You Only Know What You Know Podcast | When School Feels Impossible: The Why Behind School Anxiety, Avoidance, and Burnout featuring Adam Honecker, LCSW
For many families, school anxiety doesn’t show up all at once. It may begin with a few difficult mornings, a stomachache before class, or a request to stay home “just this once.” Over time, those moments can grow into patterns of avoidance, anxiety, and stress that affect the entire family.
In this episode, Beth Hope, LCSW, and Britt Teasdale sit down with Adam Honecker, LCSW, Director of Compass Health Center’s Adolescent PHP and IOP Programs in Chicago, to explore what’s happening beneath the surface when school starts to feel impossible.
Together, they unpack the reasons kids and teens may avoid school, including anxiety, social pressure, perfectionism, burnout, and a need for safety and connection, and how parents can begin to respond with understanding rather than fear.
Throughout the conversation, they discuss how school avoidance can show up differently across ages, why physical symptoms like headaches and stomachaches are often part of the picture, and practical ways families can support their child while building resilience and maintaining their own mental health.
Listen to the full episode on Spotify, Apple Podcasts, or YouTube
Read the Full Podcast Episode 3 Transcript: The Why Behind School Anxiety, Avoidance, and Burnout
Britt Teasdale (00:05)
For many families, the school day doesn’t start with a backpack and a goodbye. Mornings may start with tension: getting your child awake, fed, and out the door. The worry follows you on the drive, hoping the school won’t call today. Instead of feeling comforted by the routine of the day, you’re bracing for what may happen next.
Beth Hope, LCSW (00:20)
School avoidance is more common than many families realize. At some point, it affects an estimated 5 to 28 percent of young people. It might start with a missed day here or there, leaving early, or frequent complaints about going, and over time, the pattern grows. This isn’t about defiance or a simple lack of motivation. Sometimes kids are trying to avoid situations that feel overwhelming. Sometimes the pressure comes from social or performance expectations. And sometimes the pull is toward safety, wanting to stay close to a parent, or finding that being at home feels more manageable.
Britt Teasdale (00:51)
In today’s episode, we’re slowing things down and discussing the why behind school anxiety, refusal, or avoidance, and how to support your child when these struggles show up.
Beth Hope, LCSW (01:00)
Our goal today is to help families think about school avoidance through a broader lens, not just how to get a child back into the building, but how to understand what they need to thrive. Joining us today is Adam Honecker, a licensed clinical social worker, and the director of Compass Health Center’s adolescent PHP and IOP programs at our Chicago location. He is a clinician who works closely with families navigating school anxiety, avoidance, and burnout. Adam, we’re really glad you’re here. Tell us a little bit about yourself and your professional background.
Adam Honecker, LCSW (01:26)
Yeah, thanks for having me. Yes, like you said, licensed clinical social worker. I have been in the field since 2009. I started working with kids in the foster care system, mostly doing individual and family therapy. And then I’ve been at Compass 12, 13 years, and that’s where I first started to see and work with school anxiety.
So here, day to day, I work with patients and their families and oversee the teams. And yeah, you see a ton of school anxiety and avoidance. And I think, the older I’ve gotten, the more I like working with parents. We’re going to be talking about them a lot today.
Britt Teasdale (02:00)
Adam, I’m curious, when we’re talking about school anxiety or school refusal, what do those terms actually mean?
Adam Honecker, LCSW (02:06)
I actually don’t typically say school refusal a ton to families I’m working with, because it really is more avoidance. I think refusal conjures this image of a kid crossing their arms, holding their breath, and saying, “I’m not going to go,” kind of stuff. And usually for me, really, avoidance is when the anxiety or the stress of going to school is so severe that a kid is literally not attending. It is not running late, it is not disorganization, it is really such overwhelming feelings that a person is not going to school and not engaging in their daily life.
Beth Hope, LCSW (02:34)
Is it always someone not going at all, or does it start smaller or look different from just not showing up ever to school?
Adam Honecker, LCSW (02:43)
No, I mean, I think it’s annoying when therapists say it sort of depends, but it sort of depends. It can look like so many different things. And I think that’s one of the tricky pieces is, you know, it can be a little bit clandestine at first. Some kids can be dragging in the morning and struggling to get out of the door. You know, you’re hearing about stomachaches, but there’s no actual illness that you’re aware of.
Kids showing up late, missing certain classes. There are a million different ways this shows up, and I know we will get into that, but no, it’s not just like, “I’m not attending.” I think we see this showing up in many, many, many different ways. And obviously that complicates how you deal with it as well.
Britt Teasdale (03:17)
Could you walk us through the different reasons a child or teen may be avoiding school?
Adam Honecker, LCSW (03:22)
We talk about that a lot in program, and there’s actually a whole assessment that is used to kind of dig into the functions of school refusal. These are things developed by Dr. Kearney and Silverman, but, you know, broad strokes, we understand the four main drivers that lead to school avoidance or refusal are staying away from distressing or negative effects. The refusal allows a kid to avoid feelings of dread, panic, physical discomfort, and things related to what happens in school. So like hallways, talking in class, presentations, being in a locker room, being at lunch, all the things of a school environment. And for us, we see that as really connected to anxiety.
Similarly, missing school to avoid and escape social situations, especially those that will involve some sort of evaluation and scrutiny. So, kids with social anxiety, or folks with social anxiety, we see this a lot. Things like group projects, small talk, performances in front of a class, things like that.
Another thing we see show up for one of the kind of reasons to miss school or to avoid school, the way it’s described is seeking attention, but what it really means is a young person seeking attention and connection and genuinely being with their parent. People will talk about separation anxiety, but a kid wants to be home and be present with their family.
