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What is School Refusal: The Causes and Effects of School Anxiety on Teens

When your teenage son or daughter adamantly refuses school attendance, it's an alarming scenario. As a parent, questions swarm your mind about the reasons behind this resistance and its origins. You may be uncertain how to best support your child during this perplexing time. Seeking guidance from seasoned professionals is imperative to help guide you through this challenging ordeal with expertise and understanding.

It’s concerning when your teenage son or daughter adamantly refuses to attend school. As a parent, you may have questions about what is causing this resistance. Parents often struggle with how to support their teens experiencing school anxiety. Seek guidance from experienced professionals who understand this challenging situation. Their expertise will be instrumental in helping you navigate and support your child.

In this episode, therapist Tiffany Silva Herlin, LCSW, and Gentry Peppin, a special education teacher at WayPoint Academy, discuss:

  • What is school refusal?
  • What are the signs of school refusal and how does it progress?
  • What are the potential causes of school refusal?
  • What are the big risks and effects of school refusal?
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If your adolescent is experiencing anxiety and emotional distress that are affecting their ability to attend school, we have the solution. WayPoint Academy has customized interventions that target the underlying causes and enable students to regain their confidence in learning. Our compassionate and knowledgeable team offers comprehensive care to help teenagers reconstruct their educational paths, reconnect with their social circle, and cultivate their mental wellbeing for a brighter future. Let us support you in this journey of healing and growth. To learn more about our services, call us at 801-334-2694

Listen To the Podcast:

An image promoting WayPoint Academy's Podcast on School Refusal. This Episode is called What is School Refusal: The Causes and Effects of School Anxiety on Teens

Interested in Learning More?

This is the first episode in WayPoint's podcast series on School Refusal. You can listen to episodes 2 & 3 by visiting these pages:

2. How To Help A Child With Anxiety About School: School Refusal Interventions for Teens & Their Parents

3. Help, My Teenage Child Refuses To Go To School Because Of Anxiety! When to Seek Professional Help for School Refusal

School Refusal Podcast Transcript:

Podcast Topics
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    Introduction

    Welcome. This is the transcript for our podcast on school refusal. Is your teen struggling with school refusal or are you uncertain about how to support your teen in overcoming school related anxiety? Then this podcast is tailored for you. Our goal is to offer helpful guidance and insight from experienced professionals who can help you navigate this challenging situation.

    My name is Tiffany Herlin, and I am a licensed clinical social worker, and today I'm interviewing Gentry Peppin. She's a special education teacher at WayPoint Academy, a residential treatment program that specializes in helping teens with anxiety.

    Please remember that this podcast is not a replacement for therapy. Please always seek a mental health professional for your specific situation.

    All right, Gentry, thanks for joining us today. Start with telling us a little bit about yourself and what your role is at WayPoint Academy.

    Gentry Peppin: Hi, I'm glad to be here. I've been working at WayPoint Academy since 2016. I started as a secondary math education teacher there and since then have gotten my special education endorsement as well as a master's in behavior analysis.

    Tiffany: Awesome.

    Gentry: And my role now is to provide support to both students and teachers and families. throughout their education at WayPoint.

    Prevalence of School Refusal at WayPoint Academy

    Tiffany: How many kids come to WayPoint, who start off with school refusal, do you think?

    Gentry: I would say, probably about 90 percent of our students have had some experience with school refusal.

    Tiffany: So, almost all of them.

    Gentry: Almost all of the students have had at some point some school refusal, whether that be for a short while, upwards of multiple semesters of school.

    Tiffany: I've heard that sometimes it can be even like two years of school refusal, which seems like a lot.

    Gentry: Yeah, it is. We have, you know, some students come in and it can be sporadic school refusal as well. So they'll go for a little while and then have a break and then go for a little while and then fall back into that pattern again and so they come in with all sorts of holes throughout their high school career.

    Tiffany: So you probably play a pretty important role at WayPoint because you've got these parents, who their kids are refusing to go to school and really struggling and really need your support and help.

