School Refusal: Crime, Mental Disorder, or Human Right?
Views on school refusal depend on beliefs about children and human rights.
Posted Feb 23, 2020
Every state and country where school is compulsory is faced with the problem commonly labeled school refusal. Everywhere, a significant number of kids strongly resist going to school and manage to skip a large number of school days. From a legal perspective, refusal to attend school is a crime, and, if prolonged, it is often treated as a crime, even today. Children can be put into juvenile detention centers for not attending school, and parents who are either unwilling or unable to force their children to show up at school (and don’t have the means or knowhow to provide homeschooling or some other legal alternative to school) can be subject to arrest or having their children taken away from them.
Psychologists, however (no surprise), are inclined to think of school refusal not as a crime to be punished, but as a psychological disorder to be treated. Yet, as I read the psychological literature on treatment for school refusal, I can’t help but think of some of the treatments as punishment.
How psychologists generally describe and attempt to treat school refusal
If you enter “school refusal” as a search term in any database that covers the academic journals in psychology you will come up with countless articles devoted to the topic. If you read any set of the articles you will find great redundancy. Most of them start off with some sort of statement about how damaging it is for a child not to attend school—about the statistics showing that school dropouts continue to have all sorts of problems throughout life. The phrase “normal developmental pathway” is used to describe the school pathway, and not going to school then becomes abnormal, pathological.
Then the typical article goes on to define school refusal (sometimes with capital letters) in some more or less objective way. The primary symptom is that the child misses school at least a certain number of days per month, with no excused absence and despite the fact that parents and other adults are trying to get the child to attend. In addition, the definition also usually includes an emotional component, typically anxiety, related to the child’s refusal. Indeed, some clinicians use the term school phobia as an alternative to school refusal.
Having defined school refusal, psychologists then go on to treat it as a diagnostic category. It is not, at least presently, an official mental disorder in the diagnostic manual of the American Psychiatric Association, nor in that of the World Health Organization, but it is routinely treated as if it were (e.g. Elliott & Place, 2019). In the articles one regularly comes across such phrases as “patients who have school refusal,” as if school refusal were something like measles that one “has” or “doesn’t have.” It’s not an act but a disease. I think I’m going to start referring to my vegetarian wife as someone who has “meat refusal.” Of course, the clinicians justify thinking of it as a disorder by noting that people who refuse school typically experience a lot of anxiety about school; but I’ll come back to that later.
Research into the causes of school refusal has generated a wide variety of results. It is perhaps no surprise that school personnel most commonly attribute the cause to the parents or the family situation or to some genetic problem within the child, while parents and the children themselves most commonly attribute it to things that are happening at school (e.g. Ingul et al, 2019). School personnel generally believe that the parents have been too lenient, or too strict, or too protective, or not sufficiently protective, or have failed to provide the proper moral guidance. In contrast, parents and the school-refusing children most commonly attribute it to such causes as lack of teacher support, bullying by teachers or students, being treated unfairly, not being believed, lack of freedom to move around; or to the stress and tedium of the constant testing and assigned work. Psychologists involved in these discussions often acknowledge that all of these can be contributing causes, but their work in trying to “cure” the condition almost always focuses on the child and the family, not the school.
Treatments for school refusal run the whole gamut of typical psychological and pharmacological therapies. The most common treatment seems to be cognitive behavior therapy, which attempts to get the child to think differently about school and to desensitize the child to those aspects of school that provoke fear, but drugs to reduce anxiety are also commonly used (e.g. Elliott & Place, 2019). Another approach, centered on the idea that this is a family problem, involves family therapy.
In a few cases, psychologists, with the parents’ permission, have resorted to inpatient therapy. For example, Ozger Oner and colleagues (2014) describe the case of an eight-year-old girl who refused to attend third grade because she was “afraid of the teachers, headmaster, and other children.” The treatment involved her incarceration in an inpatient facility where she received therapy and was dosed with increasing amounts of forced time in school, accompanied by a therapist. Only when she was willing to go to school on her own, after three weeks, was she allowed to go back to living with her parents. [I wonder if she was really cured or if she just decided that going to school was less punishing than living in the inpatient facility.]
