A systematic replication of the prescriptive treatment of school refusal behavior in a single subject

We employed a multiple-baseline design to test the efficacy of a recently developed approach for reducing school refusal behavior. This approach uses a systematic method for conducting a functional analysis for the target behaviors and suggests specific intervention strategies based upon this analysis. To maximize external validity, the intervention was tested using a systematic replication strategy, whereby only the major conceptual elements of the intervention were retained from previous applications. The subject was a 10 year old girl who attended school with great difficulty and resistance and who was assigned DSM-III-R diagnoses of separation anxiety disorder and social phobia prior to treatment. Following 8 weeks of treatment, she showed marked reductions in problem behavior and no longer met criteria for any anxiety disorder diagnoses. The results highlight the importance of the use of functional analytic strategies to effect behavior change.