Emotionally Based School Refusers

Emotionally Based School Refusal

For most pupils attending school can be a real challenge at some point or another. For some however, this challenge can become unmanageable and the young person’s anxiety becomes so prominent that they stop attending school all together. Emotionally Based School Refusal (EBSR) is a term used to describe children and young people who experience challenges in attending school due to negative feelings (such as anxiety). It is commonly associated with emotional and physical distress, and a reluctance to attend school, which can lead to reduced attendance and further anxiety regarding school (Somerset County Council, 2022).

When anxiety is linked to school avoidance, the young person may experience anxious and fearful thoughts around attending school and their ability to cope with school, which may be accompanied by physiological symptoms of anxiety. This creates a cycle which reinforced the behaviour of avoidance (Staffordshire County Council, 2020).

Figure 1: Taken from ‘Supporting children with Anxiety in the COVID-19 Pandemic’ by Dr Tina Rae

Signs of EBSR

Symptoms and signs could include:

• Fearfulness, anxiety, tantrums or expression of negative feelings, when faced with the prospect of attending school.

• They may complain that they have abdominal pain, headache, sore throat, often with no signs of actual physical illness.

• Complain of anxiety symptoms that include a racing heart, shaking, sweating, difficulty breathing, butterflies in the tummy or nausea, pins and needles.

The symptoms are typically worse on weekday mornings and absent at weekends and school holidays.

What should you do?

  • The role of a parents and carers is crucial; your expectations and the way you respond to the young person can greatly impact how they perceive themselves and school
  • It is vital that you remind your child that it important to go to school and let them know that you will support them to attend
  • Use the ‘Do you worry about going to school’ resource below to talk to your child about their anxiety and try to establish what worries them about school
  • When the young person talks about school, listen to them and acknowledge that their fears are real to them, but also remind them that there are ways to manage anxiety and encourage them to build resilience
  • If you feel that you need extra support to assist the young person with their attendance, then you should contact the young person’s Pupil Support Leader
  • If appropriate, a referral may be made to the Support for Learning department

Figure 2: Taken from ‘Do you worry about going to school’: West Sussex

Educational Psychology Service


  • Try to resolve issues in your current school rather than suggesting a change of school; research shows that the difficulties often re-emerge in a new school and the change does not help with anxieties
  • When you talk about school and start to work on a return to school plan your child may show more unhappiness – prepare yourself for this
  • It can be a difficult process that takes time however be firm and consistent in your expectations of the young person. The language that you use can also be powerful so consider how you phrase things:

Figure 3: Taken from ‘Managing school anxiety – Parents and carers’ by the Edinburgh Working Group on EBSR.

  • Keep an optimistic approach; if your child fails to attend school one day, start fresh again the next day.
  • Remember attendance is likely to be more difficult after a school holiday, period of illness or after the weekend.

There are resources which can help you to better understand EBSR. Use the attachments and link below to access these. And remember, early intervention and a united approach shows greater success in helping a young person to improve their attendance and manage anxiety.

  • Do you worry about going to school? Information booklet for young people
  • Managing School Anxiety – Advice for Parents and Carers: Edinburgh Working Group on EBSR
  • Emotionally Based School Avoidance (EBSA) Information for parents and carers: West Sussex

Support Services for Education: Older Children and Young People – EBSA guidance | Support Services for Education