The last umbrella term we think about is the function would be gaining tangible rewards, or missing school leads to other things where you might have time playing video games, screen time, time with friends. That’s one where some therapists use the phrase behavioral, but where a kid is engaging in other behaviors that have become more appealing, and joining those is more rewarded than going to school.
Britt Teasdale (05:01)
Over your time at Compass specifically, you said you’ve been at Compass for over a decade. Have you seen the number of kids that are showing up for help with school refusal increasing? Is it decreasing? What’s the current climate for school anxiety right now?
Adam Honecker, LCSW (05:20)
I think it’s been pretty persistent. I think it’s been an ever-present concern. Obviously, over COVID and after COVID, things looked a little bit different. But no, realistically, it’s looked very, very similar from my time. I would say the approach to the work has shifted a little bit. And I think we’ve hopefully all professionally gotten better at it. We’re doing a lot more exposure therapy.
And I think finding better ways to work with it. But I have not seen this marked increase one way or the other. Parents appear to have more information and understanding about it than, say, 10 years ago. I still think I talk to a lot of parents who will say things like, “It wasn’t an option when I was a kid,” and kind of discuss it as if it is this amazing option kids are exercising now, which I think we do see some concerns where there’s more opportunity to go than kids let on based on what’s shown up for them. But parents are coming in with a little bit more information and knowledge, for better or worse.
Beth Hope, LCSW (06:13)
Knowing how much pressure kids are under these days, and teens, whether it’s academic or… most of the schools that I’ve worked with recently offer a certain number of mental health days for their students because that’s the reality we live in. So how do I, as a parent, know, like, should I let my kid take another mental health day, and when does this require some sort of intervention?
Adam Honecker, LCSW (06:35)
One of the things I always try to keep an eye out for is if you see your kid deviating from things that would be aligned with their usual kind of values or goals. So if suddenly a kid who is plugged in, they seem happy at school, they have friends, they have clubs, they are in classes that they really like, and then you see them retreating or unable to engage in those things, that’s usually one thing I think to pay extra attention to.
From a higher level, I think just generally, anytime day-to-day functioning is impacted. I think every family has to make their own decision about whether a school has a mental health day policy and they’ve got five a year. There are some parents who would say, “We don’t believe in that, we’re not doing that, you just got to go to school.” And maybe that’s okay. If your family was like, “Sure, we’ll support that,” that’s also fine. But if you’re stepping past those, and suddenly you’re seeing, you know, grades decline, decreased time with friends, again, kind of pulling away from some of those preferred, typically pleasurable activities, I think that’s where, me as a parent, I would get worried. I know with my own kids, always paying attention to what is a marked change in what they used to be able to do or want to do. If I’m hearing, “I don’t want to do something” that a week ago you clearly had love for, and suddenly you’re claiming you don’t care about it anymore, I worry about that.
Britt Teasdale (07:41)
That’s interesting. How normal is it for a kid to want to just stay home because they’re worried about a test, like they didn’t study enough?
Adam Honecker, LCSW (07:51)
I think it’s super normal. I remember being a kid when I was sick and I was genuinely sick. There’s certainly an opportunity a couple of days into it, I would milk it and be like, “One more day. I’m not quite well.” And I would watch The Price Is Right and do whatever else most kids do. But there would always be that part of me that wanted to get back because I was bored and restless. I’m not saying pick up the phone, call a therapist, or worry about it if your kid’s doing something like that. But again, if it’s persistent and getting in the way of how they navigate daily life, then it is cause for at least more conversation with them, which is usually the next step anyway.
Beth Hope, LCSW (08:23)
You mentioned feeling sick, and earlier on you mentioned sometimes kids are reporting physical symptoms. And I know a lot of the families that I’ve worked with around this issue. Kids and teens are having significant, whether it’s headaches or nausea or frequent trips to the bathroom, stomach pain, and those physical symptoms are very real. They’re clearly not lying about it, and they’re happening every day. How do you suggest parents handle these things knowing their kid is physically or feeling sick, but really medically there isn’t something going on there?
Adam Honecker, LCSW (08:58)
The thing not to do is invalidate that they’re feeling those. Nobody wants to be told what you’re experiencing physically is fake, or it’s all in your head. That adds shame to someone who is already probably experiencing a fair amount of guilt and shame or whatever other complicated feelings they’re dealing with. But I think usually tying whatever physical complaints are coming up to a school’s policy or whatever they need to… If a kid’s saying, “I’ve got a headache” or “stomachache,” but they’re not naming fever, these things that would typically prevent you from going to school, and then probably exploring, and not in a way that wants to reinforce your taking them to the doctor all the time, but if this is several days in a row, saying you’re going to schedule a doctor’s appointment.
Kids can go to school and have a headache, too. But I think using some of, “This sucks, you feel crappy, you’re not contagious, you should be in school, and here’s why.”
Beth Hope, LCSW (09:46)
Sometimes people don’t really understand that mental health can cause very real physical symptoms. So, sometimes it’s educating everyone in the family about that. And to your point, sometimes you want to get something physically checked out. And at the end of the day, we want to build that resilience and help families and kids understand you can have a headache and go to school, especially if you’ve seen a doctor, this is mental health-related and we would treat that through mental health supports.
Britt Teasdale (10:13)
I think that’s so important, what you just said, Beth. We all hold stress in our bodies differently, right? I know when I’m super stressed, I get stomachaches. So, I can totally relate to that. I’m curious, how does this look different for younger children, tweens, teens? How are those physical symptoms different, if they are?
Adam Honecker, LCSW (10:19)
I think some of the physical stuff you’re going to see across the age range, especially in terms of nausea, headaches, stomachaches. I think in younger kids, we more frequently hear that as the kind of first thing discussed: “I have a headache, I’m sick, I can’t…” And in younger kids, you’re likely to see more kind of overt emotional things like tantrums, crying, screaming, more intense stuff.
