Leora is a bright, outgoing, and well liked 6½ year-old girl who has recently become a big sister. She had no difficulties in preschool, nor with the transition into Kindergarten or returning to school for grade 1. Her teachers report that she is meeting or exceeding academic expectations, and has a good group of friends.

However, since the return from winter break Leora has developed a strong dislike of school, complaining and having a tantrum most mornings, feigning illness, and most recently running away from school and trying to walk home. The parents are aware that Leora is jealous of all the time her new baby sister gets to spend at home alone with mum, but no amount of reasoning and special one-on-one time with mum seems to have made a difference. Leora’s father thinks his wife should simply drop off Leora at school and leave, but Leora’s mother finds this particularly hard when Leora is crying and pleading to stay home. In addition, she wonders how critical it is to miss some school when Leora is still so young, but also agrees with her husband’s logic. Leora’s school refusal has contributed to increased family disruption and marital strain. The parents have scheduled an appointment with the school counselor to gain some help.