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Emotionally Based School Avoidance

Emotionally Based School Avoidance

Emotionally based school avoidance (EBSA), also known as anxiety-based school avoidance (ABSA) is a broad term used “to describe a group of children and young people who have severe difficulty in attending school due to emotional factors, often resulting in prolonged absences from school.” There is no single cause for EBSA, rather it is likely caused by a confluence of contributing factors. Certain triggers can bring on a young person’s emotionally based school avoidance. Staffordshire City Council explains that there may be one key trigger or several triggers for anxiety related to attending school, including the following examples:

  • Changes to class structure / teachers / routine
  • Poor class behavior / inconsistent classroom management 
  • Not understanding work 
  • Fear of getting something wrong 
  • Fear of exams / poor performance 
  • Group activities  
  • Break and lunchtimes (social anxieties) 
  • Bullying/peer pressure 
  • Being away from loved ones for some reason (separation anxiety) 

It is well recognized in the research literature that EBSA is often underpinned by several complex and interlinked factors, including the young person, the family, and the school environment.

Signs and Symptoms 

The signs and symptoms of emotionally based school avoidance mimic those that present in young people struggling with traditional school phobia, including but not limited to the following examples, provided by Harvard Medical School:

  • Refusing to get dressed in the morning
  • Purposefully missing the bus to school
  • Constant complaints of different physical ailments
  • Neglecting to do homework
  • Anxiety
  • Weight fluctuation
  • Depression
  • Social isolation

Most adolescents who experience emotionally based school avoidance are unable to articulate their discomfort and do understand the cause of their symptoms. When a teenager goes to a doctor for his or her physical ailments, frequently no illness or medical diagnosis will be found.


The treatment process for emotionally based school avoidance begins with undergoing a medical evaluation to rule out the presence of a physical illness. Provided the teen is physically healthy, there are a variety of subsequent treatment options available to help navigate EBSA. The purpose of treatment for young people that are school avoidants is to provide them with applicable coping mechanisms to deal with the inevitable pain and discomforts that can occur in one’s life. Everyone is different and will require a customized treatment plan to achieve the best possible recovery outcome. Certain therapeutic modalities that are commonly integrated into treatment plans for adolescents struggling with emotionally based school avoidance may include cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), mindfulness-based cognitive therapy (MBCT), and/ or expressive arts therapies. There is no universal way to treat EBSA, as the specifics of one’s treatment process are entirely personal and will be exclusively informed and guided by each young person’s distinctive needs. 

For Information and Support

Every family in need of mental health treatment must select a program that will best suit the needs of their family. When one member of a family struggles, it impacts everyone in the family unit. To maximize the benefits of treatment we work closely with the entire family to ensure that everyone is receiving the support they need through these difficult times.

Seeking help is never easy, but you are not alone! If you or someone you know needs mental health treatment, we strongly encourage you to reach out for help as quickly as possible. It is not uncommon for many mental health difficulties to impact a person’s life, in the long term. Pursuing support at the beginning of one’s journey can put the individual in the best position to learn how to manage themselves in a healthy way so they can go on to live happy and fulfilling lives.


We are available to answer any questions you may have regarding mental health treatment and our residential program, anytime. Contact us today using the form to the right.

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