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Answer A is Correct: You should complete a SCARED rating scale. In this scenario, the results are in the clinically significant range overall, suggesting the presence of an anxiety disorder and on the social anxiety and separation anxiety subscales as well. You diagnose Marcus with social anxiety disorder and separation anxiety disorder and turn your attention to treatment recommendations.

Answer B is Incorrect: Marcus is experiencing anxiety and may have an anxiety disorder. While anxiety often presents with internalizing symptoms like worrying and feeling nervous, children and youth with anxiety also present with externalizing symptoms like oppositional behavior or even aggression, which are more visible to others. Disciplinary action would not be appropriate. Instead, the clinician should seek to understand the reason behind Marcus’s actions at school.

Answer C is Incorrect: This case illustrates that children with anxiety can have trouble following directions and they experience symptoms that may on the surface look like ADHD. Rather than prescribing ADHD medication, the clinician should obtain more information about the presenting concerns.

Answer D is Incorrect: Exposure to things that make us anxious is an important part of effective treatment. However, enrolling Marcus in a public speaking class without additional support and understanding is unlikely to be effective. You’ll learn more about intervention in the next key clinical activity.