Social context

NB Names altered for anonymity

It’s normal for children to feel anxious occasionally, but for some children, anxiety affects their behaviour and thoughts daily, interfering with school, home and social life. There are many types of anxiety disorders with a variety of physical and mental symptoms.
Long-term anxiety can severely interfere with a child's personal development, family life and schooling. Anxiety disorders that start in childhood often persist into teens and adulthood. Teenagers with an anxiety disorder are more likely to develop clinical depression, misuse drugs and feel suicidal


- Ava is happy to attend sessions without mum, remaining engaged in the activities she is completing throughout the session. She has demonstrated increased confidence to work independently, is comfortable to complete a range of tasks with minimal support and is more willing to attempt to carry out a task independently before asking for help.
- Ava has also shown an increased ability to share her thoughts and feelings constructively and is developing her awareness of the impact that her thoughts and feelings have on her behaviour and attitude towards certain tasks. She is now using mindfulness exercises when she becomes frustrated.
- Ava requires less support to remain on-task and is able to distance herself from distractions. She is trying to use what she has learnt at school, where she can find the class-room environment harder to remain focused in.
- Ava is now able to reflect on the importance of physical exercise for people as well, for both our physical and mental well-being

Background to case

Ava is a 13-year-old girl referred to us for help with re-integrate into education. She has a history of poor school attendance, due to difficulties interacting with peers. XXXX has struggled with low self-esteem and confidence and is reluctant to leave her mother, who she can sometimes be aggressive towards, particularly when she is feeling anxious.
Ava has a diagnosis of ASD, Anxiety and ADHD. She is very friendly and talkative but often feels uncomfortable when sharing her feelings. She is also above the ‘expected BMI’ for her height and has shared that she doesn’t like physical exercise. She enjoys creative tasks and enjoys being around animals and has pets at home which she enjoys caring for, despite her allergies.

Process at The Seeds of Change

Ava was initially reluctant to leave mum and required significant reassurance before she was happy for mum to go. She also had a teddy with her which made her ‘feel better.’ By her second session she had left him at home as ‘she no longer needed him.’
Ava enjoyed interacting with the horses but did become nervous and required reassurance to remain in the same space as them.
Ava struggled to share her thoughts and feelings, using the word ‘anxious’ to describe her feelings. When she saw other learners would compare herself, however she is now able to identify positive attributes about herself and identify her feelings and what is behind that feeling.
Ava has engaged very well with mindfulness, particularly using the physical sensation of feeling her horse’s breathing. She uses these ‘coping mechanisms’ to reduce her anxiety when transitioning back to school. Ruby shared that she had been ‘practising’ these exercises and as a result her anxiety hadn’t prevented her from attending school.
Ava admitted that she gets distracted very easily and has worked on identifying her own distractions, by comparing them to those of her chosen horse. She now feels she is more able to focus.
Ava engaged in activities identifying the importance of physical activity, healthy lifestyle and exercise on the horses emotional and physical well-being. By observing the positive impact that it had on her chosen horse she developed a more positive attitude towards exercise and more understanding of the importance of diet and lifestyle, by discussing the impact that poor diet can have on the horses, she was able to understand the impact of these factors on people too.