Asthma is prevalent amongst teenagers and often causes significant morbidity. In a small number with severe asthma, who often have many psycho-social risk factors, there is high health care utilisation reflected particularly in frequent hospital admissions. Such teenagers present a challenge because they often do not respond to conventional medical approaches. A randomised controlled trial of the impact of a small group educational intervention, led by a nurse-educator, designed to promote asthma self-regulatory skills in teenagers will be undertaken. The subjects will all have severe asthma, defined as at least one acute hospital admission within the last year. The group work will be based on a specially developed asthma workbook and will focus on the key skills of asthma prevention and attack management, and social skill training in areas important to asthma management in teenagers. The success of the programme will be judged by its ability to reduce subsequent health care utilisation. If successful, such an approach could have considerable impact on a high risk group and would be easily adaptable for general introduction.