Multi-Systemic Intervention for School Refusal Behavior: Integrating Approaches across Disciplines

School refusal behavior is defined as 'child-motivated refusal to attend school or difficulties remaining in school for an entire day' (Kearney & Silverman, 1996 p365). Evidence exists indicating that the etiological and sustaining factors in cases of school refusal behavior are often multi-systemic in nature. Nevertheless, intervention approaches in the psychological literature have remained largely individual-focused. Similarly, literatures (for example education) in which school refusal behavior is conceptualized as 'truancy' are more likely to address the problem by intervening in multiple systems. The current paper argues for the utility of a multi-systemic approach to interventions for school refusal behavior that integrates multiple disciplines. Using an ecological systems framework, intervention options for school refusal behavior are detailed at the exosystemic, mesosystemic and microsystemic levels. Attention to systemic factors is intended to complement existing individual-focused approaches. Implications for diverse groups of young people who are exhibiting or at risk for school refusal behavior are also discussed.