Answer:
Sara is likely suffering from depression
Step-by-step explanation:
To facilitate the exam, ask the parent to wait in the waiting area so you and Sara can talk alone. This way Sara will feel more comfortable in discussion with you without her mother hovering.
Sara may be suffering from depression. Her mother's criticism and judgements may be making her feel down or never "good enough".
To address your concerns for Sara:
1. administer a depression screening such as the PHQ-9 depression test questionnaire. If you find Sara is indeed depressed or has thoughts of hurting herself or others, she will need prompt treatment from a qualified health professional.
2. If Sara does NOT have intentions of hurting herself and her behavior is related to parent conflict, friend conflict, etc. then get her permission to have a discussion with her mother about it.
3. provide Sara with local/national hotline for depression and any other mental health resources that are available in your area (therapists, psychiatrists, community centers, etc.)
4. Follow-up with Sara with another visit in a timely manner to access her mental health.