Graduated return: school refusal protocol

School refusal is rising in Australia and the families who get the best outcomes have a school as engaged as the clinician. Below is the structure we recommend.

Phase 1: stabilisation (weeks 1–2)

The child does not return full-time. Two short stints per day at most — drop-off to recess, or after lunch to home time. The goal is to break the all-or-nothing pattern, not to catch up on missed work.

One identified staff member greets the child every morning at the same door. Predictability is the medicine.

Phase 2: graduated extension (weeks 3–4)

Add one period per week. The family's job is to bring the child to the school gate; the school's job is to make staying possible. If a stint collapses, the next day reverts to the previous step — not the previous phase.

Phase 3: integration (weeks 5–8)

Full days return, with one identified 'safe person' on staff the child can go to without explanation. Demands are reintroduced incrementally, not all at once. The 'no homework' agreement may continue through this phase.

Family role

• One nominated parent communicates with school — not both. Reduces friction and confusion.
• Daily five-minute morning check-in by SMS between the family and the safe person, before drop-off.
• Weekly 15-minute meeting between family, safe person, and learning-support coordinator. Brief, structured, no surprises.

Escalate to specialist when

• The child has not returned beyond Phase 1 by week 4.
• Physical symptoms (vomiting, panic) are sustained beyond two weeks.
• There is any indication of self-harm thinking or significant withdrawal.
• Family conflict is rising rather than easing.