School Refusal & School Avoidance Support in Denver

School refusal, also called school avoidance, is when a child or teenager has serious difficulty going to school or staying there because of emotional distress. It often looks like stomachaches every morning, tears or anger at the door, calls from the nurse's office, or a student who was doing fine and now cannot get out of the car. It is not a diagnosis, and it is not the same as skipping school. It is usually a sign that anxiety, low mood or overwhelming emotion has made school feel impossible.

Mountainside Behavioral Health is an outpatient therapy practice in Greenwood Village, near the Denver Tech Center. We offer school refusal and school avoidance support for young people ages 8 and up and for their parents, using cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT) and parent training. Sessions are in person or by telehealth anywhere in Colorado.

What school refusal and school avoidance look like

Families use different words for the same problem: school refusal, school avoidance, school anxiety, "school can't." Whatever you call it, the pattern is usually recognizable.

• Stomachaches, headaches or nausea on school mornings that ease once staying home is settled
• Dread that builds after weekends, breaks or sick days
• Tearfulness, panic, anger or shutting down when it is time to leave
• Frequent late arrivals, nurse visits, calls to be picked up, or skipped classes
• Full days, then weeks, at home, often with the parent knowing exactly where the child is

Our guides on the signs of school refusal and why kids refuse school go into detail. If the pattern above sounds familiar, it is worth acting early. Time away from school tends to make going back harder, not easier.

How we help with school refusal

There is no single reason a young person stops going to school, so we start by working out what the avoidance is doing for them. A student who is avoiding a feared class presentation needs something different from one who cannot separate from a parent, or one whose mood has dropped so far that nothing feels worth the effort. The plan follows from that.

CBT with gradual exposure

The American Academy of Child and Adolescent Psychiatry describes CBT as the approach with the strongest research support for school refusal, although the number of studies is still small. Your child learns how anxious thoughts, physical sensations and avoidance feed each other, practices skills for riding out distress, and then returns to school in planned steps instead of all at once. Each step is agreed in advance and repeated until it is manageable. Our gradual return-to-school plan guide shows what those steps can look like.

Parent training

Parents are usually the ones standing at the bedroom door at 7 a.m., and what happens in those minutes matters. In parent training sessions you learn how to respond to distress with warmth while still expecting attendance, how to step back from the reassurance and rescuing that keep anxiety going, and how to set up mornings and school-day rules at home. If your teen is not ready to come in, ask at your consultation about starting with parent sessions.

DBT skills for intense emotion

For some teens, school refusal sits alongside emotions that go from zero to overwhelming, self-harm urges, or conflict at home. DBT teaches concrete skills for tolerating distress, regulating emotion and communicating. Our Teen Multi-Family DBT Skills Group for ages 12 to 18 meets for two hours weekly on Mondays over 24 weeks, and parents attend with their teen.

Treating what is underneath

School refusal often travels with anxiety, social anxiety, panic, OCD or depression. We treat those conditions as part of the work.

Who we work with

We see young people from age 8 through young adulthood, and their parents and families. Age ranges vary by clinician: Caroline James, M.A. works with ages 8 and older, Diana Huizar, Ph.D. works with ages 11 to 24 and families, Emily Biggs-Heisler, Ph.D. with ages 12 and up, Audrey Fisher, LPC with ages 13 and up, and Anabelle Brecker, LCSW with ages 15 and up.

Caroline James is a doctoral candidate in Child, Family, and School Psychology with training in DBT, Exposure and Response Prevention (ERP), parent coaching and school systems. She offers individual, group and family therapy, parent coaching and school-based service consultations.

Dr. Huizar is a postdoctoral psychology fellow and is bilingual in English and Spanish, so sessions for teens and families can be held in either language. You can read about each clinician on our therapists page.

We do not see children under 8. For a younger child, your pediatrician or a child psychologist who works with young children is the right starting point, and the parent guides in our school refusal resource center still apply.

