Systematic Review of Interventions with Some School Involvement for School Refusal in High School–Age Adolescents.

This systematic review examines interventions addressing school refusal—defined as student-motivated avoidance of school due to emotional distress—among high school–age adolescents that include some form of school involvement. Reviewing 10 peer-reviewed studies, most of which employed cognitive–behavioral therapy (CBT), the findings indicate that CBT-based interventions generally improve school attendance and reduce anxiety-related symptoms, though the extent and nature of school involvement varied widely and were often minimally described. Only three studies met high-quality methodological standards, highlighting a scarcity of rigorous research on effective school-based components and partnerships. The review underscores the need for further development of interventions with integral, clearly defined school roles, culturally responsive approaches, and multitiered systems of support to better address school refusal and its long-term consequences.