School Refusal: Just a phase? Or is it Anxiety?

Welcome to our Back-to-School Blog Series! This week, we are featuring a variety of professionals who are sharing their expertise to help make the back-to-school transition a little bit easier for students, parents, and educators. Today’s post is written by Katie D’Fantis of Inner Harmony Counseling:

Does this sound like a typical school-day morning with your teen?

  • Getting your teen out of bed and to school on time is a chore.

  • There’s so much arguing on school-day mornings that you often give up or feel like giving up.

  • You’ve lost track of how many days of school they’ve missed or how many times you’ve called them in late.

  • Your teens distress and refusal to go to school has caused you to be late for work most days.

As a counselor who works with older teens 16 years and up, I’ve seen the difficult effects school refusal can have on the teen and their parents.

Possible Causes of School Refusal

Sometimes school refusal is in an attempt by the teen to avoid something unpleasant. Maybe a test they didn’t study for or a class they’d prefer to miss. Sometimes school refusal is a temporary issue such as when school starts back up after summer or winter break. It’s common for worries to flare up then but once the teen gets back into a routine, the worry usually decreases.

Sometimes school refusal isn’t just full school days missed but multiple days tardy, leaving school early, or numerous trips to the nurse. It’s important to note that anxiety in kids and teens typically manifests in somatic symptoms, such as a stomachache or a headache. It’s important to make an appointment with your teens pediatrician to be sure there isn’t an underlying medical issue that needs attention.

When tardiness, leaving class, or school refusal become an ongoing issue, this may point to the presence of a diagnosable disorder such as generalized anxiety disorder.

Let me start by saying that this article is not intended to help you diagnose your teen. In our “WebMD world” today, it’s important to remember that diagnosing should be left to a licensed professional who administers a diagnostic assessment in person. The purpose of this article is simply to help you gain a basic understanding what generalized anxiety may look like.

So what does generalized anxiety disorder look like in teens?

Teens who are struggling with anxiety may have difficulty concentrating, experience muscle tension, may often feel irritable or on edge, fatigued, or may have difficulty falling or staying asleep. When I talk to teens who have missed multiple days of school, they often share that they feel completely overwhelmed by the piles of work that need to be made up. And the fact that they may already be flunking the class doesn’t help to motivate them; it simply creates an even more pronounced feeling of helplessness. You or I may think “Well, what’s the problem? Just take it one assignment at a time!”, but anxiety doesn’t work that way. Anxiety only allows the teen to see the enormous, daunting pile of work in front of them in its entirety and not the smaller, more manageable parts.

Your teen needs coping skills and strategies to manage the feeling of being overwhelmed, help with that feeling of helplessness, and support for all the ways anxiety affects other aspects of their life. Do them (and yourself!) a favor and talk to them about their willingness to work with a therapist. Email or text them the link to Tell them to type their zip code in the “Find a Therapist” search option, scroll through the pictures and bios of the clinicians in their area until they find someone who works with teens with anxiety and who seems like they’d be a good fit. And if your teen doesn’t jive with the first counselor they meet, don’t make them go back. Help them find a counselor that they feel comfortable with and who seems genuine and trusting so they can start moving towards a life where school isn’t plagued with anxiety and you can begin to feel hopeful for smooth and steady school-day mornings with your teen.

About the Author

Katie D'Fantis is an LPC, an EMDR (Eye Movement Desensitization and Reprocessing) clinician, and the owner of Inner Harmony Counseling in Brecksville, Ohio. She works with older teens and adults and specializes in helping those who struggle with anxiety, depression, PTSD, grief/loss, self-esteem, codependency, relationship and communication issues. For more information about Katie’s practice, visit, call 440-630-0126, email, or find Inner Harmony Counseling on Facebook at

What Does Anxiety Look Like in Kids? Well, a Lot Like Anger.

Welcome to our Back-to-School Blog Series! This week, we are featuring a variety of professionals who are sharing their expertise to help make the back-to-school transition a little bit easier for students, parents, and educators. Today, Georgie Gray, social worker and owner of Georgie Gray Counseling, will provide us insight into anxiety in young children:

We all know what anxiety is... right? It’s one of those concepts that seems straightforward until we try to define it. We might say it is worry or stress, and that is true. But what does it really mean, and what does it look like in day to day life?

Maybe for you it’s dreading an important meeting at work or feeling the constant pressure of making your paycheck cover your expenses. These thoughts and feelings might color the background of your daily life, dulling everything else, and making you short-tempered and irritable.

This is exactly what happens when kids feel anxious. Anxiety, stress, and worry come from different sources for kids but the result is the same: anxious kids have less room for the good stuff of life because dealing with stress takes so much energy.

