A Therapist’s Guide to Handling School Anxiety and School Refusal
As a parent, watching your child struggle with school anxiety or refuse to go to school altogether can be heartbreaking and confusing. It’s hard to know when to push, when to comfort, and how to tell the difference between a rough morning and an ongoing anxiety struggle.
You might find your focus jumping from your child’s emotions, your own worries, and the pressures of work or school attendance policies. It’s not easy, and it’s completely normal to feel unsure of what to do.
You’re not alone, and neither is your child. Today, we’ll share with you some practical tools, guidance, and insight to help you navigate these challenges for your young and elementary aged child.
Image Credit: Unsplash Juju_ a_la_bougeotte@juju_a_la_bougeotte
A Parent’s Guide to School Anxiety (and What to Do About It)
Why school can feel so hard (even for “strong” kids)
The start of school is a big transition. New routines, new teachers, new expectations, and a whole lot of stimulation can spike anxiety for kids and teens. Some common reasons that anxiety can spike include:
Transitions & uncertainty: New classroom, schedule changes, firsts/unknowns.
Separation anxiety: Worries about being away from you or home.
Social anxiety: “What if I say the wrong thing?” “What if I don’t have anyone to sit with?”
Overstimulation: Noise, crowds, fluorescent lights, busy hallways.
Teacher/fit worries: Fear of strict teachers, being called on, or being misunderstood.
Perfectionism & school stress: Pressure to perform, fear of mistakes, procrastination cycles.
Common signs of school anxiety (including the ones that look like “misbehavior”)
You may see tears at drop-off, hear complaints of tummy aches and headaches, or notice a sudden change in how your child feels about school. Some children may become unusually quiet or clingy in the mornings, while others might act out or become irritable when it’s time to get ready for school - or even when it’s time for bed. You might notice trouble sleeping, avoiding homework, or a drop in grades. These signs are your child’s way of saying something feels too big or overwhelming.
A helpful reframe: anger is trying to protect you. Morning meltdowns, “No! I’m not going!” and doorframe standoffs are often a nervous system stuck in fight/flight, not willful disobedience. Your child’s anger is protecting their anxious part, and is often masking underlying stress and anxiety. So instead of saying to yourself that they’re willfully disobeying you, consider if it’s really stress.
My 3-Step Approach for Parents
1) Identify & Empathize
Talk with your child about what’s going on. If you start by criticizing they behavior, or saying that they’re going to be in so much trouble, you might ramp them up again. So instead, focus on helping them understand what lead to this response:
“It seemed like you got really angry when we went to your new classroom, and I’m wondering if part of you was feeling scared, too. Sometimes when our bodies feel really scared, it makes us feel really angry. That’s just my guess, though - what do you think made you feel this way?”
It’s really an opportunity to get curious about what’s underneath. Avoid arguing with the fear (“There’s nothing to worry about”). Try:
“Of course a new classroom can feel scary. I get it.”
“I noticed you got upset when we walked toward your class. I’m wondering if part of you was feeling nervous, too.”
Name it to tame it. You’re not fixing it yet, you’re helping your child feel seen and safe.
2) Calm Down
Before problem-solving, we need to calm down our brains and bodies. And when we offer a choice, we can help our kid or teen feel a little more in charge of what is going on. We’ve got tons and tons of relaxation skills on the blog, and the more you practice outside of the stressful situations, the easier it will be for your child or teen to use the skill when the really need it. You can try…
4–6 count belly breaths
Squeeze-and-release muscle relaxation
Grounding (“Name 5 things you see, 4 you feel, 3 you hear…”)
Guided imagery (“Let’s picture your calm spot for 30 seconds.”)
You can say, “Let’s pick one calm tool for 60 seconds, then we’ll make a plan.”
3) Game Plan
Now collaborate on “the next small step.” Keep limits clear and steps small. Examples:
“We know that you need to get your shoes on. Would you like to put on your shoes, or have me help?”
“We need to walk to the front door, which we will do together. You can hold my hand or your bear, your choice.”
“We’ll check in with Ms. Lee, take 3 breaths, and you’ll start with a quiet warm-up at your desk.”
Routines that make mornings easier (ideally we can start these a couple weeks before school)
Visual schedules can help anxious brains predict what’s next.
Build a simple visual: pictures or words for wake up → bathroom → get dressed → breakfast → backpack check → shoes → out the door.
Practice the drill: Practice a couple 10-minute “mock morning” in the weeks before school. Keep it light and playful beat the timer together.
Shift sleep gently: Move bedtime/wake time by 10–15 minutes every few days until you’re on school schedule.
Preview the day: “First bus, then homeroom, then art. After school: snack and some tv time!”
Create a separation plan: A short goodbye script, one calm tool, and a predictable check-in (“I’ll text your teacher a thumbs-up at 10:00.”).
School Refusal and a Gradual Exposure Plan Example:
When kids or teens simply refuse to go into the school, we need to create an exposure plan, and break down the fear into small, manageable steps. Stay at each step until anxiety drops from “high” to “low-to-medium” several times in a row.
