Psychosocial interventions for school refusal in children and adolescents: a protocol for a systematic review and meta-analysis
Abstract
Background: Attending school can be emotionally distressing for some children and adolescents. When school attendance becomes difficult for a child and is accompanied by emotional distress, the condition is called school refusal. Contextual factors at the individual, parental, and school levels that interfere with school attendance may complicate school refusal. A 2015 systematic review of psychosocial interventions, including both randomized and non-randomized studies, reported mixed results for treating anxiety in school refusal, while showing promising results for school attendance. No systematic review or meta-analysis restricted to randomized controlled trials, however, has been conducted. We will therefore conduct a systematic review and meta-analysis of randomized controlled trials to determine whether psychosocial interventions reduce anxiety and improve school attendance among school-refusing children and adolescents.
Methods: Our protocol followed the PRISMA-P guideline. We will include individually- and cluster-randomized trials in which most children and adolescents are aged 18 years or younger, are enrolled in primary or secondary education, have exhibited school absence, and received psychosocial interventions for school refusal. Our primary aim is to reduce anxiety and increase school attendance. We will search CENTRAL, MEDLINE, PsycINFO, CINAHL, ERIC, ClinicalTrials.gov, and the ICTRP. Two reviewers will independently assess the study selection, data extraction, risk of bias in included studies, and reporting bias. We will also investigate heterogeneity and conduct sensitivity analyses. We will present ‘summary of findings’ tables to show the estimated effects and the certainty of the evidence.
Discussion: This will be the first systematic review to include only randomized trials and to broaden the concept of school attendance to capture the child’s engagement with learning in education.
Related
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BibTeX
@misc{sato2026psychosocial,
title = {{Psychosocial interventions for school refusal in children and adolescents: a protocol for a systematic review and meta-analysis}},
author = {Akira Sato and Yan Luo and Satoshi Funada and Masatsugu Sakata and Motoki Kurumai and Ethan Sahker and Toshi A. Furukawa},
howpublished = {PsyArXiv},
year = {2026},
month = oct,
doi = {10.31234/osf.io/8p6da_v1},
url = {https://osf.io/preprints/psyarxiv/8p6da_v1/},
note = {CC BY 4.0},
}
RIS
TY - UNPB
TI - Psychosocial interventions for school refusal in children and adolescents: a protocol for a systematic review and meta-analysis
AU - Akira Sato
AU - Yan Luo
AU - Satoshi Funada
AU - Masatsugu Sakata
AU - Motoki Kurumai
AU - Ethan Sahker
AU - Toshi A. Furukawa
PY - 2026
DA - 2026/10/13
PB - PsyArXiv
DO - 10.31234/osf.io/8p6da_v1
UR - https://osf.io/preprints/psyarxiv/8p6da_v1/
AB - Background: Attending school can be emotionally distressing for some children and adolescents. When school attendance becomes difficult for a child and is accompanied by emotional distress, the condition is called school refusal. Contextual factors at the individual, parental, and school levels that interfere with school attendance may complicate school refusal. A 2015 systematic review of psychosocial interventions, including both randomized and non-randomized studies, reported mixed results for treating anxiety in school refusal, while showing promising results for school attendance. No systematic review or meta-analysis restricted to randomized controlled trials, however, has been conducted. We will therefore conduct a systematic review and meta-analysis of randomized controlled trials to determine whether psychosocial interventions reduce anxiety and improve school attendance among school-refusing children and adolescents. Methods: Our protocol followed the PRISMA-P guideline. We will include individually- and cluster-randomized trials in which most children and adolescents are aged 18 years or younger, are enrolled in primary or secondary education, have exhibited school absence, and received psychosocial interventions for school refusal. Our primary aim is to reduce anxiety and increase school attendance. We will search CENTRAL, MEDLINE, PsycINFO, CINAHL, ERIC, ClinicalTrials.gov, and the ICTRP. Two reviewers will independently assess the study selection, data extraction, risk of bias in included studies, and reporting bias. We will also investigate heterogeneity and conduct sensitivity analyses. We will present ‘summary of findings’ tables to show the estimated effects and the certainty of the evidence. Discussion: This will be the first systematic review to include only randomized trials and to broaden the concept of school attendance to capture the child’s engagement with learning in education.
ER -