The current study aimed to investigate emotion regulation (ER) strategy use in a sample of 21 clinic-referred children and adolescents (10-14 years old) pre-senting with school refusal, all of whom were diagnosed with at least one anxiety disorder. Being the first known study to examine ER and school refusal, hypotheses were guided by previous research on anxiety. It was hypothesized that the school refusal sample would report less healthy ER strat-egy use compared to an age-and sex-matched nonclinical sample (n = 21). As expected, the school refusal sample reported less use of cognitive reappraisal and greater use of expressive suppression to regulate their emotions than did the nonclinical sample. Although preliminary, the findings provide important information regarding the emotional functioning of children and adolescents presenting with school refusal. Future directions for research and implica-tions for improved prevention and intervention programs are discussed. S chool refusal is characterized by refusal to attend school resulting in prolonged absence, remaining home during school hours with parental knowledge, severe emotional distress at the prospect of going to school, absence of antisocial behavior, and reasonable but ineffective parental efforts to enforce school attendance (Berg, 1997). School refusal differs from truancy where the child attempts to conceal nonattendance and often has a pattern of behavior problems. A related term, school phobia, may apply when the child has a specific phobia of school (Kearney, 2008). The