The most serious thinking about how to treat the children and families in our program happens mostly on Friday mornings. Within the confines of the University of Hawaii’s Center for Cognitive Behavior Therapy, we provide mental health services to children between the ages of 6 and 18, mostly referred from Hawaii public schools and the Department of Health. A handful of those served are self-referred families from around the Pacific region who have sought specialty treatment for complex anxiety problems. The cases are almost always challenging—much harder than I remember seeing when I was receiving my own graduate training (a confession that my current trainees find quite satisfying),.