For this practice improvement project, an interview guide was developed to identify chronically absent middle school students’ reasons for school absence. Of the 17 students interviewed, 82% ( n = 14) identified illness as the reason for absence, although they rarely saw a health care provider. The students all shared dreams for the future; 50% involved further education, and 50% involved job training. A support group intervention was offered to the 17 students during spring term. Only three students were able to participate in a weekly group meeting for 5 weeks. Two of the three students were depressed and referred to their health care providers for evaluation. The topics presented to the group included being sick and options available, setting weekly attendance goals, identifying depressive symptoms and what they mean, and likes and dislikes about school. The support group occurred late in the school year, so its effect on attendance was not determined.