Family environment of youngsters with school refusal behavior: A synopsis with implications for assessment and treatment

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Abstract
Several predominant themes for conceptualizing school refusal behavior in children and adolescents have endured across decades of study, including the idea that problematic family relationships are integral to etiology. We review evidence that several familial subtypes are characteristic of this population. These include enmeshed, conflictive, detached, isolated, and healthy parent-child dyads, as well as mixed familial profiles. Recommendations for educators and health professionals who interact with this population are made subsequently. These include guidelines for integrating familial profiles into contemporary classification and assessment strategies, and for modifying treatment protocols based on differential family dynamics.