    Gentry: Right. Yeah, and all our students, you know, their main goal is to graduate high school. It's not that they don't want their education or they don't want to go to school. They want to succeed. They want to find success and go on post secondary education and they just really struggle to get there and thrive in that school environment.

    What Is School Refusal?

    Tiffany: Well, let's talk a little bit about school refusal. But let's discuss the facts first, like, what is it? Well, before we get to what is it, I have a few things I want to share with the audience that I think if you're listening to this, you've already probably experienced a lot of these statistics, so that may not be new to you, but it might be for some of our families, but school refusal is actually about anxiety, right?

    Gentry: Right.

    Tiffany: And we'll dive more into that, like what could be driving that, but do you have anything to add to that?

    Gentry: Yeah. There's usually some underlying fear, anxiety that's driving not going to school.

    Tiffany: Yeah. Interesting enough though, school refusal is not a diagnostic category, like you're not gonna find it in the ICB 10 or the DSM 5. While it may not be diagnosed, a couple things, they're likely to meet diagnostic criteria for specific phobias such as generalized anxiety, social anxiety disorder, separation disorder. They might have symptoms of depression and meet the criteria for a diagnosis of that. So really interesting. There's usually something underlying this, like you just said.

    Gentry: Correct. Yeah, and that's different for every student, whether that could be anxiety, OCD, certain events that have happened, overarching things, but every student has some kind of underlying piece that's making it difficult to attend school.

    Tiffany: Yeah. Another interesting statistic is up to 28 percent of youth will experience some type of school refusal in their lives. So it's more common, you know, than we think. Anxiety disorder affects 31. 2 percent of children between the ages of 13 and 18 years old.

    More than 80 percent of children and adolescents with anxiety disorder do not receive treatment, which is shocking. There's these kids who could be getting help, which we'll talk more about what that looks like and support for parents who are listening. And then, this is probably no shocker, but chronic absenteeism is the strongest predictor of a student dropout, which probably the students don't necessarily want to drop out and the parents don't want them to drop out. So if you're listening to this podcast and you're experiencing this, like that's probably a lot of our parents biggest fear, right?

    Gentry: Right, yeah, that their child's not going to complete high school. We know how important the high school diploma is in this day and age. And so that's that first goal really with your education is to get to the end of high school.

    Tiffany: Yeah. Especially for their career, their future, their success. Okay, so what is school refusal? Big question.

    Gentry: Big question. And it looks different for everybody, but, you know, school refusal can look like the total refusal, not attending school at all, staying at home. It could be going in late some days, avoiding certain class periods, not engaging while there, avoiding, finding other places in the building to be. Drastic differences from student to student.

    Tiffany: I do want to point out that school refusal behavior was introduced in 1993, child motivation, refusal to attend school or difficulties remaining in school for the entire day.

    So, like you said, they're either struggling to attend or they're not remaining in school for the entire day. So, my next question is, you touched on this a little bit, but let's talk about some of the different types of school refusal that we see. What do you see and then I can touch on some that I've researched as well.

    Gentry: Yeah, I think for our students, when we're getting to the point of seeking residential treatment, we're seeing mostly outright refusal, not attending school, not coming at all for multiple periods, you know, multiple days up to months of missing school, but it can start out as just missing a day here and there, being sick, having symptoms of being sick to avoid going to school, going in late, having trouble getting going in the morning can be some of the precursors.

    Tiffany: Yeah, so maybe refusing to get up, missing the bus, right? And then what about like, I know there's some that are like unauthorized excuses, like parents don't know they're missing school. And then there's some cases where parents are maybe enabling and allowing some of the missing school. What does that look like?

    Gentry: Yeah. And sometimes parents can be, you know, providing those excused absences and not even realize, especially in the beginning, right? You think your kid is sick. They're having migraines, stomach aches, and you want your kid to stay home and feel better. And really, it starts to add up over time and then you realize, oh, there's something else underlying. It's not just sickness, that there's probably some anxiety going on underneath that that's leading to not wanting to attend school.

