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.

School Avoidance V2

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.

Talk With Our Team

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.

The Measurable Impact of
Reducing Chronic Absenteeism

Use your district’s enrollment and chronic absenteeism rate to estimate how supporting students with
school avoidance can reduce missed days, increase instructional time, and improve attendance outcomes.

Impact Calculator

Number of Enrolled Students

Use the slider to enter your district's total student enrollment.

0 150,000+

% of students who are chronically absent

Use the slider to enter the % of students who miss 10% or more of the school year for any reason.

0 50%

Estimates are illustrative and based on district-provided data and observed outcomes from schools using Cartwheel.

Estimated Impact

↓ 0

Fewer chronically absent students

↓ 0

Fewer days missed per year

↑ 0

Increase in instructional hours per year

Talk with our team to review your results and learn how Cartwheel partners with districts to support students struggling with school avoidance.

Real Results: Peoria Public Schools

Peoria Public Schools was facing rising chronic absenteeism and behavioral incidents, long waitlists for mental health services, transportation and language barriers, and school staff overwhelmed by frequent crises.

After partnering with Cartwheel, the district saw a 62% reduction in absences per student, along with decreases in suspensions and symptoms of depression and anxiety.

Read the 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

“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

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

This program is the right fit for:

Students who:

Experience difficulty getting to school—physical complaints, emotional meltdowns, refusing to leave home
Have anxiety, depression, or trauma contributing to chronic absences
Want to attend school but can't overcome the emotional barriers

Families who:

Are ready to participate regularly in telehealth sessions
Seek guidance on supporting their child at home
Are committed to being active partners in treatment

What Families and Schools Are Saying

“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, Peoria Public Schools

“Cartwheel has broken down cultural barriers and shows families that we hear you, and we are here to support and give you the tools you need to be successful.”

Bria Scott, School Social Worker, Peoria Public Schools

“Cartwheel understood what was really behind why our child wouldn’t go to school. Our mornings are so much easier now.”

Parent

“I'll say [our] number one [issue] would be school avoidance. And that's where I think Cartwheel can really be so beneficial because that's not something that our school-based counselors are really addressing.”

Karri Isidoro, Psychologist, Danvers Public Schools

Frequently Asked Questions

Common questions from districts considering specialized school-avoidance support.

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

A Mental Health Solution That Helps Students Return to School

The Measurable Impact of Reducing Chronic Absenteeism

Impact Calculator

Estimated Impact

Learn More about Cartwheel's School Avoidance Program

Real Results: Peoria Public Schools

Absences per Student Before vs. After Cartwheel

“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.”

Why This Matters for Districts

“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.”

What the Program Includes

This program is the right fit for:

What Families and Schools Are Saying

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

“Cartwheel has broken down cultural barriers and shows families that we hear you, and we are here to support and give you the tools you need to be successful.”

“Cartwheel understood what was really behind why our child wouldn’t go to school. Our mornings are so much easier now.”

“I'll say [our] number one [issue] would be school avoidance. And that's where I think Cartwheel can really be so beneficial because that's not something that our school-based counselors are really addressing.”

Frequently Asked Questions

How is specialized school avoidance treatment different from school counseling?

How is school avoidance different from truancy?

How quickly can students begin receiving support?

Can Cartwheel support students across the full spectrum of school-avoidance needs, including school refusal?

Will teletherapy work for school-avoidant students?

How do you measure whether the program is working?

What if a student may need medication?

What is expected of families?

How much coordination is required from school staff?

What kinds of students benefit most from the program?

How does the program work with IEP or 504 supports?

Is this financially sustainable for districts?

Ready to Address Chronic Absenteeism in Your District?

The Measurable Impact of
Reducing Chronic Absenteeism