Relation of school refusal to "Belief in a Just World"
Returning again to causes, one interesting study examined the relation between Belief in a Just World (BJW) and school refusal (Donat et al, 2018). The BJW construct is measured by a questionnaire getting at the degree to which a person feels that the world is fair and that people deserve what they get. In much of the psychological literature this construct is discussed in terms of the just-world fallacy, or blaming the victim, which is the tendency to blame people who are poor, or are suffering from a disease or some other malady, for their own condition. If the world is just, then it must be something that they did, or failed to do, that led them to this condition. By thinking this way, people maintain their belief in a just world despite seeing what others of us interpret as injustice.
Some research—which is the springboard for Donat’s study—indicates that believing in a just world is psychologically adaptive. People with this belief are less likely than the rest of us to get upset by what others see as injustice, because they don’t see it as injustice. Belief in a just world may even help them deal with their own hardships in life, because that belief may lead them to think that any pain they are suffering is ultimately for their own good. [I can’t help interjecting here that high BJW may be good for the psychological ease of the person, but not for society as a whole. If we all believed that the world is just, just as it is, we would still have slavery and ___ (fill in the blank).]
So, here’s what Donat and his colleagues found. Children who refuse school have a weaker BJW than do those who don’t refuse school. Not a surprising result. If you believe that you are being treated unjustly in school, then you are likely to believe that the world is not just. Conversely, if you don’t believe that the world is just, you are less likely to believe that the seemingly bad things happening to you are for your own good. So, your beliefs about the injustice of the world and the injustice at school feed upon one another.
Donat’s takeaway from this research is that an underlying problem of children who refuse school is that they don’t believe in a just world. Donat, like almost everyone else, begins with the assumption that school, though it entails some hardships, is good, even necessary, for children. He goes from there to say that children who believe in a just world recognize that school is good for them and that children who lack a belief in a just world fail to see that it is good for them. So, if children were brought up in such a way as to believe the world is just, we wouldn’t have this problem of school refusal. Wow! (He doesn’t mention that we would still have slavery.)
School refusal as a human right
Those who are regular readers of my blog and my other writings know where I am going from here. The truth of the matter is that compulsory schooling is unjust. It is involuntary incarceration. It runs completely counter to the nature of childhood and to children’s real, biological needs to learn through free play and exploration. And it is not necessary for normal development. That has been proven repeatedly, by the thousands of families that have chosen Self-Directed Education for their children (for some of the evidence, see Gray, 2013, 2017).
Many of the families that have chosen unschooling or a school designed for Self-Directed Education made that choice precisely because their children were in one way or another refusing school (Gray & Riley, 2013). In fact, resources for Self-Directed Education can be provided with much less expense than standard public schooling and far less expense than incarceration in a juvenile detention center or a psych ward. In a previous post I describe an experiment done long ago in which boys who were chronically skipping school were provided with a room at the school where they could do whatever they wanted—including leaving the room to play in the gym or work in the workshop—as long as they would come to school and not make a nuisance of themselves out on the streets. They were not taught anything, they were not given any assignments, but they were tested at the beginning and end of the four-month trial period just to see what would happen. The academic gains they showed were far greater than the gains of those who were taking classes! That’s just one simple example of the power of being allowed to take charge of your own life and education.
One clinical psychologist who came to a similar conclusion to mine is Naomi Fisher, who recently published an article in The Psychologist, the journal of the British Psychological Society, called School’s Out. Here’s how she began the article:
“In my early career as a clinical psychologist, I worked with several young people who had stopped attending school. I understood this as anxiety-driven school refusal. I devised graded-exposure programmes, and wrote letters making it clear that in my view a successful outcome would be a return to school. It seemed the reasonable thing to do. One girl, Nina, didn’t want to go back. When I made my perspective clear, she and her family disengaged... they stopped coming. … As I continued to work with children in different contexts, I found myself feeling more uncomfortable with my focus. For some of them school was a positive place, and the problem was indeed anxiety. But for some, school was a painful experience, where they felt like they weren’t learning and weren’t able to be themselves. One boy showed his mum a picture of a caged animal and said ‘That’s how I feel at school’. I felt ill at ease with locating this problem in the child, and assuming that the school itself was fine. What alternative environments were possible? How might they impact the child psychologically?'
