Exploring Separation Anxiety in Childhood: A Case Report of an 8-Year-Old Zimbabwean Girl after Cross-Border Relocation

This case study examines the therapeutic journey of Zuva, an 8-year-old Zimbabwean girl presenting with moderate separation anxiety following her family’s relocation from Botswana to Zimbabwe. Initial assessments included clinical interviews and two standardized anxiety measures, Screen for Child Anxiety Related Emotional Disorders (SCARED) and Separation Anxiety Scale for Children (SASC), with Zuva’s scores indicating clinically significant anxiety. Behavioral indicators included persistent crying at school drop-off, refusal to sleep alone, and recurrent somatic complaints (e.g., stomach aches) when separated from her mother. The psychologist diagnosed Separation Anxiety Disorder (DSM-5-TR F93.0) and implemented a multimodal intervention comprising play therapy, cognitive-behavioural therapy (CBT), and structured family involvement. Therapy spanned seven sessions of approximately one hour each. Post-intervention assessment revealed a reduction in SASC and SCARED scores alongside observable behavioural improvements such as independent sleeping, reduced school refusal, and increased social engagement with peers. Cultural differences between the two countries intensified Zuva’s distress, as her Shona-rooted expectations of maternal proximity clashed with the more collective caregiving practices encountered in Botswana. Cultural considerations informed therapeutic choices such as play therapy which was adapted to incorporate familiar Shona storytelling and symbols of kinship, while family sessions emphasized bridging Tswana communal expectations with Shona attachment practices. This culturally sensitive approach facilitated both emotional adjustment and strengthened family cohesion. Overall, the case underscores the importance of integrating standardized assessment, behavioural observation, and cultural context in tailoring interventions for childhood anxiety disorders, particularly in cross-border relocation scenarios.