http://www.anxietybc.com/parenting/home-management-strategies-separation-anxiety-disorder\n\nhttp://www.kathyeugster.com/articles/article004.htm\n\nHopefully someone else on here will chime in with some ideas."}" data-sheets-userformat="{"2":961,"3":{"1":0},"9":0,"10":1,"11":4,"12":0}">This sounds like a really tough case with circumstances at home beyond anyone's control. Is the grandmother actually sick or in peril of passing at any moment? Or maybe a better way to put it is, is there any legitimacy to the child's concern, or is it just a random unsubstantiated worry that has popped up?

It's important to maintain a structured routine for the child in the morning when the anxiety is apparently highest. It may be helpful to have a morning transition routine where they don't go directly to class, but to another area with adult supervision where they can calm down, do some relaxation exercises, draw, write, journal, talk with a counselor or social worker, etc. Perhaps providing some distraction, if possible, might help. For example, give them a job they have to do in the office or lunch room. Something that kids like to do and help with. Make this a morning routine and maybe it will help distract them from perseverating on their worry.

If the student has the capacity, teaching some coping skills, at a time when they are not freaking out, might help as part of a morning structured routine. Teach the student 5 coping strategies and list them on a poster. During the morning transition period while they sit in a room in the office or library, they could refer to this list and someone could help them choose a strategy from the list and do it. Strategies could include relaxation techniques, listening to music, writing out the best and worst things that could happen and then reflecting that the extremes usually do not happen, but something in the middle, etc.

The child sounds really agitated, so it may be that no strategies are very useful due to their heightened state of anxiety and panic. If a structured morning routine is strictly adhered to, over time the student may begin to utilize the time and strategies.

Sometimes it can help to make a deal with the student that if they go to calm down and go to class, they will be able to call the one they are worried about once in the morning and once in the afternoon. But this can backfire and be very tricky to implement depending on the child. This could do more harm then good, but with some kids it's useful.

Here's some links on more strategies and thoughts:

http://www.anxietybc.com/parenting/home-management-strategies-separation-anxiety-disorder

http://www.kathyeugster.com/articles/article004.htm

Hopefully someone else on here will chime in with some ideas.