School refusal during the adolescent years appears to be more severe than in childhood. While there is support for the efficacy of cognitive-behavioural therapy (cbt) in the treatment of school refusal generally, adolescents are clearly less responsive to currently available versions of cbt for school refusal,relative to younger children. As a response to the discouraging research findings related to treatments for adolescents, and in view of the paucity of reports on adolescent-tailored cbt for school refusal, we argue that it is important to design, implement, and evaluate an adolescent-focused program for school refusal. In this presentation we review an adolescent-tailored cognitive-behavioural approach for anxiety-based school refusal and a method to research its efficacy. Adolescents and their parents will be randomly allocated to a cbt condition or to a supportive psychotherapy condition. Treatment is offered individually, and a treatment algorithm is used to guide the selection of and emphasis upon the various treatment modules. In addition to measurement of treatment efficacy (e.g., school attendance; self-report and other-report of internalizing behaviour; diagnostic status), measurement of moderating factors (e.g., developmental level; ethnicity) and mediating factors (e.g., adolescent self-efficacy) will shed light on for whom, and how this developmentallytailored intervention may be most beneficial.