School Refusal Program

School Refusal Program

One definition of “School Refusal” is “child motivated refusal to attend school due to an emotional or psychological difficulty.” (Kearney, 2007)

Children may exhibit full or partial school refusal behavior for varying reasons. School refusal behavior occurs for one or more of the following reasons:

  1. Avoidance of situations, people, or places that induce a sense of negative emotion (i.e. when a child is being bullied, fear of the classroom or bus, etc.);
  2. Escape from aversive social or evaluative situations (i.e. public speaking, worries about peer involvement or social interaction);
  3. A perceived need to stay at home;
  4. Powerful reinforcers outside of school (i.e. video games, internet and sleep).

If not identified and treated, school refusal behavior has severe short- and long-term consequences. The longer a child refuses to attend school, the more difficult it becomes to get a child to go back to school.

Research has shown that traditional treatments for school refusal have had limited success. Therefore, we at The Koch Center have chosen to base our program on a cutting edge treatment protocol for school refusal called “Dialectical Behavior Therapy – School Refusal” (DBT-SR). DBT uses multiple modalities to directly address the emotional and behavioral dyscontrol that drives and maintains school refusal behavior. Unique to this treatment is that we focus on helping students and parents negotiate the morning time period, which is typically the most difficult and crucial time of day with respect to school refusal. Our School Refusal Program also addresses both the positive and negative reinforcers that are associated with school refusal behavior and any comorbid psychiatric disorders.

We offer a comprehensive evaluation that allows us to establish an intensive individualized treatment plan for school refusers and their families. This program is for children of any age (Elementary School through High School) who exhibit full or partial school refusal behavior.

Our treatment protocol includes:

DBT Skills Training for Parents and Child
Individual DBT Therapy for the Child
Weekly Parent Meetings with a DBT Therapist
Collaboration with School Personnel and Outside Providers

If you would like to schedule an initial evaluation or if you have any questions, please call Dr. Cyndi Koch at 201-670-6450 x1 or email