A six-year-old feeling upset or sad is likely manifesting it differently than a 16-year-old who’s internalizing and looking sad and depressed. You see a lot of kids who are going slowly about the morning, not getting out of bed, requiring lots and lots of a parent coming in, shaking them and moving them out of bed and moving about things more slowly. I think the older you get, the more opportunity there is to physically assert yourself and say, “I’m just not leaving the house.” I see that a fair amount at Compass, where the kid’s struggling and they are generally so anxious and overwhelmed, they’re just not leaving the room despite having two parents hovering over them, calling them. I’m trying to talk to them on the phone but they’re just physically frozen or unable to move themselves.
Britt Teasdale (11:35)
If families are experiencing that, or maybe a lighter version of that, what are some tips or skills that they could start using in their home when mornings are tricky?
Adam Honecker, LCSW (11:45)
A lot of therapists, more and more lately, we’re using the phrase co-regulation, and I think just reminding ourselves as parents to keep ourselves as calm and collected as possible as a way to kind of model for kids: I can be stressed out, but also kind of manage. So, when we’re checking in, reminding them about going to school, we’re trying our best not to have elevated voices or yelling.
It’s extremely human and normal. I know you said in the intro something about mornings being these high-energy moments. And I think if you’re like me, I’m running out the door and saying, “I got to get to work. I can’t miss this meeting.” And then I’m finding my blood pressure rising and yelling at a kid. That’s not going to really translate well to them feeling less anxious. So, I think trying to be as calm and neutral as possible.
I think a lot of parents do it anyway but set timers and then disengage them for intervals too. So, if you’re talking to a younger kid and say, “I’m going to come back in and check in five minutes, and I want to see your clothes on, teeth brushed, whatever.” We do that in my house with basic morning routine stuff.
Britt Teasdale (12:41)
Yeah, and something that we were talking about with Dr. Levine on our previous episode, where she said if you’re working on new skills in your household or on a new behavior plan, that you only really have to get 85 percent of it right. And so just reminding parents that you don’t have to be perfect all the time. I know I’ve been there, I raise my voice sometimes, or you don’t get it right every time, and that’s okay.
Adam Honecker, LCSW (12:56)
I do think when working with therapists, sometimes parents get perfectionistic about going through some of these plans or suggestions and that they think if they mess up one thing, it was like resetting the clock. And I like that 85 percent idea.
You’re going to screw it up. There’s just no way around it. But you don’t have to refresh and reset. A lot of kids have that mentality too, which is one of the reasons getting to school can be hard. It’s that perfectionism and stuckness that happens.
Beth Hope, LCSW (13:26)
Obviously, this plays out differently in every household, and it’s going to depend on if you have an adult who stays home all day or works from home, or you have multiple children that you’re trying to get out the door, and you need to get to work. That really adds so much stress. I wonder, though, we talked about the different functions that underlie the school avoidance, and I know that we intervene differently depending on what’s going on. If a child is having severe panic attacks over social-related or performance-related things going on in school, versus they’re so low and depressed that they truly aren’t functioning in any areas of life, versus “I want to stay home because when I’m home, no one’s home and I’m going to sneak in and play video games.” Can you talk us through the different approaches we might take based on what’s going on underneath?
Adam Honecker, LCSW (14:14)
If we’re seeing someone’s home playing video games, they’re not exhibiting any other signs of anxiety, depression, lower mood; we probably are thinking about rewards and/or consequences and some more old-school plans along those varieties. I would say that’s not something I interface with a ton. I don’t work with too many kids where that’s the issue. A lot of parents wish it were that simple.
Typically, if you’re seeing that more marked anxiety and panic related to going to school, especially if it’s more on the social side, I think it’s always tricky, but we do want to be doing everything we can to eventually interface with school, but then we get into it in a really slow, deliberate way. I think that’s the common concern that we run into at Compass because our program is such that people aren’t going to school for a while. We want to keep on the tip of a parent’s tongue: yes, there’s anxiety. We might need to take a step back and figure it out piece by piece, but we’re also not taking the school off the table. So gradually exposing the things that are causing anxiety and doing that slowly and deliberately, but also building in supports, skills.
That’s usually deliberate, and you have to figure out from the kid what’s driving it in the first place.
Beth Hope, LCSW (15:17)
If a young person is avoiding school and we can’t get them to go, what are we recommending doing at home? And again, it will depend if a parent or an adult is able to be home at the same time as the child or not, depending on how old the child is. What are we suggesting that the kid does all day if they’re inclined or feeling up to not necessarily doing all of their homework?
Adam Honecker, LCSW (15:39)
Yeah, it’s usually when we sound like jerks as therapists, because what I end up telling 99 percent of parents is you’d need to help the home environment be supportive, but not particularly comfortable, if possible. So not having access to screens, creature comforts, things like that. Because yeah, The Price Is Right is cool if you’re sick for two days with, like, a stomach bug, but beyond that, we don’t want a kid who’s wanting to miss school because chemistry class is hard, or they’re having panic attacks, to suddenly find home to be this very comforting, soothing environment. Having some of those creature comforts inadvertently reinforces being home as the easier, better, softer option or just the more desirable option. So usually for parents I’m saying limit screen time.
Unless there’s academics that they could be doing. If a kid is at home occasionally, they can do some schoolwork while they’re home. But, beyond that, having it be dry and boring, as you’re concurrently trying to talk to them, get a sense of what’s actually going on, and explore those paths. But usually, the first advice I give is cell phone, TV, all those things. I think we need to be taking that away and having home be pretty, pretty dull and boring.
Britt Teasdale (16:39)
And just kind of to piggyback on Beth’s question there, I mean, it must be incredibly stressful and difficult for families who are going through this with their children or teens, especially when they need to leave the house to go to work. I mean, that seems so hard. What do you do in that situation? Your kid won’t go to school. You need to go to work.