    Tiffany: Well, and if you're a parent listening, like if you have found yourself maybe, you know, allowing some of the absences, it's not, like, something that... what am I thinking of or trying to find? It's not your fault. It's easy when you have a kid with anxiety to want to create accommodations and to help your child with whatever challenges they're having.

    Gentry: Right, you want your kid to feel safe, you want them to find success, you want them to not be in pain or not feel well and then you find yourself later down the road, Oh, there might be something else going on that's leading to this.

    Tiffany: Yeah, I'll have to say I'm the first guilty of this where I've created, we'll talk more about parent accommodations down the road, but I've definitely been guilty of accommodating for my kids, you know, when they're feeling sick or have a stomachache or maybe there's something going on at school that they're struggling with, like, you know, that's my like initial reaction as a parent is like, I want to kind of protect you and make you feel better.

    Gentry: Right.

    Tiffany: So it's so natural as a parent, if you're listening, to fall into that. So I guess more I want to say to parents is don't beat yourself up if that's where you're at.

    Gentry: Correct.

    Tiffany: It's okay, it's normal and we're going to talk about how to get you support and work through this issue, right?

    Gentry: Correct.

    Tiffany: Yeah. So we talked about, basically unexcused absences. Then there's the school withdrawal, which, you know, calling home due to illness. Parents also might need help at home, especially if they have younger siblings or they're single parents and struggling with that or maybe they're even worried about something at school, like bullying or some type of situation.

    I actually just was thinking, I had a friend's little child who was struggling to go to school because when the fire alarm went off or they did the drills, it scared them and so the parent would sometimes keep them home whenever they knew there was a fire drill and things, because that really freaked them out. And then obviously we talked about the school refusal, missing the bus, refusing to go in, developing some type of physical symptom so that they don't have to go to school, or maybe they stay up late on devices and sleep in. They're up all night trying to self soothe and then they now have an excuse not to go.

    Gentry: Yeah.

    Tiffany: Am I missing anything?

    Gentry: No, I think that really hits it, you know, the big one of refusing to go. But we also see students who, you know, will get up and go in the morning and then feel overwhelmed throughout the day.

    Tiffany: Okay.

    Gentry: And do those call homes and start withdrawing from school and it's only natural probably as a parent, you know, your kid calls you either not feeling well or in distress, that you want to go pick them up and help them with that.

    Tiffany: Yeah, there's always like a moment as a parent that when you get that call, you have to, like, go through your head like, okay, is this real? Like often, I have to go through these questions like, have you drank in water if your stomach hurts? Have you eaten any food yet today? Can you call me in an hour? You know, or like, how real is this? And it's so hard to gauge as a parent. When you're not there and you don't know what's going on, you know, or sometimes they'll call you like, oh, they might have a fever, they feel warm, or they're coughing, or it's just so hard.

    So parents, if you're listening, like, please don't beat yourself up. This podcast isn't to say you're doing anything wrong or right. It doesn't matter. This is a hard situation to gauge as a parent.

    Gentry: It's gotta be. You know, I'm not a parent myself but, you know, I see the students even on a day to day and they start to feel bad in the afternoon, and, you know, as teachers in a residential facility, we play that guessing game with them, you know, where are you at? You know, is this anxiety related? And, or are you truly sick and need to go lay down?

    Progression of School Refusal

    Tiffany: Yeah. It's so hard to gauge. So, what does a progression... maybe we've talked about this, but it's not like someone goes from missing a few days to a year overnight, like there's some type of progression, right? Have we touched on that already or is there more?

    Gentry: We've hit that. You know, I think the biggest thing is to recognize that it's different for every student.

    Tiffany: Okay.

    Gentry: Some students might have a triggering event that occurs, you know, something traumatic happens at school, bullying starts to take place, and so you might see a change overnight.

    Tiffany: Okay.

