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Published Online:https://doi.org/10.1176/ajp.121.8.801

Four cases are presented of school refusal behavior in university students. Similarities to younger patients are noted. Differences include the greater separation and challenge of the setting, absence of supportive authority figures, and enhanced difficulties in therapy for parents. The college psychiatrist must attempt early detection, an initially directive pyschotherapy, and energetic definition of the problem to assure proper psychotherapy whatever the outcome.

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