How is this different from school counseling?

Cartwheel provides clinical mental health treatment from licensed therapists specializing in school avoidance, which differs from school counselors who focus on academic and social guidance. Our clinicians are specifically trained in evidence-based approaches for school refusal and anxiety disorders.

What is the difference between school avoidance and truancy?

School avoidance is driven by emotional distress such as anxiety, depression, or trauma, where students want to attend but struggle due to mental health barriers. Truancy typically involves willful absence without emotional distress as the primary cause.

How quickly can students access services?

Students can typically access services within 7-10 days of referral.

Does Cartwheel provide full-spectrum treatment?

Yes, Cartwheel provides comprehensive mental health care including individual therapy, parent guidance, psychiatric evaluations, and medication management when needed.

Is teletherapy effective for school avoidance?

Yes, teletherapy has proven effective for treating school avoidance. It provides accessible, convenient care that removes barriers to treatment and allows for flexible scheduling.

How are outcomes measured?

Outcomes are measured through validated clinical assessments, attendance data tracking, and the School Refusal Assessment Scale (SRAS) to monitor progress throughout treatment.

Is medication management available?

Yes, psychiatric evaluations and medication management are integrated into the program when clinically appropriate.

What is expected of families?

Families are expected to be committed to regular participation, seek guidance actively, and serve as active treatment partners in their child's care.

What is required of school staff?

School staff coordination involves collaboration with Cartwheel clinicians to support student progress and implement recommended accommodations.

Is the program compatible with IEP/504 plans?

Yes, the program is fully compatible with IEP and 504 plans and can support documentation and recommendations for educational accommodations.

Case Study: Peoria Public Schools

Case Study

Peoria Public Schools Reduces Student Absences by 62% with Cartwheel Partnership

44% reduction in chronic absenteeism

68% fewer suspensions

Measurable results for students and schools

Like many urban districts, Peoria faced serious challenges: rising absenteeism, frequent behavioral incidents, months-long waitlists for mental health care, transportation and language barriers, and school staff overwhelmed by daily crises.

The district needed a partner who could expand access quickly, deliver high-quality care, reduce burden on school teams, and provide data to understand impact. Cartwheel delivered.

Download Case Study

Peoria, Illinois

12,600 students across 32 schools

79% free/reduced lunch

Comparison group: Students who did not receive Cartwheel services did not see improved attendance

Sample size: n=141 students who engaged in Cartwheel telehealth services in a 12,600 student urban district (79% free/reduced lunch) during the 2022-23, 2023-24, and 2024-25 school years. First bar shows the % of students receiving Cartwheel who were chronically absent in the year they were referred for services. For the same cohort, the second bar shows the % who were chronically absent in a subsequent school year. Chronic absenteeism is defined as missing 10 percent of school days within an academic year.

Absences per Student Before vs. After Cartwheel

↓ 44%

Reduction in
chronic absenteeism

↓ 68%

Fewer suspensions

↓ 90%

Reduction in depression/
anxiety symptoms

Clinical outcomes that support academic success

↑ 5 point

Improvement

In depression symptoms

2x

Engagement

Versus other  teletherapy programs

96%

Satisfaction

Reported by students

“Cartwheel has become a key part of our student support infrastructure, delivering measurable improvements in attendance and behavior, and positioning our schools as hubs of comprehensive wellness support.”

Dr. Alexander U. Ikejiaku

Associate Superintendent
Peoria Public Schools

What This Meant for Peoria Public Schools

More Instructional
Time

Additional school days means better academic outcomes and improved accountability metrics

Improved School
Climate

Fewer behavioral incidents means less disruption for all students

Better Resource
Allocation

School counselors can focus on tier 1 and tier 2 supports instead of crisis management

Stronger Family
Engagement

Parents receive guidance that improves outcomes at home and school

"Since partnering with Cartwheel, we have observed a noticeable shift away from externalizing behaviors. Aggression against staff has decreased."

Dr. Ann Bond

Assistant Superintendent of Student Services

Hear from Bria Scott, School Social Worker

Why Peoria Needed a Different Approach

Like districts nationwide, Peoria recognized growing student mental health needs —and the barriers families faced accessing care.

Before Cartwheel, students needing tier 2 and tier 3 support faced:

3-6 month waitlists for community providers

Transportation challenges preventing families from attending appointments

Language barriers limiting access for  non-English speaking families

Overwhelmed school staff managing increasing crises with limited resources

The consequences appeared in the data: rising chronic absenteeism and increasing behavioral incidents. Students struggling with untreated anxiety, depression, and trauma were missing school, acting out, and falling behind academically. These barriers didn’t just impact well-being—they eroded instructional time and academic progress district wide.

School Avoidance Program

Students with Mental Health Needs Miss Twice as Many Days of School

Cartwheel's specialized School Avoidance Program helps students address the challenges at the root of chronic absenteeism—so they can confidently return to school.

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What Makes Cartwheel Different

Peoria Public Schools partnered with Cartwheel to remove barriers, integrate with school teams, and address the root causes of attendance and behavior challenges.

Specialized for school outcomes

Therapy, psychiatry, and family support focused on school avoidance, anxiety, depression, and behavioral challenges.

Rapid access to care

Students are matched with clinicians in 7–10 days instead of waiting months.

Integrated with school teams

Ongoing collaboration with counselors and social workers, shared strategies, and real-time progress updates.

Sustainable through insurance

No costs for families on Medicaid; in-network with military and commercial insurers.

Multilingual care

Students are matched with a clinician who speaks their native language.

”Mental health was not just a clinical issue—it was  an educational access issue. Students can't learn if they're  not in school.”

Dr. Ann Bond

Asst. Superintendent of Student Services
Peoria Public Schools

“Cartwheel functions as an extension of our district—not a separate vendor. This level of integration has been transformative.”