    They might go from being A plus, attend everyday students, and then one day, a class doesn't go well, a grade drops, a test they bomb, and that instant anxiety starts to sit in. We see this a lot with our students who are perfectionists, have perfectionism and anxiety around getting that perfect A, and then something happens, they bomb a test and now that fear starts to kick in, and you can start to see that progression. So sometimes it's gradual, and I think other times it can really, just, overnight, due to an event that happened at school, that switch can flip.

    Tiffany: So it can, I mean, a lot of things that I've seen with researching this, it's like an occasional, it starts with maybe an occasional missing of class, or maybe they're, you know, tapping out because they're sick. Next thing they know, it's like missing weeks of school and then maybe parents progressing to homeschool or tutors and then there's this increased need for parental accommodation and then all of a sudden parents are realizing like, oh we're doing this for a year now or something longer, right? It's not just an occasional theme. We need help.

    Gentry: Correct. Yeah, you might see, you know, trying to change a school also is another one. Okay, this school's not working. Maybe we try a different school in the district or a private school setting. Oh, it's happening again. Now we can try at home tutoring and we continue to see that withdrawal and lack of engagement, even with the change of environment.

    Tiffany: So if you're a parent listening and you're finding yourself in this place where you've tried multiple, like, whether school, homeschool, switching schools, I kind of already said that, but, and you're still experiencing the school refusal, then that might be a good indicator, a red flag that there's more going on that you're missing. It's kind of like putting just a band aid on it, right? When you're doing these accommodations as a parent, if they're not solving it, you're really not getting down to what's really the issue and you're just putting a band aid on it versus helping it heal.

    Gentry: Correct.

    Tiffany: Yeah, and we'll talk more about when do you start seeking out support and other treatments as well, so stay tuned for that.

    School Attendance Model

    Tiffany: I don't know a lot about this, and I'd love you to teach our audience about what the school attendance problem model is. It's SAPs right? Is that correct?

    Gentry: Yeah, in the School Attendance Problems model, also we can look at it as the functions of school refusal, it's really trying to look and get at what is the root cause of the school refusal, right? School refusal is not a diagnostic.

    Tiffany: Yep. It's not diagnosed

    Gentry: It's not a diagnosis... It's not...

    Tiffany: It's not diagnosed. We can't find it in the DSM-5.

    Gentry: Correct. And so what we need to look at is why is this happening, right? Every student is different. Every student has had different experiences in school. It could be something even outside of school that's leading to it. And so that's what we're trying to get at is what's going on. So some of those are, we're looking at often escape, attention, or access to something else.

    Tiffany: Okay.

    Gentry: So there's a couple of different things they might be trying to escape from. One of those being negative stimuli in the school system. Something that provokes negative thoughts, negative feelings towards self, uncomfortability, and so they're looking to escape those feelings. They don't want to be in that situation.

    Tiffany: That makes a lot of sense, especially when you have anxiety involved, it's this need to remove the anxiety, right? So if there's this thing that is putting pressure on you, you want to get away from it.

    Gentry: Correct. Yeah. And that could be a specific class, a specific type, maybe group projects, presentations, tests, peers. Another one is escape from social situations. And we see that a lot with the social anxiety, generalized anxiety, where we're not sure how to navigate those, especially as students hit their teenage years, things get complicated.

    Tiffany: Middle school is the worst. Can I just say that?

    Gentry: It's gotta be.

    Tiffany: I have a daughter in middle school and I'm like, just... you're gonna make it. We all have to go through it. It's the right of entry into adulthood.

    Gentry: Yeah, and so that pressure, you know, outside of what's happening in the classroom is you have all these peer things you're trying to navigate and what if I don't have a class with someone I know, how do I navigate the hallway? That can cause a lot.

    Tiffany: Who do I eat with at lunch? What if no one wants to sit by me?

    Gentry: So that's another thing we might be trying to escape, those social situations.

    Attention, so they might be looking for better connection at home. They really enjoy being with their parents. Staying home from school is a time to be alone with their parents, gain that attention, do something fun, and gain access to that where maybe they're not feeling that need met somewhere else.

