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.