Anxiety disorders affect more members of the global community that any other psychosocial phenomena. Their voluminous impact is not limited to adults; anxiety disorders substantially influence the quality of life of many children and adolescents as well. This chapter diverges in format and intent from previous chapters in that the goal herein is to provide the reader with some of the applied difficulties that can emerge when attempting to intervene in the school setting. This chapter is not built upon the weight of empirical inquiry that defined previous chapters—indeed, that weight of evidence does not exist for the following topic. In order that the reader can appreciate the functional impairment that can be associated with anxiety disorders, a discussion of one type social anxiety disorder is reviewed. Then, in an attempt to illustrate the school effects related to what is perhaps the most common anxiety disorder most have never heard of paruresis and how it results in considerable distress as well as significant intervention challenges. The reader is strongly encouraged to exercise imaginative projection into the complications associated with this disorder in the school environment. Finally, a treatment protocol developed by the senior author is presented for the purpose of conveying the importance of school involvement.