A Systematic Review on School Phobia and Refusal in Adolescence: Causes, Symptoms, and Intervention Methods

This study aims to identify the causes, symptoms, and intervention strategies associated with school phobia and school refusal in adolescence by undertaking a systematic literature review. School phobia and school refusal, which has been linked to school attendance anxiety, may arise during adolescence, a period of physiological, psychological, and social transformation. A systematic review of articles related to school phobia and refusal that were published between 2000 and 2023 was conducted. The results showed that school phobia and refusal are influenced by individual factors, including genetic predisposition, psychological well-being, and personality traits. Familial factors, such as parental overprotection and intra-family conflict, along with school contextual factors, such as peer bullying or negative interactions with educators, also contribute to a fear of dissociation and academic difficulties. These issues lead to physical, psychological, and behavioral symptoms, such as headaches, nausea, and fatigue, anxiety, panic attacks, and depression, and school refusal, truancy, and dropout. In repsonse, a combination of effective interventions, such as cognitive-behavioral therapy (CBT) to improve maladaptive thoughts and behaviors, family therapy to enhance the home learning environment, and school-based strategies to boost academic performance, were identified. These findings highlight the need for interdisciplinary and multi-faceted approaches to address school phobia and refusal comprehensively. Further research with other inclusion/exlusion criteria and larger, more diverse populations is recommended to explore these issues and identify more effective intervention strategies.