So, what does anxiety look like in kids? It looks like a tantrum about how you didn’t say, “good morning” the right way. It looks like rigid rules about how to correctly pack one’s backpack before school. It looks like bedtime battles, quick tempers, and tears. In other words, anxiety in kids often comes out as irritability and anger (very much like adults).

The difference is, adults are better able to name what is happening (“I’m so stressed about money”) and take steps to cope, like making a budget, venting to a friend, or exercising, for example. Kids just don’t have the insight and experience (yet) to feel help themselves feel better.

There are several things parents can do to help:

Behavior is Communication

Understand that children’s behaviors are their way of expressing themselves (not just their words). Anger and tantrums are your child’s ways of saying, “Things feel terrible inside me right now.” Try not to get caught up in your own worries (like: “My kid is manipulating me”). Let go of the idea of figuring out why your child is behaving the way he is, at least for the moment. Focus instead on the goals of helping your child feel better right now, and supporting him in learning new skills for feeling better in the future.


Problem-solve with your child about the things he seems to struggle with most. For example: “It seems like packing your backpack stresses you out. Is there anything we can figure out together to make that easier?” Collaborate on solutions. Offer your support and guidance. If your child feels that you are on his team, he may be able to offload some of his stress, and his behavior may improve. Together try to come up with strategies for coping with anger the next time your child is upset. For example, taking slow, deep breaths; squeezing a stress ball; listening to music; or running, jumping or dancing to use up nervous energy.

Talk about It

Invite your child to talk about what is on his mind. Avoid putting your child on the spot or asking too many questions. Instead, just spend time near your child, doing things you both enjoy. Talking about emotions makes people—kids and adults—feel vulnerable, so take care to honor the signals your child is giving about his comfort level. Set yourself up as a good listener, not a good advice-giver. You’ll get much further that way. Side-by-side activities often work best for conversations like these, such as riding bikes together or driving in the car; things feel less intense when there is no chance for eye contact, and when the talk feels more spontaneous.

Show Support

Use your body language and attention to convey that your child is enough, just as he is. This is a powerful message, and the more we send it to our kids the better they will feel. When kids believe that their parents love them, warts and all, they feel less afraid to try new things, and to make mistakes (often what kids worry about most). Send your child a “you’ve got this” look, or touch his shoulder to let him know you’re there, you support him, even with all his big and hard-to-understand feelings.


Most important of all: try to have empathy when times are tough. Try to see your child’s tantrums, irrational behavior, tears, and drama through a new lens, the lens of anxiety. Though you may never know exactly what feelings are underneath your child’s behavior, empathy goes a long way toward making things better. After all, when you’re frantically trying to get out the door in the morning for that dreaded work meeting, doesn’t a kind word feel better than somebody sternly saying, “it’s not that big a deal, pull yourself together!”? I know it does for me.

About the Author

Georgie Gray, MSSA, LISW-S, is a therapist in private practice with over 20 years’ experience working with children and families. She works primarily with families with children ages 10 and under, and specializes in anxiety, depression, peaceful parenting, attachment, and trauma. Georgie’s work is home-based, not office-based, because of the unique opportunities that provides for understanding families’ issues and needs. You can contact Georgie by phone (216-225-3859) or e-mail ( For more information about her practice, visit her website:

5 Tips to Help to Help Ease Back-to-School Anxiety

Welcome to our Back-to-School Blog Series! This week, we are featuring a variety of professionals who are sharing their expertise to help make the back-to-school transition a little bit easier for students, parents, and educators. Today’s post was written by Allison West Kaskey of West Counseling and Consulting:

Returning to school after summer break can cause increased anxiety for children. Transitions can be especially difficult for children with anxiety, autism spectrum disorders and ADD/ADHD. This can be a stressful time for the child, parents, and the entire family. It is normal to feel anxious during times of change and transition. However, if anxiety is interfering with your child’s ability to return to school or to perform his or her daily activities, here are a few tips on how to ease the back to school anxiety:

Encourage your child to share their fears

Ask him or her to be specific and allow them to be the expert and problem solve. For example, “If _________happens, what could you do?” or “Let’s think of some ways you could handle that situation” or “What has worked in the past, when you felt this way.”

Create a routine

Ease your child back into a school routine by waking up, eating, and going to bed at regular times, and gradually limiting screen time on devices. Continue everyday activities as normal. To involve your child ask him or her to help plan school lunches for the week and pack their backpack in advance together. If your child would like, have them pick out their outfit for the first day or the week.

