Sean

Nine-year-old Sean has been a worrier since early childhood. In the preschool years, he was afraid to be left alone in his room, and dropoffs at preschool were sheer trauma with Sean terrified of separation. Now a fourth grader, he is shy and withdrawn at recess, certain that he will do something “dumb” and suffer ridicule. When his teacher assigned an oral report, Sean was paralyzed by fear that he would make a fool of himself in front of the class. He trembled throughout the report, forgot his main points, and was mortified afterward. Fear robs Sean of peer connections as well. He avoids play dates, certain that other kids see him as “weird” or “a loser.” He is also too afraid of separation to leave home for sleepovers. Recently, Sean has developed a fear of eating in the school cafeteria; he says his hands tremble, and other kids will see and mock him. So he looks for empty classrooms where he can eat hidden from view.

Megan

Thirteen-year-old Megan is both miserable and angry. She mopes around the house, snaps at her parents, and complains bitterly when asked to help with housework. She resents family rules and recently told her mother, “When I'm at home, I feel like a prisoner.” For years, Megan has had an eye for dark clouds rather than silver linings. Her current bout with depression began when members of her clique began to exclude her. She lost confidence in herself and seemed adrift socially. Since then, her parents have heard her crying behind her locked bedroom door, and she has tearfully told her mother, “No one likes me anymore.