Behind the SCREEN: identifying school refusal themes and sub-themes

School refusal is heterogeneous in aetiology and presentation. The heterogeneity in its presentation, the focus of this study, complicates the conceptualisation and assessment of school refusal. The present study documents the development of a descriptive model of school refusal that was used to inform the development of a questionnaire for identifying manifestations of school refusal (the SChool REfusal EvaluatioN – SCREEN). Semi-structured interviews were conducted with 42 participants: adolescents who display school refusal and those who do not, middle school professionals, and care professionals working with adolescents displaying school refusal. Analysis of interview data led to the organisation of school refusal manifestations according to four main themes comprising ten categories. The four themes were: School, Daily and Family Life, Health, and Socialisation Outside Home and Family. These themes correspond to the various contexts in which school refusal may be manifest. Results support the common notion that school refusal manifestations are not limited to absence from the school context, and are likely to occur outside this environment. This study represents the first empirical analysis of the manifestations of school refusal among French youth displaying school refusal.