Adam Honecker, LCSW (17:00)
Yeah, I mean, I think many, many different things. Obviously, I think we see plenty of parents, and if they have the access, if short-term time to be at home is possible, whether you can kind of flip to working remotely so you can be with your kid and getting other people in your life as supports. But I don’t think many families have that luxury, and working remotely today is not a thing.
So, I do think if your mornings are disruptive to that nature, that’s usually when you kind of call in somebody else, like try to start to explore other professional options. I think you can do that on a morning or two, but very few people have jobs or bosses that are so—
Britt Teasdale (17:30)
If kids are having a hard time going to school, it’s that severe that they really cannot go and it’s affecting all aspects of family life and work. How hard is it to get them to, say, a program like Compass’s? How does that transition happen?
Adam Honecker, LCSW (17:36)
I’ve been fortunate to not have to go through that process with my own kids. I talk to parents all the time about going through this. I do think programs like Compass or therapy, for a lot of kids, even if it sounds scary and the idea of going into this new environment could feel very similar, and frankly Compass, it looks like a school in a lot of ways. It can be very similar to the environment.
There is potentially relief in sight, at least coming for an initial discussion. Many people are able to do that. I think day in, day out, things like coming to a program like ours, if they are, it’s a very similar challenge. I mean, there’s a reason I’m on the phone with parents pretty much every morning trying to provide guidance and support. They were struggling with school, and now they’re struggling getting to Compass and implementing a lot of the same strategies.
I think it’s extremely difficult. I try to be pretty candid with most parents I work with that this is going to be hard when you start to dig into this because fundamentally, you’re asking your kid to feel more uncomfortable and more discomfort and more anxiety and more distress versus less. Like the easy thing would be to say, “Sure, stay home, watch TV, chill out.” But what you’re asking them to do is face their anxiety and work on stuff even more after they’ve already gone through a pretty rough period.
Beth Hope, LCSW (18:47)
Knowing that a lot of the avoidance symptoms, and I know we often see it in particular after kids and teens have been home for a weekend and they’ve had comfort and the pressures that come with school, are there specific recommendations that families can try either the evening before or over the weekend so that they don’t lose that momentum or they can help prepare kids for what is likely to come up in the morning if they’re really struggling?
Adam Honecker, LCSW (19:14)
Yeah, I mean, having all the checks and balances in terms of kind of morning routine, all the things that could potentially be hiccups, you know, basic stuff like having clothes laid out and backpack ready and some of the real fundamentals of you just have your ducks in a row to be walking out the door, I think can be really helpful so that there’s not opportunity for potential excuses or curveballs in the morning. So just having some of that real basic stuff figured out.
I do think it’s not what to do, but what not to do. Given this can be such a fraught thing, the morning time for families. And I think most parents, they’re going to bed on the Sunday night thinking, “Oh my gosh, I hope tomorrow morning is not as bad as it was last Monday and the Monday before that, the Monday before that.” Not getting into too many conversations with their kids about what they’re going to be attempting to do. Having it be matter-of-fact, like, “We’re going to school, it is the plan tomorrow,” but not getting into, “I hope tomorrow’s okay. Are you going to be okay tomorrow?” I think that only inflames some of the anxiety, and people use the phrase “Sunday scaries,” but that kind of thing that’s already in the kid’s head. That’s already there for sure. I think if you’re a parent thinking, “I hope tomorrow’s not that way,” at the end of the day, kids can be thinking that, too. If they’ve seen it 10 times, they’re pretty sure it’s going to happen again.
Britt Teasdale (20:18)
What are some tools that parents can use to work on that side of the equation for themselves? So, if they are feeling really anxious about that Monday morning or the school pickup, what are some tools that parents can use to ease what they’re going through alongside their child?
Adam Honecker, LCSW (20:33)
If there are multiple parents in the picture, it’s great if you have some sort of tag-team system where if you only have so much bandwidth to manage a certain situation, that you’re able to get reciprocal support from the other parent.
Ensuring that parents are feeling aligned on approaches and strategies, so they’re going to deal with the kid with the exact same kind of messaging.
I do usually advise parents that if there’s anything you would typically do for self-care or stress reduction while you’re dealing with a kid going through something like this, don’t pause it. And if you can double down on it, I think most therapists like the “put your own oxygen mask on before your kid’s on an airplane” analogy because fundamentally, it is necessary. So, if you normally go for a run, do that. Do the basic self-care things you can do.
Beth Hope, LCSW (21:25)
You mentioned earlier that exposure therapy can be a really effective intervention for some types of school avoidance. Tell us a little bit more about when we would employ that tool and if that is helpful, what kind of exposures would we be doing?
Adam Honecker, LCSW (21:40)
Yeah, it totally would depend on the school situation you’re seeing. For many kids, one of the first steps we’re talking about is gradual reintroduction to the things that were typically avoided and causing anxiety. So, we usually talk to kids about developing a hierarchy, and you talk about, “What’s the least anxiety-provoking thing of the things that are anxiety-provoking?” If talking in class is 10 out of 10, that’s the most anxious thing I can do, but asking my teacher a question is anxiety-provoking, but that’s like a 1 out of 10. After identifying those things through conversation, therapists can help your child tackle those triggers.
Every day you’re trying something new or every week you’re trying something new. It depends on the format you’re doing it. And usually trying to build in safeguards of other folks to collaborate with in that process. If somebody is worried about a teacher’s perception of them, then asking a teacher for extra work or asking a teacher a question after class ends is really hard for them.
We might want to work on prompting that exercise for the kid, but then also making sure they know, “I’m going to check in with my school counselor and they’re going to give me a little bit of support.” I talk it through with them, so they know they have a safe adult in the building who’s helpful in addition to that adult they were just talking to. For some, we might start really, really, really small. If getting to school in the first place was hard, one of the first things I talk to families about sometimes is, drive by the school on the weekend, go to the parking lot when school is not even in session, just be in the presence of this huge building that to them might be the scariest thing in the world. So really slowly facing the thing that is causing anxiety.
