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QUESTION
Sue is 8 years old and her mother brought her in for treatment due to feeling extremely frustrated with Sue’s current behavior. Sue is an outgoing child around her family members (she has two older siblings), she prefers being with her mother and has significant anxiety if she has to go to school and/or when she is away from her family members. Sue cries and throws a fit each morning prior to her mother dropping her off at school. She has missed multiple days of school due to her mother just giving up and letting her stay at home with her. Her mother reported just feeling worn out and feeling frustrated with Sue’s school for telling her that Sue has to attend school but not seeing what mom has to go through each morning to get her to class. In the past, Sue has become so anxious that she has made herself sick (throwing up, breaking out in hives), this is especially true right after any school breaks and Mondays seem to be the most difficult of days.
Sue’s mother works from home and she wonders if maybe homeschooling Sue would be better. She and her husband at first were worried about Sue’s clinginess but she was the baby of the family and just attributed it to her being the youngest and wanting more attention. They tried preschool and kindergarten but more frequently than not, Sue stayed home with mother due to her behavior rapidly escalating and seeing the stress on her child. During 1st grade, Sue was frequently sent home due to the school nurse believing her to be sick. In 2nd and now in 3rd grade, her school has changed their policy and is no longer allowing her to leave school unless she is showing physical symptoms (fever, rash, vomiting), which seems to have elevated her symptoms. She has recently begun breaking out in hives and having more occurrences of vomiting.
Sue’s parents have tried bribery (offering money and toys if she goes to school without throwing a fit) with no results. Sue’s grades are good and she does well with the homework; however, she usually tests poorly in class. Sue will frequently end up with the school nurse complaining of her head or stomach hurting, despite having no physical symptoms of illness. She has made no friends at school and Sue reports constantly worrying about something bad happening to her mother and older siblings.
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