When do you write notes excusing children from certain school activities (ex. gym) due to anxiety disorder?

As a CAP who also works in schools, I usually try to coordinate with the school and therapist to best meet the patient's needs. Ideally, the child would be addressing their fears in therapy and would create a hierarchy of fears that they are working on. I would collaborate with the therapist, who is...

I am more likely to write to excuse the child when the anxiety about the class is disrupting their availability for learning or even getting to school at all.