Paradox and a Systems Theory Approach to a Case of Severe School Phobia**

A recent case of severe school phobia treated by the author and a colleague is discussed. Systemic assessment indicated high resistance to change. Our initial paradoxical strategy utilising a “therapeutic triangle” is outlined, designed to bind the family into arguing in favour of change. With the lessening of resistance, direct interventions were utilised, combined with re-framings preventing the family developing a rationale that would allow them to escape change.