    Tiffany: Sure.

    Gentry: And then we also see the pursuit of access to tangibles, the reinforcement that they're looking for such as video games, TV, you know, hanging out at the park somewhere else.

    Tiffany: Get to read a book, yeah.

    Gentry: Anything but school, right? And then, and that can not only are they escaping maybe the anxiety provoking events but now they're also finding pleasure in other ways. And that reinforces that I don't want to be at school because this is more fun.

    Tiffany: Yeah. My girl's dad actually struggled with some of this, like not wanting to go to school and would find ways to fake being sick and being home and doing fun things.

    And so now, we have a strict rule at our house that when they're sick and I was just having this argument with my... she was genuinely sick. She was miserable. I did let her watch a few shows. But she was trying to convince me to let her play video games and I was like, we have this rule of like, if you get your schoolwork, you know, that you need to get done at home and we have piano as well, you get those done, then we can talk about video games. She's like, but I'm too sick to do those things, but I can really do fine at video games. And I'm like, I'm sorry, you can, first of all, thank your dad for this rule that we don't do video games when you're sick at home. In fact, we typically don't even let you watch TV, but it's for that very reason so that it's not like, Oh, when I'm sick and I get to stay home, I get to do these fun things and therefore I'm getting rewarded for it. It's hard when your kid's genuinely sick to, you know…

    The Behavioral Model of School Refusal

    Gentry: Right. Because you want them to feel better.

    Tiffany: Yeah. Like, oh, yeah, sure. Go play video games and watch all the shows you want. It's easy to want to fall into that yet, I was joking with her. I'm like, well, you can ask your dad why we have this rule, because your dad was really good at it as a kid.

    Gentry: Yeah. So really, really tracking down what are those underlying issues. And a lot of the times it's a combination of them.

    Tiffany: Yeah.

    Gentry: Right. So there's something anxiety provoking going on. We want to escape something. And then there's also a comfort that's happening at home, whether that be the attention or the access to video games, TV, whatever it may be, that then also rewards our brain for avoiding the anxiety provoking event.

    Tiffany: Yeah. So it's kind of like a behavioral model to it. Yeah, so if I heard you right, it's avoidance of something that provokes, like, a negative effect. Then you have an escape from something adverse. Then there's pursuit of attention, and then pursuit of a tangible reward.

    Gentry: Correct.

    Tiffany: So all those things typically allow and encourage the school refusal. That is really interesting and makes a lot of sense.

    So, let's talk about, we've talked about, I think, a lot of these. I have a list, but if we're missing any, I'm trying to think... Well, I'm going to list a couple things that I found on my research and you tell me if I'm missing any else on this, but what may be the cause of school refusal.

    Tiffany: A few things I found is, obviously we talked about bullying, poor teacher support, maybe they have a learning disorder at school, diagnosed with ADHD that can often, you know, they're really struggling to do well in school and they have this self-narrative that I'm not good enough or I'm not smart enough, so therefore I don't want to go to school. It's an adverse thing like you were talking about. Distress at school, social and separation anxiety from family and parents, school phobia. I talked about this fear of a specific object at school like a fire alarm. Parents separating, getting divorced, marital problems. Sometimes even just having a new sibling, birth of a new sibling, death in the family, new school, social anxiety. Is there any others? I mean, I'm sure we could list a ton more.

    Gentry: I'm sure we could list a ton. Yeah, I think we've hit the broad categories there where a lot of it comes down to navigating those feelings, those underlying feelings, right? With the bullying or perceived bullying or lack of being able to interact in social situations can lead to a lot of anxiety and a lot of our students don't have the tools to either ask for help, speak up about what they're feeling, even understand exactly what they're feeling themselves.

    Tiffany: Yeah. They don't have that insight often, I feel like, at that age.

    Gentry: Right. And they're lacking that insight and awareness and all they know is that this makes me not feel good.

    Tiffany: Yeah.

