The therapy is described of an adolescent who presented to a private consultant pediatrician with school refusal. An initial eclectic approach was used resulting in the patient returning to school. This was followed by a further assessment and the recommendation of psychoanalytically oriented psychotherapy for the adolescent together with counseling and/or therapy for her depressed mother. Despite gains experienced by the patient, increasing resistance was noted from the mother who eventually terminated her daughter's treatment, having refused any treatment for herself. Discussion centers around the approach used, speculating about other modes of treatment, including the use of family therapy.