"It was like a weird, paralysing thing": Understanding the development and consequences of emotionally based school non-attendance (EBSNA) through young people's and parents' experiences.

Emotionally based school non-attendance (EBSNA) is an increasing concern, yet relatively little research has integrated young people's and parents' perspectives to understand how attendance difficulties develop and affect young people and their families. This qualitative study explored the development and consequences of EBSNA through the complementary experiences of young people and parents. In-depth semi-structured interviews were conducted with 20 parents and 16 young people aged 11-17 years who had experienced EBSNA. Young people could participate through either verbal or written interviews to support inclusive participation. Data were analysed using the Framework Method, with multiple researchers contributing to coding, charting and interpretation. Three overarching themes were identified: misalignment between young people's needs and the school environment; becoming unable to attend school; and the wider impact of EBSNA. Across accounts, EBSNA developed gradually through interactions between individual needs and school environments, rather than being attributable to individual characteristics alone. Sensory, social, organisational and academic demands, particularly during the transition to secondary school, combined with unmet needs, bullying, punitive practices and difficulties establishing trusting relationships to progressively undermine psychological safety and belonging. As distress escalated, anxiety increasingly extended beyond specific school situations to school itself, eventually making attendance feel psychologically and physically impossible. Once established, absence created additional barriers to returning through lost confidence, disrupted friendships and concerns about falling behind. Despite substantial educational disruption, young people generally remained motivated to learn. EBSNA also had profound social and family consequences, including isolation, deteriorating parental wellbeing, disrupted family relationships and financial pressures. Findings conceptualise EBSNA as a dynamic socioecological process and highlight the importance of early, individualised responses that address unmet needs and create psychologically safe, inclusive and supportive school environments.