422. https://doi.org/10.1007/s12144-024-05742-x
[35] Ulaş, S., Gonzálvez, C., & Seçer, İ. (2024). School refusal: Mapping the literature by bibliometric analysis. Frontiers in Psychology, 15, 1265781. https://doi.org/10.3389/fpsyg.2024.1265781
[36] Van Eck, K., Johnson, S., Bettencourt, A., & Johnson, S. (2018). How school climate relates to chronic absenteeism. Journal of School Psychology, 68, 66–78. https://doi.org/10.1016/j.jsp.2018.03.002
[37] Yadav, A. S., Rajendra, K. M., Sravanti, L., Kommu, J. V. S., Seshadri, S., & Girimaji, S. C. (2024). Functional analysis of school refusal: An exploratory study in the Indian context. Industrial Psychiatry Journal, 33(2), 305–311. https://doi.org/10.4103/ipj.ipj_133_24
[38] Zhao, N., Yang, S., Zhang, Q., Wang, J., Xie, W., Tan, Y., & Zhou, T. (2023). School bullying and psychological problems among students. International Journal of Environmental Research and Public Health, 20(8), 1–12. https://doi.org/10.3390/ijerph20085432
Downloads
Published
Issue
Section
License
Copyright (c) 2026 International Journal of Management, Public Policy and Research
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