Beth Hope, LCSW (23:16)
I think on the flip side of exposures, my brain goes to accommodations. I’m not talking about necessarily formal accommodations like a 504 and IEP, although sometimes those things are helpful and necessary. I know there are ways to partner with schools, right, either in the short term or for a while.
For example, if someone is avoiding school because they’re having significant anxiety around being called on in class unexpectedly, there are ways to work with school supports, whether it’s a counselor or the teachers themselves, to ask that temporarily the child not be called on unless they raise their hand or give them opportunities to provide written responses or just present to the teacher. What would you recommend families explore with schools, what might be available, either to ease a kid back into school if they’ve really been avoiding or preventatively if it’s still in sort of minimal stages?
Adam Honecker, LCSW (24:19)
I think typically, first pass is usually reaching out to their counselor or advisor and making them aware that you’ve noticed some challenges and anxiety. Obviously, if it’s impacted attendance, the school may be aware of that already. But in my experience, at plenty of schools the counselor has a few hundred other kids on their caseload, and they’re not necessarily that aware. So, you have to make them aware.
And I think making them aware there seems to be an anxiety concern here or something related to their mood versus this kid’s ditching class, you know, so putting some context to it. And then some schools are a little used to relatively feisty parents who might be asking too much of them. So, I usually suggest entering gently and asking what is possible. And then many schools are very glad to give, like you said, informal accommodations. So, if it’s been a rough couple of weeks, can we have a conversation with Mr. Blank and figure out, can they step out for a sip of water? Can they talk about the presentation more informally?
And then there are opportunities to, of course, if you’re noticing persisting concerns and if you’re working hand in hand with a provider, asking what it takes to look into a 504 plan so there can be some more formal accommodations. And there are good resources online for that. A lot of extremely smart, well-versed parents are like, “I don’t know what a 504 plan is. How do I ask for it? How do you do this?” And there are form letters, and you can send it to the school, and then they have a certain amount of time to respond. We often work with parents on how to at least initiate that conversation. Worst-case scenario, the school assesses and says they’re not seeing the criteria, but it’s never wrong to ask the question.
But I think again, just reaching out to that counselor as a starting point. Again, I would suggest going in gently.
Britt Teasdale (25:53)
I think that’ll be really helpful for our families to hear.
How often does a single event lead to school anxiety and avoidance versus there are things that have been happening for a long time that lead up to not going to school? Are there things that they could start doing?
Adam Honecker, LCSW (26:17)
Right, every parent already struggles with hindsight is 20/20 and they’re like, “Oh, when they were six they were showing all signs of this, and I didn’t do anything about it. Should I have gotten a therapist earlier? Should I have talked to him about that kind of stuff?”
No, I mean, I feel like most parents I talk to almost wish there was something you could point your finger at and say there was one event that happened and now we can address it.
It’s rare, at least in my work, that I’m seeing a large-scale traumatic, stressful event happen and now the kid’s not going to school. Of course that does happen. I’ve worked with kids where there was something very public or something very difficult in the school, like a breakup or any number of kind of big social fallouts can lead to some avoidance.
But I think the stuff we see most of the time is unfortunately a lot more subtle and gradual, and it has more to do with what’s going on internally than it does with something externally you can point your finger at.
Beth Hope, LCSW (27:04)
All of us therapists like to say all behavior is communication, and most behavior is the communication of an unmet need. And so that just takes us back to the idea that if there is bullying happening, and that is why someone is avoiding school and having stomachaches, like we’re going to intervene very differently. But we need to understand. Maybe that child is afraid to tell us, or there is a learning or processing issue or something else that testing is going to help us understand, and that child learns differently and maybe needs accommodations or different teaching styles. And so again, there are so many reasons why a person might feel anxious about going to school or avoid going to school.
In addition to all the ones we’ve mentioned, that has to be the first step. And depending on what it is or who the child is, it’s not always easy to communicate, and they themselves might not have the words.
Adam Honecker, LCSW (27:58)
I talk to a lot of kids who almost feel betrayed by what’s going on because maybe school was this beautiful place for them for so long. And suddenly they’re like, “This was my place and now I hate it.” Sometimes that’s kids who are also not necessarily dealing with school anxiety, but it’s more like burnout and they’ve been just kind of grinding and grinding and grinding. And that might be a little bit of a different thing.
But I think it can be very confusing. Like, why is this different? I don’t know. When I talk to my eight-year-old, who’s often pretty anxious, like, “What are you worried about?” she says, “I wish I knew.” She doesn’t have words for it, and that only adds to it.
Beth Hope, LCSW (28:30)
And there’s kids with perfectionistic tendencies, like the kids that you just described, where school was where they were excelling, oftentimes without even having to try. And suddenly, the inability or need to do something completely is so overwhelming and grows to the point where they are paralyzed. They can’t turn in work. They are rewriting, not meeting deadlines, and so afraid to not get it perfect that they’re completely overwhelmed. Once you get to the high school level and beyond, a day of school or a specific project causes you to fall behind, and then you just see it snowball so quickly.
I think that can be really overwhelming for kids. And then that gets scary for families. I’ve worked with a lot of families where, let’s be honest, your kid is struggling to the degree that they’re not able to get to school and turn in their assignments. Then we start to talk about maybe it’s time to lighten the course load.
“But we’ve been on this track for so long that we are going to be in all AP classes. That is what we know this particular child is capable of.” The idea of veering from that course, temporarily or not, is so scary to people that the pressure stays. And that’s not a judgment at all. It’s just so hard, and it impacts the whole family.
