Abstract
Four case descriptions are offered to illustrate the principles of an outpatient management approach to severe school phobia, (i) Active therapeutic intervention is necessary to challenge the adolescent's omnipotent fantasies and help overcome his anxiety. (2) Concurrent family work is needed to capitalise on the powerful re‐structuring effect of this intervention. (3) Liaison with other agencies is often important in reinforcing the therapeutic confrontation. Details of an escorting procedure are described.This active approach can promote major therapeutic change, even in severe and longstanding cases.
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