Intensive (Daily) Behavior Therapy for School Refusal: A Multiple Baseline Case Series

The following multiple baseline case series examines school refusal behavior in 4 male adolescents. School refusal symptom presentation was ascertained utilizing a functional analysis from the School Refusal Assessment Scale (Kearney, 2002). For the majority of cases, treatment was conducted within a 15-session intensive format over a 3-week period. Treatment elements included cognitive-behavioral therapy with the adolescent, parent training sessions, or a combination of these strategies. Treatment was effective for 3 of 4 cases in the short term. At 3-year follow-up, all 3 of the acute treatment responders had switched to alternative educational programs, although parents rated them as significantly improved and less impaired compared to pretreatment. Obstacles to treatment, and recommendations for program improvement, are discussed.