Develop a plan and reward system

Discuss the schedule for the week ahead and allow your child to plan an activity and/or reward that they will look forward to each day or each week. For example, allow your child to pick out a snack every day after school, choose a game to play, or t.v. show to watch each evening. Then at the end of the week, allow your child to plan an outing of their choice, for example going for ice cream, to the zoo or to see a movie.

Teach and practice coping skills

Here are coping skills to use when your child is feeling nervous, such as journaling, artwork, or using methods such as How to Do Calm Breathing, Developing and Using Cognitive Coping Cards or Creating a Worry Box (see links below).

Remember: Easing anxiety is a process

It takes time to adjust to a new schedule. Be patient. It is normal for children to have trouble for a week or two after a break or the start of school. Each day can bring new challenges. This is especially true for older students, who are navigating new classes, different teachers and schedules.

When to seek professional help

There are some warning signs that your child may need some extra help. Here are a few: If after a few weeks you see your child is still struggling, not wanting to go to school, finding it difficult to perform normal activities, feeling increasingly anxious at nighttime seek help from a professional.





About the Author

Allison West Kaskey is a Licensed Professional Clinical Counselor and Educational Specialist. She has over 20 years of experience in the helping profession. She has worked in a variety of counseling and higher education settings with a wide range of roles. Her specialization is in working with clients with disabilities, specifically clients on the autism spectrum. She is the owner, counselor and consultant at West Counseling and Consulting in Richfield. She provides individual, couples and family counseling and consulting. For more information about Allison’s practice, call (216) 532-3168 or visit her website at:

Addressing Unhelpful Thinking Styles: A Coping Strategy for Students Experiencing Anxiety

We are pleased to welcome Katie D’Fantis to the Achievement Advantage Blog.   Katie is an LPC, a board certified music therapist, and an EMDR (Eye Movement Desensitization and Reprocessing) clinician who works with teens and adults. She specializes in helping those who struggle with relationship issues, anxiety, and issues of self worth that stem from adverse life events such as grief/loss, abuse, and other traumatic experiences.  You can learn more about Katie's experience and services she offers, by visiting The Balanced Living Center's website.


You can often hear me ask my clients “Where do you feel [that emotion] in your body?” And very often when the emotion they’re feeling is anxiety, my clients say they feel it in their head like “a dark cloud” or “a tornado” or like “static on a television set”. If you have ever struggled with anxiety, then you know that anxiety clouds your thoughts, perceptions and beliefs about yourself, others, and your experiences within the world. I have heard countless stories from my clients who are students and/or professionals about how these unhelpful ways of thinking have gotten in the way of their school work, preparing for a test or presentation, trying something new, or going out with friends on the weekend. As we embark on a new school year - a time when anxiety can run high - I want to share with you a tool that I find myself teaching almost every one of my clients at some point in our work together.

Below is a list of Unhelpful Thinking Styles. These are unhelpful ways of thinking that we all use from time to time and you may find that there are a select few that you use more often. Here are the steps to using this as a coping skill to develop more helpful ways of thinking:

Read through the left column and take note of which unhelpful thinking styles you have used in the past/noticed yourself using presently. Become familiar with the ones you use most often.

Over the next week, just notice when you use an unhelpful thinking style. You will most likely notice you’ve used it after the fact; this is completely normal and is a step in the right direction!

Name It
Once you’ve noticed it, name the unhelpful thinking style. Just naming it and calling it what it is helps to diminish its power in the moment. For example, “I’m totally going to bomb this test! ...oh wait, that was me jumping to conclusions. I always do that before a big test, don’t I?!”

Work To Change It
Now it’s time to familiarize yourself with the right column of the page. These alternative responses are the ideal/more positive ways of thinking.  Over time and with continued work to improve your self-awareness, you’ll become better at noticing when you use these unhelpful thinking styles. Then you can work to change them by substituting the unhelpful thought with the alternative responses. Or, better yet, you’ll be able to anticipate the unhelpful thought, stop it before it happens, and the alternative responses will become your default way of thinking.

Wood, J.C. (2010).  The cognitive behavioral therapy workbook for personality disorders: A step-by-step program.  Oakland, CA: New Harbinger Publications, Inc.

Wood, J.C. (2010). The cognitive behavioral therapy workbook for personality disorders: A step-by-step program. Oakland, CA: New Harbinger Publications, Inc.

Mastering these steps will take practice. Don’t forget to have compassion for yourself and to be patient. Think about it this way, you’ve likely spent years perfecting these unhelpful styles as your default, so naturally it would take time to change your default way of thinking. Practice makes permanent.

Wishing you all a successful start to the school year!