Adam Honecker, LCSW (29:53)
I think, like you said, not judging a family, but having that conversation where there is a recontextualization of your sense of your kid as a student and your family as a family in a school. And it is fundamentally going to work toward their advantage if you do maybe take some of those, what feel like big steps, to drop the class level. Ultimately, you’d rather have passing grades on a student who attends school than one who’s failing their AP-level classes or not even attending those classes or having even bigger concerns arise.
Beth Hope, LCSW (30:20)
There really are things that schools can do, like you said, Adam, informally or formally. I know we’ve worked with schools where morning is so hard and getting a student to school is so hard, regardless of the reason. And also, on top of that, their first class of the day is their most challenging and least favorite class. Is there a way to work with the school to change the schedule so that it’s something they can ease into or enjoy? There was a past bullying situation, and so lunchtime is really difficult. Is there a way to have a friend at lunch or an alternative location for the rest of the semester until the schedule changes? On the one hand, that can feel like accommodating. On the other hand, it’s a step in the right direction. It can be helpful to partner with schools, and there’s a lot that can be done creatively.
Britt Teasdale (31:13)
Yeah, and I think what you’re saying about expectations is so important, right? I think we’ve talked about this in a previous conversation, Beth, where it’s like, as parents we have expectations on who our child’s going to be, how they’re going to show up and perform a lot of the time, and that’s not available to the child, or that’s not who they are. We have to shift our expectations as parents a lot of the time too, to make space for the child, right? And where they’re at in that moment or whatever they need to an extent, of course, without being accommodating and all that.
Adam Honecker, LCSW (31:49)
I think the trickiest thing is that balance of how you provide support but also encourage, push, and not accommodate. It’s like, how do you hug somebody and kick their butt at the exact same time? And that is really tricky because you don’t want to let them off the hook. You don’t want to rob them of the gift of resilience by accommodating too much.
They need to face distress, but also, like, if they’re in hell six hours a day in school, we got to give some of it somewhere. That’s the only way you can do it.
Britt Teasdale (32:16)
Are there times when a traditional school environment just isn’t the right fit for a child or teen? My kid’s pretty young, he’s only five and a half, but he was in one school and he was going, but he really was not enjoying it. A lot of like, “I don’t want to go to school, I don’t want to do this.”
He transitioned into a different school, and it’s been so easy ever since. He loves going to school. It’s just a different type of day. That’s only one example of one kid in my case, but I’m just curious, are there times when a school environment isn’t the right fit and maybe a shift can happen?
Adam Honecker, LCSW (32:50)
Yeah, I mean, every kid has unique learning, social, and emotional needs. There are some schools where the education there doesn’t match somebody’s specific academic needs or interests, and all sorts of factors are potential there, right? I know in Chicago, there are kids who are in quite small elementary schools and middle schools, and then they go to high school, they’re looking at potentially like a 5,000-person high school, and an environment like that could really, really be different for them. And that same environment could be amazing for many, many kids.
I think often, you have to look at the match. And I think back to the conversation about partnering with the school. You know, I don’t think anybody’s actively interested in thinking, “My kid’s in 10th grade, I want to change high schools,” or whatever the case may be. That can be really tricky. But after exploring what accommodations and supports can be available in the school and working with other folks to help a kid be successful in that, if you’re consistently making attempts to adjust to that environment and help support them and you’re still seeing struggle, sometimes there’s nothing wrong with that school. It’s just a hard fit for that kid, and I think many families who do explore other options with support find a big difference.
In my experience, I’m rarely, rarely excited to hear somebody doing online school or virtual school where they’re not having those more traditional social interactions. There are probably some kids and families who disagree with me, and that has worked for them because that met the needs they had.
Britt Teasdale (34:07)
Yeah, how does a child or a teen being neurodivergent factor into this discussion? And I know that’s an umbrella term. But if they are neurodivergent, how does that change the conversation about what the family or school might be seeing with respect to school anxiety and avoidance or a plan for that child?
Adam Honecker, LCSW (34:27)
If a child has diagnosed, say, autism spectrum disorder, neurodivergence, usually that’s obviously very important for the school to be aware of so they can look at structural accommodations and supports. But say if it’s not diagnosed, I see plenty of kids where the teacher’s experience of a young person or the school’s experience of a young person can be quite a bit different than the kid themself. Certain behaviors can seem like they’re disinterested; they’re not being engaged.
Behaviors that don’t match up with the expectations in the classroom can read very differently than if they had a better understanding of what the person was navigating from a diagnostic perspective. Typically, if a young person is neurodivergent, they’re in a school and in a world that isn’t, and the expectations are mismatched, and it’s profoundly confusing and unfair.
Beth Hope, LCSW (35:14)
Sometimes medication can help. How do you know whether it’s something to look into when it comes to treating, I guess, school avoidance, which is the symptom and not necessarily the diagnosis? In what ways can it be helpful, and how do parents know when it’s time to consider it?
Adam Honecker, LCSW (35:30)
If traditional therapy and other interventions are not working for a sustained period of time. If you’re going to a therapist once a week, or you’re going to a daily program and you’re not seeing any change, I think it has to at least be a lever you discuss.
Plenty of families have reservations, concerns, and philosophies about medication. If therapy is not showing any dent in the progress you’re looking for, I think at least it’s the next conversation. I always advise parents to be as transparent as you can be about your reservations. No doctor’s offended if you say, “Hey, I have some thoughts about this.” They’re used to that, and you should speak candidly about your reservations entering into those conversations if they’re present.
Beth Hope, LCSW (36:07)
Britt brought this up earlier, oftentimes in the same ways that kids might be really anxious or refuse to attend school, they might feel the same way about going to see a therapist or taking a medication or showing up at a program like ours. What can you do? I mean, I have a three-year-old who’s refusing to go to preschool, I can pick them up and I can put them in the car and hopefully by then I can offer them a treat. As kids get bigger and symptoms of anxiety and depression increase, you can’t just do that. You can’t really make a teenager do anything.