From this beginning, Fisher went on to describe her discovery of Self-Directed Education and her interviews with some of us who have conducted research on this topic. We need more Naomi Fishers—clinicians who are willing to listen to children with open ears and willing to question a system that demands that every child must get educated (or go through the motions of getting educated) in the same, standard, forced way.
Most clinicians involved with school refusal justify thinking of it as a psychological disorder because it is so often associated with severe anxiety, and severe anxiety is a disorder. Well, it should be no surprise that children who experience pain, suffering, and injustice at school would feel anxiety and fear about going there! The fact of the matter is that school is a huge source of anxiety for many if not most students who attend regularly. Indeed, a third of all students in school suffer, at some point, from anxiety to a degree sufficient to warrant a clinical diagnosis of an anxiety disorder (here), and in research where they were asked about the source of their anxiety, the vast majority cited school (here).
Elsewhere (here) I have summarized research showing that the rates of suicide and suicide attempts are much greater during the school year than during school vacations. In a book entitled The Scarred Heart, Helen Smith described the case of a school-refusing 13-year old who was given the choice of returning to school or going into a juvenile detention center. In Smith’s words, “She decided that the better alternative was to go into her bedroom and hang herself with a belt. … In times past, she could have just dropped out of school, but now kids like her are trapped by compulsory education.” What a shame that this girl was not given the option of home education or a school for Self-Directed Education, where every child can learn in their own way and bullying is almost unheard of (see here).
Maybe, at least to some degree, the school refusers are the courageous ones. Refusing school takes more than a recognition that the world is unjust and that you are being treated unjustly in school. It also takes courage, especially when the injustice that you see is viewed as normal and reasonable, something that must be endured, by everyone around you. Think, for example, about times and places when the decision as to whom a young woman would marry was made by her father. Refusal to follow the father’s orders was in some cases a crime and in others a psychological disorder. Women were sometimes put in mental hospitals because of it. It takes courage to say, “Hell no, I won’t go,” when everyone else operates on the assumption that going is necessary and not going is either crazy or criminal.
And now, what do you think? Do you know people who would have fit the “school refusal” diagnosis? What happened with them? This blog is, in part, a forum for discussion. Your observations and thoughts, including disagreements, are treated with respect by me and other readers. As always, I prefer if you post your thoughts and questions here rather than send them to me by private email. By putting them here, you share with other readers, not just me. I read all comments and try to respond if I feel I have something useful to say.
Donat, M., Gallschütz, C., & Dalbert, C. (2018). The relation between students’ justice experience and their school refusal behavior. Social Psychology of Education, 21, 447-475.
Elliott, J. G., & Place, M. (2019). Practitioner review: School refusal: developments in conceptualization and treatment since 2000. Journal of Child Psychology and Psychiatry, 60, 4-15.
Gray, P. (2013). Free to Learn: Why unleashing the instinct to play will make our children happier, more self-reliant, and better students for life. Basic Books.
Gray, P. (2017). Self-directed education—unschooling and democratic schooling. In G. Noblit (Ed.), Oxford research encyclopedia of education. New York: Oxford University Press.
Gray, P., & Riley, G. (2013). The challenges and benefits of unschooling according to 232 families who have chosen that route. Journal of Unschooling and Alternative Learning, 7, 1-27.
Ingul, J. M., Havi, T., & Heyne, D. (2019). Emerging school refusal: A school-based framework for identifying early signs and risk factors. Cognitive and behavioral practice, 26, 46-62.
Oner, O.,et al., (2014). The inpatient treatment process for severe school refusal, Klinik Psikofarmakoloji Bülteni—Bulletin of Clinical Psychopharmacology, 24, 176-179.