Safety notes: Pair steps with calm tools, brief praise, and a simple reward tracker (stickers, extra story, choice of dinner music). Keep goodbyes short and confident. Check in with the school, too, to collaborate - and, please note that exposure plans should really be done in consultation with a therapist. This is an example that you can bring to your next session with a therapist, or work on in collaboration with an in-school counselor!
Each day or each week, you’ll move one step up the ladder.
Drive to school & park. Sit for 2–3 minutes, name the win, go home.
Stand by the school door. 2–5 minutes; practice breathing; leave while it’s still going okay.
Step just inside the door. Wave to staff, 2–5 minutes, exit.
Walk one hallway. Peek into classroom, greet teacher, exit.
Enter classroom for a short anchor activity. (e.g., 10–15 minutes of a calm, low-demand task).
Stay for ~1 hour. Teacher has a soft landing task ready (drawing, sorting cards, quiet reading).
Stay for 2 hours. Add a planned break with a calm tool.
Stay until lunch. Predictable check-in at mid-morning.
Full day with planned supports. Fade supports gradually as success builds.
How to pace it: Repeat each step for 1–3 days until it feels “pretty boring.” Then move up. If a step is too hard, step back one, get a few wins, and try again.
School Anxiety and Holding Firm Boundaries:
It’s much easier to keep school consistent from the start than to rebuild after lots of misses. For students brand new to the school, avoid offering late starts or early pick-ups unless you’re certain they cannot be successful otherwise. Gentle firmness helps anxiety learn, “I can do hard things, and my grown-ups believe I can.”
What helps:
Short, confident goodbyes (“Love you. You’ve got this. See you at 3:10.”)
Predictable plans (who meets them, where to put their backpack, what to do first)
Warm and firm boundaries (“I won’t leave you stuck. I will help you take the next step.”)
Read more about setting boundaries from Compassionate Counseling St. Louis Senior Therapist Molly Shaffer, LPC: Setting Boundaries for Anxious Kids in St. Louis with St. Louis Anxiety Therapist Molly Shaffer, MA, LPC
Partner with the school (you don’t have to do this alone)
Loop in your school counselor, teacher, and admin early. Ask for:
A soft landing: Greeted by a consistent adult; first task is predictable and easy.
A calm-corner pass: Short, timed breaks with clear return steps (2–5 minutes, then back).
Check-ins: One morning hello and a mid-morning thumbs-up.
Reduced public demands: No cold-calling while anxiety is high.
Transition supports: Help moving between loud spaces (hallway, cafeteria, specials).
Quick email template to start the collaboration:
Hi [Counselor/Teacher],
I’m reaching out because [Child] is experiencing school anxiety, which can look like tears or refusal at drop-off. We’re using a 3-step plan (Identify, Calm, Game Plan) and a gradual exposure ladder. Could we set up:A consistent morning greeter and soft-landing task
A short, timed break option (2–5 minutes) with a clear return
One mid-morning check-in
I’m happy to share our ladder and check in weekly on how it’s going. Thanks so much for your partnership!
—[Your Name]
The 3 Steps in Action — real-life mini-scripts from me
Doorway standoff (elementary):
Parent: “New rooms can feel big. Makes sense this is hard.” (Identify)
Parent: “Pick our calm tool: 3 balloon breaths or wall push-offs?” (Calm)
Parent: “Great—now we’ll walk to the rug. Ms. Lee has your drawing ready. I’ll give a squeeze, then I’m heading out. See you at 2:55.” (Game Plan + firm goodbye)
Bus worry (middle school):
Parent: “First days can feel awful, even for confident kids. I’m wondering if you’re feeling a little anxious or stressed out.”
Parent: “Let’s calm down first. Would you want to do square breathing or a progressive muscle relaxation?”
Parent: “Awesome, we’re feeling calm and relaxed. Next is your bus ride to school. If it’s tough, use the counselor pass and do 3 breaths, then back to class.”
When to reach out for extra support
If anxiety is causing frequent school refusal, panic, angry outbursts, or grades/relationships are taking a hit, it’s time to bring in help. This is exactly what my team and I do every day at Compassionate Counseling St. Louis.
Support for Parents is Available
We know parenting can be the best job, and one of the hardest jobs! Navigating the beginning, middle, and end of the school year all brings unique challenges for parents. This is why we offer Therapeutic Parent Coaching at Compassionate Counseling St. Louis - because parents need support too.
Looking for More Support?
As St. Louis anxiety therapists, Compassionate Counseling St. Louis specializes in working with kids who struggle with the return to school. You can schedule your free consultation call with Compassionate Counseling St. Louis to learn more about how your child can benefit from working with our team of St. Louis therapists.
You can read more from our team in these blogs:
Trauma-Focused CBT for Weather Related Anxiety with Molly Shaffer, LPC
Curious to learn more about support for your child and your family at Compassionate Counseling St. Louis? Reach out to us at hello@compassionatecounselingstl.com. As child anxiety experts, we love working with kids, teens, college students and parents to help manage their anxiety, stress, and anger. Compassionate Counseling St. Louis is located in Clayton, MO and works with families throughout St. Louis City, St. Louis County, Ladue, University City, Town and Country, Webster Groves, Creve Couer, Kirkwood, Richmond Heights, and Brentwood. We also provide online therapy Missouri wide to teens and college students. You can set up your first free consult on this website, on our consultation page.
