Managing Anxiety; Skills for Success- Interest Form

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A Skills Based Group for Middle School Girls Ages 11-14 that is designed to teach practical tools for managing stress and anxiety. Participants will learn evidence-based coping skills to build confidence, resilience, and emotional balance in a supportive setting.

This group will be held for 6 consecutive weeks beginning in January 2026.

*Please note: Groups are not a substitute for individual therapy. They are designed to provide education and practical coping skills related to the group topic.

Parent/Guardian Name *

Parent/Guardian Email *

Child Information: Name, age, grade, and school. *

Has your child ever participated in therapy or a group before? *

Yes

How does your child typically experience anxiety? (check all that apply)

Physical symptoms (headaches, stomachaches, racing heart)

Worry thoughts (overthinking, “what if” thinking)

Avoidance (school refusal, avoiding activities or social situations)

Emotional outbursts (irritability, crying, anger)

Other:

Preferred days and times (select at least one) *

Mondays 4-5pm

Mondays 5-6pm

Mondays 6-7pm

Tuesdays 4-5pm

Tuesdays 5-6pm

Tuesdays 6-7pm

Required

Is there anything else you would like us to know about your child?

Submit

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