In most cases anxiety or fear on the part of the child or adolescent who is experiencing school refusal is obvious. What may not be so obvious is the obsessive and overwhelming worry of the sufferer.

Be clear anxiety is fear. When anxiety results in avoidance of the threating scenario a phobia is present. This dynamic worsens with time. Belief that the child will grow out of the problem is an investment in futility and pathology. Sufferers need to learn their way out of the problem.

This is why understanding and negotiating change regarding the avoidant-dependent dynamic, which is usually an ingrained dynamic in the family culture, can be a daunting challenge, but is crucial for healing.

The reason for this is that the sufferer does not have initiative for healing due to the breakdown in functioning that has occurred. Fear of panic, obsessive worry, and irrational thinking rule. While many sufferers are intellectually intelligent emotional intelligence is very much at risk.

A requirement for effective treatment is that parents/caregivers leaning an empowering and non-enabling strategy in addition to individual therapy. If this does not happen parenting dysfunction will “enable” the “addiction to school avoidance.