This case study describes a school social worker's development of an in-school intervention for reducing severe anxiety in a fourteen-year-old student. The student was faced with the possibility of a transfer to a more restrictive setting for students with emotional disabilities because of apparently unmanageable anxiety in his regular school setting, which severely compromised his educational potential and his health. This intervention and follow-up provide a model for innovative school social work practice that combines principles of cognitive behavioral therapy with aspects of psychodynamic technique. Forty fifteen-minute sessions took place over a four-month period. Follow-up interviews at three, six, twelve, and twenty-four months revealed that the student had been able to maintain his behavioral change and improved social functioning.