School refusal is a condition which was delineated by a large quantity of empirical work carried out in the 1960s and 1970s. The current study reveals a pattern at variance with the traditional picture of the child and their family, with the children generally coming from socially deprived backgrounds, having significant difficulties relating to peers, and a family life containing conflict and stress. The pattern described suggests that elements of therapeutic intervention may need to be altered to give the greatest opportunity for the youngsters to overcome their school attendance difficulties and minimize the likelihood of future psychiatric problems.