What to expect

1. A free consultation. You tell us what mornings look like, how much school has been missed and what you have tried. We tell you honestly whether we are a good fit.
2. Understanding the pattern. In the first sessions we meet with your child and with you to work out what is driving the avoidance and what is keeping it going.
3. A plan. Together we agree on the first steps back, what happens at home on days school is missed, and what you will say and do in the morning.
4. Weekly work. Individual sessions are 45 minutes. Many families combine sessions for the young person with sessions for parents.
5. Adjusting as you go. Setbacks after weekends, breaks and illness are normal. We plan for them in advance.

How long this takes depends on how long school has been missed and what else is going on, and we cannot promise a timeline. CBT is a structured, time-limited approach; our guide to how long CBT takes explains what affects it.

Preparing for conversations with your child's school

A return plan is easier to carry out when the school knows about it. Part of our work with parents is preparing for those conversations: who to contact, what to ask for, and how to describe the return plan so staff can support it.

Our resource center covers the school side in detail, including how to talk to the school, 504 plans and IEPs, and what Colorado attendance law says about excused absences and truancy.

What we do not offer

We are an outpatient practice, and it is fair to be clear about the limits of that.

• We do not prescribe medication. That is a decision for a prescriber such as a pediatrician or child psychiatrist.
• We do not run an intensive outpatient, partial hospitalization or day treatment program.
• We do not provide the educational or psychological testing a school uses for a 504 plan or IEP.
• We are not a crisis service.

If your child has been out of school for a long time, is not safe, or weekly therapy has not been enough, a more intensive program may be the right next step. Our guide on when outpatient therapy is not enough explains the options in the Denver area.

Fees and insurance

Individual sessions and parent training sessions are $175 to $200 per session. The Teen Multi-Family DBT Skills Group is $150 per two-hour session. We are an out-of-network provider and do not bill insurance directly. We provide superbills, which are itemized receipts you can submit to your insurer for possible out-of-network reimbursement. See insurance and pricing for details.

If cost is a barrier, our Denver mental health resources page lists free and low-cost options.

Where we are

Our office is at 8100 E Maplewood Ave, Suite 230, Greenwood Village, CO 80111, near the Denver Tech Center and close to Centennial, Englewood, Cherry Hills Village, Littleton, Lone Tree, Highlands Ranch and southeast Denver. Telehealth sessions are available to families anywhere in Colorado, which can be a practical way to start when a teen is not leaving the house.

If your child talks about wanting to die, is harming themselves, or you are worried about their safety, call or text 988 to reach the 988 Colorado Mental Health Line (free, confidential, 24/7). If anyone is in immediate danger, call 911.

From our school refusal resource center

We keep a resource center for parents with plain-language guides you can use before, during or instead of therapy.

• Signs of school refusal

  Early and established signs of school refusal at home and at school, by age, plus the red flags that need urgent help.

• What to do when your child refuses school

  A step-by-step plan for today, this week and every school morning, plus what to avoid and when to call a therapist.

• A gradual return-to-school plan

  How to build a step-by-step ladder back to school, with example steps, what to ask the school for, and what to do when a step fails.

• Colorado attendance law and school refusal

  What Colorado statute and CDE say about excused absences, truancy, court and chronic absenteeism, and how to document absences.

• 504 plans and IEPs for school refusal

  How 504 plans and IEPs apply to school refusal in Colorado: who may qualify, how to request an evaluation, and what to ask for.

• For teens: when you can't make yourself go to school

  For teens: why school can feel impossible, how to tell an adult (with a script), small steps you choose, and where to turn on a bad day.

Browse every school refusal resource →

School refusal therapy: common questions

Related reading

• School Refusal Resource Center
• Teen Therapy in Denver
• CBT for Teens: Helping Denver Adolescents Build Healthy Thinking Habits
• Parent Training With CBT Techniques: Support for Families in Denver
• DBT Groups in Denver
• Anxiety Treatment in Denver

This page is general education, not medical or legal advice, and it does not replace an evaluation by a licensed professional who knows your child. Laws, district policies and program details change; confirm them with your school district or the organization named.