J is a teenager who has a hard time making and maintaining friends. She fears saying or doing something wrong since she automatically thinks people don't like her and hence will ridicule her if she makes a mistake. She is intelligent. In every case, she wants to answer the teacher's question so that he can be perfect. Results are emotions such as anxiety, anger, frustrations and low self-esteem when she is not able to achieve success.
Techniques to use
To begin understand the cause of the fear and anxiety that J faces, conducting an assessment would be key. The assessment involves the asking of questions about J's beliefs, his childhood experiences as well as his relationship with parents or guardian. A corrective technique would then be employed to address J's fear and anxiety issues.
Incorrect views and beliefs by J could be identified. For example, J thinks that academic failure is possibly the worst thing that could happen to him. Understanding how this distortion took root is basic as well as finding ways to correct these notions.
Description of techniques to client
Writes down your thoughts, frustrations, and anxiety such as people will laugh at me, I can't afford to lose or fail, I can't say anything I might say something wrong and instead state what you would prefer to do. The exercise will help find the trigger for the automatic thoughts mentioned above.
Encourage yourself to identify and acknowledge accomplishments by making positive statements such as I can do this, I am not afraid to yourself.
Learns how to connect her thoughts and feelings
J should stop telling herself that she is a failure. She should evaluate her position with the fact that she has a GPA of 3.8 proves she is intelligent.
J thinks that if she says something wrong, she is going to be ridiculed and hence the anxiety when answering questions .By identifying the ideologies that scare j such as those of losing, will aid in making her see that whatever she fears are not as bad as she thinks
Examining the validity of his beliefs
This will aid in erasing the belief by J that failing is the worst thing that could happen to her. She also believes that when she says something wrong, she will be mad fun of which is not necessarily true (Beck, 2011).
Replacing negative thoughts with more positive ones
J already has a GPA of 3.8. It's a starting point to drawing out all the negativity in his mind and begins to believe he is an achiever and not the opposite.
Questions to ask
What evidence backs up your belief that academic failure is the worst thing that could happen to you?
The question will help her understand that academic failure is not a failure in life.
Could there be an alternative explanation to why J is struggling to make as well as maintain friends?
This will help her understand that other factors such as other people could be intimidated by her intelligence which is a good on her side.
Homework to assign
This homework will enable J to make new friends and socialize which has an anxiety-reducing effect (Cherkin, et al.2016).
Sample case 2
Steps to follow in the first session
First, identification that Vic has a problem of taking excessive responsibility for everything and everyone. His does see the positive side that his wife had helped him in one of his courses. Realizing that he has a problem would be the beginning of productive therapy.
Next step is to observe Vic's attitude and mood so that it is possible to know how to approach him without offending or over intruding into his personal space.
Any new updates would then be discussed given the evaluation done on Vic
For the first session, the diagnosis of Vic would deliberated with him stating the possible reasons for his behavior such as he is feeling overstretched and not appreciated by his wife that why he thinks she is always on her case
In this stage, it is already clear that Vic has an emotional problem of excessive responsibility, mental filters as well as mind reading since he thinks his wife is always on his case.
Educating Vic about the cognitive model is the next step. He is hence able to understand his situation, which is the trigger for his automatic thoughts, his emotional and physical reaction such as leaving suddenly and therefore able to counteract his behavior positively.
Discussion of the problem, provision of a summary and checking homework assignment is similarly useful so as to obtain feedback.
Procedure is similar to the first section however it focuses on a specific problem that is given more priority. In this case is the desire of Vic to be perfect in his endeavors which would be corrected through therapeutic skills. Some include assertiveness and self-instructive training among others. Note taking would be encouraged to aid the review of previous work as well as discussion and summary. New homework shall be assigned and reviewed to get feedback.
Techniques to use
Setting achievable goals
Learning how to set goals that he can manage for a certain period of time would be useful for his recovery (Corcoran, 2006). The fact that he struggles to take care of everything and everyone feels like he is stressed and overworked. It will help him increase his self-efficiency and ability to do things so that he does not feel like his wife is always on his case.
Thought to challenge
Vic will be learning how to identify negative thought such as his relationship is becoming difficult with his wife. He also tells his wife that she should find herself another husband bringing out that he thinks he is incompetent. With these techniques, Vic will not only be able to identify the negative thoughts but also question these ideas and replace them with more positive ones. Example, he should consider that his wife only wanted to help showing that she cares and does not think he is incompetent.
Homework to assign
Vic should write a minimum of 10 positive things that have happened to him during his day's activities which must be genuine. He will realize that things are not necessarily gloomy with his relationship and hence able to let go some of the responsibilities he thinks he must take on for things to be perfect.
Beck, J. S. (2011). Cognitive behavior therapy: Basics and beyond. Guilford Press.Cherkin, D. C., Sherman, K. J., Balderson, B. H., Cook, A. J., Anderson, M. L., Hawkes, R. J., ... & Turner, J. A. (2016). Effect of mindfulness-based stress reduction vs cognitive behavioral therapy or usual care on back pain and functional limitations in adults with chronic low back pain: a randomized clinical trial. Jama, 315(12), 1240-1249.
Corcoran, J. (2006). Cognitive-behavioral methods for social workers: A workbook. Pearson/Allyn and Bacon.
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