    Gentry: And what's the easiest way to avoid that, is to not be at school.

    Tiffany: Well, and sometimes even the somatic responses kids may be having are real.

    Gentry: Yeah.

    Tiffany: But it's to something that they're having anxiety over and they don't realize it. Our bodies are so interconnected to our emotions that oftentimes the somatic reactions that our bodies have can be related to something emotional.

    Gentry: Right, yeah. You know, we talk through a lot with our students on, you know, they might have a big presentation coming up that day and the joys of being a small school is you know that that big presentation is coming up that day and, you know, they wake up just not feeling well. And so you, you have that ability to sit down and walk them through why might you not be feeling well? Is it truly that you're nauseous and you're going to throw up because you have the flu? Or is it that something's coming up today and you're feeling anxious about that?

    I had, with my daughters, both of them I think struggled for a little bit of calling me with stomach aches around the same time every day.

    And I can't say that I really ever figured out what was causing the anxiety, but I eventually started being like, what's going on at school? Let's talk about what's going on at school versus, well, you're sick again. What do you need? And just instantly just bringing them home. You know, that's when I started pushing, like, let's give it an hour. Can you drink some water? And then trying to figure out too, was there something that was stressing them out at school, and typically there was, right, so.

    The Risks and Effects of School Refusal

    Tiffany: What are the big risks and effects of school refusal?

    Gentry: I think long term school refusal, you know, the biggest effect is dropping out or not graduating high school and the effect that that can have on their life, you know, that's, I think the big obvious one of not going to school, but also what happens to their self esteem through that process and kind of where then are they heading into adulthood, having this lack of ability to attend school and the negative, maybe social... or not social.

    Tiffany: Well, I think social for sure. I mean, school provides not only an education, but it provides a social arena that helps us develop skills into adulthood, right?

    Gentry: Right, yeah, so lacking that peer relationship, problem solving skills, and also I think a sense of self. You know, especially if there are students who have had a long history of school refusal, they're lacking that confidence in themselves. They feel defeated. I haven't done school. This is my fault.

    Tiffany: Yeah.

    Gentry: And now I don't know how to dig myself back out and so the longer that perpetuates, the more we just see it spiral into a deeper hole.

    Tiffany: Well, I'm sure they develop this self narrative of like, I'm not good enough, right? That core belief of I can't even complete school. All these people around me are smarter than me, complete school. And then what effect does it have into trying to, you know, get a job and go into adulthood? I'm sure that definitely feeds into depression and low self esteem and low motivation, like you were saying.

    Gentry: Yeah. It's got to make missing out on those core teenage years of building relationships, practicing that social skills as well as academic skills.

    Tiffany: Yeah.

    Gentry: Can really lead into troubles in adulthood.

    Tiffany: Yeah. So not only do we have the obvious drop in grades and possibly not graduating, but we also have this really important piece that I think is, I'm going to argue, at times more important than the grade levels, right?

    Gentry: I would agree with you.

    Tiffany: It is a social piece and the self confidence and the self identity that comes with this.

    Gentry: Yeah.

    Tiffany: How common is school refusal in teenage boys and girls with anxiety?

    Gentry: I think we see it very common to varying degrees. You know, some just anxiety about going to school, being there, but they can make it through.

    Tiffany: Yeah.

    Gentry: Leading up to on the severe end, refusing to go to school and longterm absentee, and that chronic absenteeism.

    Tiffany: Yeah, I agree, and I think it's going to be much more prevalent in teens who experience anxiety, regardless of their gender. So, like you said, in the very beginning we talked school refusal, it's about anxiety. I mean, that's really what I'm hearing you say over and over again is there's this underlying anxiety around something going on.

    Gentry: Right.

    Tiffany: So, does it look different for teenage boys versus girls?

    Gentry: You know, I think it can, but also not.

    Tiffany: Okay. I have some statistics if you want.

    Gentry: Yeah. If you wanna share statistics and then we can go into it.

    Tiffany: And we can talk about your experience with it.

    Gentry: Yeah.

