Cognitive-behavior therapy is frequently used in the treatment of school re
fusal, a challenging problem for mental health professionals and school aut
horities. We review the clinical and research support for the efficacy of c
ognitive-behavior therapy using recently published guidelines for determini
ng the level of evidentiary support for psychosocial interventions. Althoug
h cognitive-behavior therapy appears to be a useful treatment for school re
fusal, further research is needed before it can be considered as having "we
ll-established" empirical status. Several other important methodological an
d theoretical issues are emphasized. (C) 2000 Elsevier Science Ltd.