[Father-child hospitalization in the separation anxiety]

Severe forms of separation anxiety disorder with school refusal can be difficult to treat: on the one hand the resistance to outpatient treatment is usual, on the other hand, fear of separation is so overwhelming that hospitalization can be seen as too dramatic. We suggest hospitalizing the child with his or her father as fear of separation with the mother is usually the main problem. We report a case study of a 13 year old child with separation anxiety disorder who refused to go to school and to be separated from his mother. Treatment consisted of hospitalizing the child with his father and to gradually restore his autonomy. The father was given the role of a co-therapist: the main therapeutic decisions about graduated exposure to separation were taken after discussion with the father who passed them on to the child. These structuring interventions re-established the father's control which helped to sedate the child's anxiety.