This refers to youth who refuse to go to school or have difficulty attending classes or remaining in school for an entire day. The study profiles five familial relationship subtypes descriptive of children and adolescents with school refusal behavior. The "enmeshed parent-child dyad" is characterized by dependency and overindulgence, and "conflictive" families have high rates of coercion, noncompliance, and aggression. "Detached" families have a diffusion of activity and little intrafamilial interaction; "isolated" families are characterized by little extrafamilial contact; and "healthy" families have a child with individualized psychopathology. Because these subtypes may coexist within a family, a separate section addresses the most often observed combinations. Recommendations are offered for educators and health professionals who interact with these types of families and juveniles. These include guidelines for integrating familial profiles into contemporary classification and assessment strategies and for modifying treatment protocols based on differential family dynamics. 41 references