School Refusal Behavior: A Narrative Review

Abstract

This narrative review aims to identify key concepts associated with school refusal, including various risk factors, and to discuss current practical assessment and treatment methods available or under trial. For this study, we searched MEDLINE and Scopus databases for articles containing keywords like “school refusal” and associated keywords such as “childhood,” “adolescence,” “risk factors,” “interventions,” and “assessment.” Thirty-eight original articles in English containing these keywords, published in the last 10 years on the above platforms, were included. We excluded studies focusing on school refusal solely in a subset of the population, such as autistic children or immigrant children. This review found that in India, school refusal is often ignored, especially in lower socioeconomic families, due to non-affordability and poor access to appropriate resources, and is sometimes also equated with truancy and bad behavior. Various risk factors at the parental and school level promote this behavior, and therefore, appropriate interventions at these levels are necessary. As per current evidence, psychoeducation and multidisciplinary treatments are the most effective in managing such children. Early detection of such cases and coordinated efforts by all stakeholders are crucial for effective intervention.