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

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

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.

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 Peoria’s Students academic success

↑ 5 point

Improvement

In depression symptoms

Engagement

Versus other  teletherapy programs

96%

Satisfaction

Reported by students

A Mental Health Solution That Helps Students Return to School

Evidence-based care designed specifically for students struggling with school avoidance.

Regular therapy & family sessions from licensed clinicians with specialized training.

Integrated psychiatric support when students might benefit from medication evaluation.

Ongoing collaboration with schools to ensure consistent strategies across settings.

“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

”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

What This Means For Schools

Why Peoria Needed a Different Approach

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

Why This Matters for Districts

Most Mental Health Services Improve Symptoms—Not School Outcomes

Traditional telehealth addresses clinical symptoms but often misses the school-based challenges districts need help with most: attendance, behavior, and engagement.

‍Cartwheel's School Avoidance Program fills that gap. We deliver evidence-based care tailored to the real issues educators and families face, improving both clinical and educational outcomes—so students return to school consistently and confidently.

‍Districts see improvements in:

Attendance rates & chronic absenteeism metrics

Classroom engagement & instructional time

Behavioral incidents & disciplinary referrals

Family engagement & follow-through with interventions

“Cartwheel's School Avoidance Program speaks directly to the challenges families face every day, making it easier for them to raise their hands for help and follow through.”

Jillian Kelton, M.Ed

Director of District Engagement, Cartwheel and Former Chief of Student Support, Boston Public Schools

What the Program Includes

Specialized care designed to reduce school avoidance and improve attendance.

1:1 therapy with clinicians trained in school avoidance

1:1 parent guidance sessions & optional skill-building groups

School Refusal Assessment Scale (SRAS) to identify the “why” behind avoidance

Psychiatric evaluations and medication management when appropriate

Ongoing school collaboration for consistent strategies across settings

Telehealth from home (8am–8pm + weekends)—no transportation barriers

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