Adam Honecker, LCSW (36:39)
I think the older they get, the more tied they get to things like phones and technology. So that’s a natural starting point. I think certain privileges like cell phone, and social time, and time out on weekends, if we tie those to things that we get access to because we’re functioning and we’re doing all the other things that are important, maybe those are things we don’t get access to if we’re not. It’s not to punish, but it’s to provide an opportunity to at least look into support for the clear need. We never want to shame or make a kid feel like they’re being punished for having depression or anxiety but letting them know we can’t provide extracurriculars and incentives if we’re not able to function.
So, I think for many kids, I’m talking to parents about, like, they might not get the phone, or they may not get to do these things if they at least don’t go to talk to somebody. Let the professional be the person who says, “Mom and dad are over the top here. Like this is too much. They’re exaggerating. This is no big deal.” At least talk to somebody like a therapist to check it out. And then go from there.
Beth Hope, LCSW (37:35)
You mentioned a lot of times when kids are refusing to go to school or refusing to go to a therapist or program, they’re thinking of the future and the what-ifs, whatever misconceptions they have in their mind about what goes on in therapy or those programs. And it reminded me about what it’s like when they’re thinking about going to school and feeling really anxious. And one of the ways that we often suggest that parents try to help in the morning is to not focus on school, but just the next small thing, the next small step. So, it can be as small as taking the blankets off the bed and putting your feet on the floor or, hey, let’s get up and brush your teeth. Like one thing at a time, we’re not even talking about getting out the door to school. We’re talking about getting through each step of the hygiene routine and eating some breakfast and not focusing on that end result that’s what’s causing them a lot of anxiety.
It sounds like you’re saying that can be helpful for getting them to go to a therapist or program or other undesirable activity as well.
Adam Honecker, LCSW (38:36)
I think any baby steps, I think a teenager would be annoyed by that phrase, but yeah, just incremental steps. And if you’re somebody who the idea of even getting out of bed feels difficult, brushing your teeth 10 minutes later is impossible in your brain, but then you do it. The next thing potentially leads to the next thing. And then I think it’s the parent’s job not to be rushing that process necessarily but still encouraging it.
Britt Teasdale (39:02)
I’m wondering, Adam, if you could share, of course without any identifying details, a story of a family that you’ve worked with where they were having a really hard time and you really did see great progress, they were able to make some big strides with treatment. I’d love to hear about that if you’re willing to share.
Adam Honecker, LCSW (39:20)
Honestly, not to say families blur together, but there typically are these thematic things that pop up with different families. I don’t have a particular success story of, “Holy cow, that was the greatest thing I ever saw a family do.” But like we said earlier about kind of making adjustments to your expectations of your kid, I think that really resonates because I have seen so many families be like, “My kid was this kind of student, this kind of athlete and this kind of whatever in school,” and seeing families with grace not give that up, but just kind of shift their perspective and understanding of what success means for their kid. And the fact that several families I’ve worked with, like their child can still go into school, they’re with friends, they’re doing things academically still, they’re still engaged in extracurriculars, but it’s just dialed back or it’s less intense, and the parents are able to kind of shift their expectations of the kid and still congratulate and praise that and see that as victory.
I have all sorts of expectations for my kids, and I’m cheering for them, and I’ll be disappointed, I’m sure, if I go, “You don’t want to do this thing that is important to me?” I think seeing families cheer for something that they weren’t expecting to be cheering for is huge. Cheering for just, like, going through treatment and navigating anxiety.
To see a dad who’s just as proud of his kid for doing an exposure as they would be for some math test or sporting event, I think is huge. And really praising that as just as brave and just as strong as any other accomplishment they might have.
Beth Hope, LCSW (40:38)
When thinking about the days that you have been successful, what was the recipe there and how can we recreate it? Really reinforcing the positive while understanding that just like you said, Britt, Dr. Levine mentioned that 85 percent consistency is a huge success. There will be lapses. There will continue to be hard days, and it doesn’t mean that we all need to start spiraling about how we’re back to square one.
You’ve done this before. We know that there’s been success before. That means we know that you can do this. That means we know that we can do this. We’re just going to keep at it and keep trying.
Adam Honecker, LCSW
I think many parents I’m talking to in their first week at Compass and they’re like, “It’s been a good few days. I’ll talk to you Tuesday morning. I plan to hear from you about 7 a.m. I expect your kid might be having a hard time.” This is normal. It’s going to be okay. Enjoy this, and life’s going to happen. I think not letting it be so discouraging that this is a forever state, but every single person’s going to take a back step. That’s just the way it works.
Beth Hope, LCSW (41:38)
No child has refused every day of school for their entire life. I think reminding you that you’ve done this before and you can do it again can be really helpful and reinforcing that to ourselves as parents.
Britt Teasdale (41:49)
Yeah, and I think that also speaks to, as parents, how we talked about this earlier, but how our energy can really help. Like, we live in a time where there’s just so much fear around parenting and we’re bombarded with so much information, and we’re so worried that if we do one little thing, we’re going to wreck our kid or like one little decision or one little interaction is going to be a big deal. I think that kind of plays to the fact of it doesn’t have to be perfect. What you’re doing doesn’t have to be perfect. Also, to what Adam said earlier, missing a few days of school here or there can be normal. Wanting to stay home and watch your favorite show can be normal.
When does it merit paying a little closer attention?
Adam Honecker, LCSW (42:33)
Yeah, and we didn’t talk about it a ton, but I think I’ve always leaned toward transparency with kids, whether they’re my own or kids I’m working with. Like, “We’re trying this. This is what I believe will work. This is what I believe is helpful. This is what I believe is the problem. But you tell me if I’m wrong.” Not saying I’m clueless here but naming yourself as a human being who’s trying to figure it out. I think a lot of kids respond to transparency and realness, and they can tell.
