A case study is presented of a 13-year-old adolescent male with a long history of anxious symptoms related to school attendance. At the time of referral to the school refusal clinic, the adolescent had significant difficulty attending school, having attended for only 1 day in the past 3 weeks. A cognitive-behavioural treatment program was conducted over 3 weeks, consisting of seven sessions with the adolescent, seven sessions with his parents, and consultation to school personnel. Treatment focused on the implementation of behaviour management techniques by caregivers as well as teaching anxiety management skills to the adolescent. Positive treatment outcomes included the adolescent's return to full-time attendance at school as well as a decrease in emotional distress. The implications of treatment are discussed in relation to the simultaneous application of behaviour management and anxiety management strategies in the treatment of school refusal.

The heterogeneous nature of school refusal has led to much confusion surrounding the conceptualisation of this phenomenon. A number of researchers have developed taxonomic systems in an effort to enhance our understanding of school refusal and to facilitate communication among professionals working in the field. The current paper explores the evolution of these systems and outlines the limitations of each. Non-empirical classificatory systems are reviewed first, followed by empirical systems based on factor analyses and diagnostic profiles. A functional taxonomic system for problematic school attendance is then reviewed. Future research based on sound methodological procedures should aim to examine a broad range of child and family characteristics in order to develop reliable, homogenous subtypes for this population.

This article describes a cognitive-behavioural intervention implemented over 10 sessions with an adolescent girl experiencing school refusal and depression. Treatment focused on the learning of various coping skills to deal with stressful situations at home and school. Following a decision to change schools, a rapid school return was employed. A multimethod, multisource evaluation was used at pretreatment, posttreatment, and follow-up assessments. The data indicated positive treatment outcomes: the adolescent returned to full-time attendance at school and exhibited decreased levels of emotional distress. The treatment gains were maintained at a 3-month follow-up.

This paper reviews the role and indications for pharmacotherapy of children with school refusal. The psychopharmacological treatment of school refusal is based mainly on evidence of the effectiveness of certain drugs in the treatment of adult disorders. There is some evidence that tricyclic antidepressants and benzobiazepines may be specifically useful in the treatment of school refusal, but further research is warranted. Potentially serious side effects mean that drugs are best confined to cases where psychological treatments have not been effective or where drugs are used briefly as an adjunct to a broader psychological treatment plan. Drugs may also have a role in the specific treatment of comorbid conditions associated with school refusal. Any use of drugs should involve regular reviews to monitor response, compliance, and side effects.

Whilst nearly all couple relationships start out happy, half of all marriages end in divorce. Relationship education is a potentially effective strategy to reduce the prevalence of relationship problems and divorce. The substantial empirical research on the determinants of relationship satisfaction shows that there are key relationship skills, such as communication and conflict management skills, which impact on the course of relationship satisfaction and stability. Relationship education can teach couples these key relationship skills, and this may prevent relationship problems. However, relationship education is not targeted at those couples who need it most. Research needs to be focused on the effects of relationship education for couples at high risk for relationship problems. The reach of education programs to couples can be enhanced by developing flexible delivery education programs. Relationship education programs also need to promote coping with stressful events that often lead to relationship problems, such as the transition into step-families, the onset of chronic illness, and unemployment.

Analyses and interventions were conducted to reduce challenging behaviour in two adolescents with multiple disabilities. A functional analysis of each child's challenging behaviour was conducted initially. Although the results of this functional analysis showed that challenging behaviour occurred during roughly 30 to 60% of the assessment trials conducted under each of several conditions, there was one condition for each child that was associated with little or no challenging behaviour. These conditions were then manipulated using stimulusfading procedures. Initially, the stimuli associated with low rates of challenging behaviour were provided on a nearly continuous and noncontingent basis. Next, exposure to these stimuli was systematically reduced. The present studies suggest that analysis of the conditions associated with low rates of challenging behaviour may be helpful in designing interventions.

Many researchers report the p value of an analysis to communicate whether findings are significant. This may be misinterpreted to imply that if p < .05 the finding is also of clinical significance. Researchers should also report the magnitude of the association, an easily calculated statistic, to allow a better understanding of results when p < .05. Methods for doing this for t, χ2, and F values are given. The clinical significance of an intervention is also commonly determined by whether p < .05. A better understanding, however, is gained by then calculating the effect size (d). This measure enables effects and strengths of association to be compared among studies. Methods for doing this, for the same statistics, are given.