I have worked with many teenagers experiencing significant difficulties with school attendance.

Earlier in my career, I was contracted by Foróige to work within school settings, supporting young people experiencing a range of emotional, behavioural and personal difficulties.

My experience of working directly with young people in schools, combined with my earlier work developing behavioural support plans for children and my ongoing work in private practice, has shaped the way I approach school avoidance.

Although I no longer undertake school-based contracting because of the demands of my private practice, I continue to support young people and families experiencing school attendance difficulties within my own practice.

I don't see school refusal as simply a behaviour that needs to be stopped.

I want to understand what the behaviour may be communicating.

My first step is to spend time with the young person and understand their experience.

We may explore:

• What is happening when they think about going to school?
• What feels difficult or overwhelming?
• Are there particular parts of the school day that feel harder than others?
• How are friendships and peer relationships?
• Are there worries about teachers, exams, homework or academic expectations?
• Are they experiencing anxiety, panic or physical symptoms?
• Are they feeling exhausted or emotionally overwhelmed?
• Are there difficulties with concentration, motivation or getting started?
• Are transitions, changes or unexpected situations particularly difficult?
• Could sensory or social demands be contributing?
• Are they experiencing bullying or feeling excluded?
• How do they feel about themselves?
• What do they wish was different?
• What would make school feel more manageable?

The aim isn't to arrive with assumptions about why the young person isn't attending.

It is to listen carefully and understand their individual experience

I believe it is important that the young person has a voice in understanding what is happening.

Where appropriate, I will work with them to identify what they are finding difficult, what they would like to change and what they feel might help.

This might involve looking at anxiety, emotional regulation, confidence, relationships, school pressures, neurodivergence, executive functioning or other factors affecting their ability to manage school.

Sometimes a young person has been experiencing difficulties for quite a long time without anyone fully understanding what is happening for them.

Having an opportunity to talk about this in a safe and non-judgemental environment can be an important first step.

With the young person's permission, I then invite parents or caregivers into the process.

This gives us an opportunity to talk through what I have learned from the young person's perspective and consider what may be contributing to the difficulties.

Parents often have their own observations and concerns, and these are important too.

The aim is not to decide who is right.

It is to bring the different pieces of the picture together.

We can then consider what might help the young person feel more understood and what practical changes or supports may be worth exploring.

Where appropriate, I provide parents with a written report or summary following the assessment and therapeutic work.

This can outline relevant findings, areas of difficulty and suggestions that may help support the young person.

I may then recommend that parents bring this information to the school so that they can discuss the young person's needs and consider what support may be available within the school environment.

The intention is to help parents approach the school with a clearer understanding of what their young person may be experiencing, rather than simply reporting that they are refusing to attend.

The report is intended to support a conversation between parents and the school.

It is not a prescription for what a school must do, and I do not determine what educational or clinical pathway a family should take.

For some young people, school attendance difficulties are closely connected to anxiety.

They may worry about being judged, getting something wrong, speaking in class, friendships, exams, separation from parents or simply being in an environment that feels overwhelming.

Anxiety can also show itself physically. A young person may experience headaches, stomach aches, nausea, exhaustion, difficulty sleeping or a strong physical sense that they simply cannot face school.

Understanding the anxiety rather than focusing only on the attendance is an important part of the work.

We can explore what the young person is afraid might happen, what situations they are avoiding and what happens emotionally and physically when they feel unable to attend.

Some young people become overwhelmed very quickly.

They may appear angry, shut down, become tearful, withdraw completely or seem unable to communicate what is wrong.

This can sometimes be misunderstood as defiance or unwillingness.

I am interested in understanding what happens before, during and after these moments.

What is the young person experiencing?

What are they finding difficult?

What helps them regulate?

What makes things worse?

Understanding these patterns can help identify more supportive ways of responding.

For some young people, particularly those with ADHD or other neurodivergent profiles, the difficulty may not be a lack of desire to attend school.

They may genuinely want to go but struggle with the processes involved in getting there.

This can include waking, getting organised, finding what they need, transitioning from one activity to another, managing time, beginning tasks, remembering instructions or dealing with multiple demands at once.

When these difficulties are misunderstood, a young person may hear messages such as:

“You're lazy.”
“You don't care.”
“You're not trying.”

Over time, these messages can affect confidence and self-worth.

Understanding what is actually getting in the way can allow us to think about more appropriate strategies and supports.

School attendance difficulties rarely affect only the young person.

Parents may become exhausted from trying to encourage, persuade, negotiate or manage difficult mornings. Relationships can become strained, and everyone can begin to feel stuck.

My role is not to replace the work of the school or other professionals involved with the young person.

Rather, I can help the young person and their parents understand what may be happening and provide information that can support conversations with the school.

Where appropriate, the written report can help parents communicate the young person's experience and identify areas that may need further consideration.

Tusla's Education Welfare Service also provides support around school attendance, and schools have their own attendance strategies and support structures. Families may therefore have several sources of support alongside therapeutic input.

Sometimes the young person who is struggling with school is also unwilling to come to therapy.

This does not necessarily mean that there is nothing a parent can do.

In some circumstances, it may be appropriate for parents to begin with a Parent Consultation & Support session.

This can provide an opportunity to talk through what is happening, understand possible contributing factors and consider how parents can respond.

There is no single reason why a young person may struggle to attend school, and there is no single solution.

The first step is understanding what is happening for that particular young person.

From there, we can consider what might help — whether that involves therapeutic work with the young person, parent support, changes within the school environment, further assessment or another form of support.

I will share my professional observations and recommendations based on the work I have undertaken with the young person, while recognising that parents ultimately decide what steps they wish to take.

If parents decide they would like to explore a referral or further assessment, I can share information about services or practitioners based on my knowledge and experience, including feedback from previous clients where appropriate.

If your teenager is struggling to attend school, you don't have to have everything figured out before seeking help.

You may simply know that something isn't right.

Perhaps the school mornings have become increasingly difficult. Perhaps your child is anxious, overwhelmed, withdrawn or exhausted. Perhaps they are attending some days but finding it increasingly difficult to maintain.

Or perhaps you have reached a point where you are asking:

“What is really going on for my child?”

That is often a very good place to begin.

The aim is not simply to focus on getting a young person through the school gates.

It is to understand what is making school difficult, listen to the young person's experience and work towards a way forward that takes their emotional wellbeing and individual needs into account.