School absenteeism refers to physical absence from school, but school refusal behavior refers more broadly to child-motivated refusal to attend school. This chapter focuses on child-motivated school refusal behavior. Youth with school refusal behavior evince substantial heterogeneity in behavioral characteristics or symptoms. This population is notably high in internalizing behavioral problems, such as general and social anxiety, fear, worry, depression, self-consciousness, fatigue, and somatic complaints. Interventions for school refusal behavior can be arranged along a multitiered system similar to a Response to Intervention (RtI) model. RtI involves problem-solving-based interventions that focus on prevention, early intervention for emerging cases, and intense intervention for severe cases. The chapter contains a step-by-step process for several evidence-based interventions that address school refusal behavior in youth, including child-based therapy that focuses on anxiety management, parent- and family-based therapy that focuses on contingency management, and a broader approach that incorporates school personnel and other professionals.