They know. And I think being transparent of like, “Guys, this is what I think it is. So, I’m going to try this with you this morning when we go to school. And if I’m getting it wrong, tell me and I’ll change course.” I think being a little bit vulnerable, but not making your stuff your kid’s stuff, has been useful for me.
Britt Teasdale (43:11)
I love that. I love that idea of something like, “I’m going to try this. Let me know how it goes.”
Adam Honecker, LCSW (43:17)
I remember my parents acted like they knew everything. It’s like, I know you don’t. Like I can see it in your eyes. It’s just so clear.
Britt Teasdale (43:21)
Yeah, the veil comes off eventually anyways.
Beth Hope, LCSW (43:26)
I fear-based parented in the reverse way. I remember when I first started treating and learning more about school anxiety and school avoidance, my kids were a lot younger, and I was so worried that was going to be my kids that I sent them to school sick. And I remember I got a call from school that one of my daughters was itching her eye and it was looking a little red, and “Is it pink eye?” And I was like, “No, it’s just allergies. She’s trying to get sent home from school.” I refused to pick her up. I was so worried. I mean, I was worried about the future and her becoming a full-on, quote-unquote, school refuser. They said, “You have to come get her. Her eye is red and she’s itching it.” I brought her home. I was like, nope, this looks like allergies to me. I brought her back to school.
Long story long, I ended up having to pick her up again, took her to the doctor, and she had pink eye. So, sometimes you can overcorrect it.
Britt Teasdale (44:18)
Yeah.
Adam Honecker, LCSW (44:17)
I may have five books about childhood anxiety coming to my doorstep later this afternoon because my kid made one comment about, “What happens when you die? I’m anxious about dying.” Like, well, you’re six, that’s normal. But let’s just get ahead of this.
Britt Teasdale (44:30)
Oh my gosh, my five-and-a-half-year-old is asking those questions as well. And I’m like, is this normal? Where are we going with this conversation right now?
Adam Honecker, LCSW (44:37)
That’s when I wish I had a better answer than I don’t know. But yeah.
Britt Teasdale (44:40)
Yeah, it is like, my gosh. We’re mostly just parenting in the dark, and it helps to talk about these things, right? That’s why we’re here at the end of the day, because you only know what you know until you talk about it and learn more, right?
Adam, if a parent or caregiver is listening and feeling overwhelmed or unsure what to do next, every day is really hard, what would you say to them? Just like a little takeaway.
Adam Honecker, LCSW (45:08)
Oh man, I hate to say things like it gets better, but I mean, like you said, there is no kid who has refused school every day of their life. This is a problem with a solution. There are resources, there are people who understand, and it’s going to take hard work. There is an end in sight for this, and it is going to be relatively difficult and potentially miserable for you as a parent because you do have to carry a lot of the burden. But obviously it’s worth it. It’s potentially not as mystifying as it could seem.
Beth Hope, LCSW (45:38)
It is so, so, so challenging. It’s called school refusal or has been historically because it looks and feels like a choice and behavioral. But I think all of us are aligned that kids are doing the best they can in the moment. And we know oftentimes that they can do better with the right supports. This is hard, and there is hope for this. And I think just to underscore again, the idea that all behavior is communication. We need to figure out when kids aren’t able to communicate or don’t know what they’re trying to say, how we can help them untangle that. This is a tough one. This is one of the, I think, one of the harder things to treat, and we see everyday successes. It sounds very cheesy, but there is hope and there is treatment, and it’s a bumpy road for this one.
Britt Teasdale (46:24)
If you’re worried, if you have concerns, just start the conversation, right? Call.
Beth Hope, LCSW (46:27)
Yep. Conversation with your kid, with the school support, conversation with an existing or potential mental health support, conversation with a friend, just start, and things will fall into place. There’s so many things out there that can help this.
Adam Honecker, LCSW (46:31)
This is enormously complicated. Like you said, Britt, just being curious and then starting the conversation with whoever’s in your orbit, whether it be your kid first or your friend next to the soccer game or whatever, because you need to talk about the problem your kid’s going through. I think that’s the best way to start.
Beth Hope, LCSW (46:58)
And the best cure for a true, true stomachache is The Price Is Right.
Beth Hope, LCSW (47:05)
As we wrap up today’s conversation, one of the biggest takeaways is that school avoidance is rarely about a child simply not wanting to go to school. More often, it’s a signal that something underneath the surface—anxiety, social stress, perfectionism—is making the school day feel unmanageable.
Britt Teasdale (47:21)
When we understand that behavior is communication instead of defiance, it changes how we respond as parents and caregivers. Then we can start asking different questions like, what is my child trying to tell me? How can I best support them? And what might I need in order to do so?
Beth Hope, LCSW (47:35)
Remember that progress usually happens in small steps. Sometimes success is not a full day of school right away. Sometimes it’s getting out of bed, brushing teeth, and walking through the school doors. Those incremental steps build resilience over time.
Britt Teasdale (47:48)
And parents, we know how important it is to take care of ourselves in the process. These situations can be incredibly stressful for families, and it’s okay to ask for help, whether that’s reaching out to your child’s school, a therapist, or a parent who’s been through something similar.
Beth Hope, LCSW (48:02)
If you’re navigating school anxiety in your own family, remember, you don’t have to figure it out alone. Starting the conversation can be the first step toward support.
Britt Teasdale (48:10)
Before we go, maybe this can be a reminder to step outside today, take a deep breath, and check in with the people around you and with yourself. Sometimes the smallest pause can help us reset and connect with what really matters. Thank you for listening to You Only Know What You Know. We’ll see you next time.