    Tiffany: So often we find that school refuse was more common in girls than boys. But that doesn't mean we don't see it in boys. The things I found that girls tend to experience more, like, internal symptoms, which is no shocker to us, right? So they're going to have more anxiety and depression, body image issues, academic pressures, social challenges. Whereas boys, we're going to see more external symptoms. So, aggression, more kind of conduct disorder, maybe academic difficulties, bullying, social challenges as well. Does that sound about right?

    Gentry: Yeah, I think that's definitely the case although I think a lot of our boys will fly under the radar. Many of the students at WayPoint academy, you would actually probably classify more into those internal symptoms, where they were just withdrawing and holding those feelings and escaping into the video games and In the classroom, you would have no idea as a teacher, you know, when you have a classroom of 30 students, the student might just be sitting there keeping their head down, not causing any problems. And really it's all internal world that at some point then just blows up and they can't engage anymore.

    Tiffany: Yeah, that makes sense And it's no shocker, I mean, I think often we try to pair girls versus boys girls are more internal boys are more external but I don't think it's fair to say that boys don't have those internal symptoms as well and that, you know, we're built more similar than we are different.

    So there's a difference between primary and secondary anxiety meaning primary anxiety is that inherent predisposition to experience anxiety. So internal factors versus a secondary anxiety is caused by a direct or specific event, situation or circumstance, so external, like something happened at school versus internally, you know, maybe they're struggling with self esteem or struggling with ADHD or struggling with learning disorders, right? Does that make sense?

    Gentry: Yeah. So that primary anxiety could be, you know, we see a lot of students who struggle with OCD and it's not anything particular with school or an event that happened. But that OCD flares up in school, or that makes it harder to do school, which then leads to that school anxiety.

    Tiffany: Yeah, and with the secondary anxiety that we see how it relates to school refusal is maybe there's like, we've talked about this, but bullying, or maybe they don't get along with a teacher, or maybe they flunked, you know, bombed a test.

    Gentry: Right.

    Tiffany: There's gonna be these things that kind of... it goes hand in hand with both of those things, right? Probably contributes to this perfect storm.

    Gentry: Exactly. Yeah, the two of them together, some underlying thing that's going on and then also oftentimes an external event that happens that really flares up that anxiety.

    Tiffany: It doesn't sound like it needs to be one or the other. Like it probably is a mixture combination.

    Gentry: I would think so, yes

    Tiffany: Is there anything else we're missing about helping our audience understand school anxiety.

    Gentry: I think we've hit, you know, a lot of the root causes, the events that can be happening at school that can exacerbate the anxiety that leads to school refusal and the biggest thing is just looking at what is that underlying cause?

    Tiffany: Yeah.

    Gentry: Where is this school refusal coming from? What's contributing to it? Is it a specific event or is it an overarching anxiety, generalized anxiety, social anxiety that's occurring.

    Tiffany: So I think for our parents who are listening, if they are listening, you already are experiencing school anxiety. If you are listening, you probably are already struggling with your student with school refusal and anxiety. I guess what we wanted to help you start thinking and turning the wheels is what might be the root cause of that. What are some of the things that are driving this? Because again, it's easy to do those accommodations and to try to just, you know, fix the external things. But if you're not getting down to the root cause of it, it's not gonna go away.

    Gentry: Correct. You can put, you know, one thing is fixed or kind of glossed over and then another event comes up.

    Tiffany: Yeah, so I think it's important as a parent, rather than it's easy to hyper focus on the behavior, which is they're not going to school, but then doing that detective work and digging and we'll talk more about actually in the upcoming episode that we're going to do is the challenges faced by parents and teens and what support is there to help you through these challenges and to help you get, parents realize that you're not alone in this challenge. You really are not. This happens more often than not with any teenagers from 13 to 18 and we want to offer with the support we can on this podcast and give you some guidance on it.

    Thank you so much for joining us today, Gentry, and we'll look forward to our next episode.

    Gentry: Fantastic.