[Analytic child and adolescent psychotherapy in school refusal].

School refusal can be divided into different subgroups, i.e. truancy and school-related fears and Phobias. Psychodynamic psychotherapy is primarily indicated in the treatment of school phobia, which is caused by relationship-based separation anxiety due to fixed dyadic patterns. To avoid further chronification a triangular treatment process should be started. If the child is missing out on school, an in-patient treatment should be considered. Thereby, dysfunctional phantasies can be replaced by age-appropriate ego-functions. With parents projective and identification-processes and libidinous overrepresentations can be worked through. School related fears are not psychoneurotic disorders, but real fears regarding violence or unattainable academic demands. Other forms of therapy and educational interventions are indicated in these cases. Parents can be counselled psychodynamically, if needed. Truancy should be treated by educational means, including interventions by social services if indicated.