ANXIETY DISORDER AND CBT

Anxiety Disorder and CBT



Anxiety Disorder and CBT

Case Study 1

Introduction

The following essay is a case study of a client named John who is suffering from major depression and was sent to see me for treatment by his concerned wife. I will provide brief background information about John then further discuss interventions and strategies I believe can be applied in each session with my client in order to make John's life more manageable. In the essay, I will be writing as the therapist, and the sessions are based on a ten week period.

Background Information (Case History)

A 27-year-old man named John came to see me with the following litany of complaints, "I've reached a point where I can't go on....Got no fight left in me. And not enough guts to end it here. Best damn job I ever had almost can see my way out of the debt. Now, it's all going to hell...and now I really don't care about anything, except not going back to work. I can't kid myself. I just can't take it anymore. And I have to confess I have no faith left in anything including your profession. I came here on my wife's insistence but I don't think you can help me either....But, maybe I can tell someone how I feel, how balled up I am...I can't find any work...I can't afford to relax a couple of weeks on some warm beach, or forget my troubles with some floozy blonde. Hell that's for the books on the best seller's list. I've just got to go about acting like my normal stupid self and something's got to blow. It goes in waves. Sometimes, I am alright and then I get anxiety feelings, and my heart pounds. I shake all over, and think I am going to die. God, it's awful!"

Presentation Of The Problem

Since the client appeared to be an intelligent, executive type with a graduate degree, who reported no other major problem, except for the fact that he couldn't stick to a regular job and this is what appeared to be triggering acute anxiety attacks in him, I decided to use Cognitive Behavior Therapy (CBT) with him.

The Client`S Reaction To The Problems And Symptoms

I had worked with many clinically depressed patients before, but this one, despite the severity of his symptoms appeared very motivated for change and prima facie also appeared an intelligent, reasonable patient to deal with.

Conceptulalisation Of The Problem

As is clear from the patient's description of his problems, most of the symptoms that he has described --- sleeplessness, weight loss, loss of appetite, loss in interest in major activities --- fit in very well with the American Psychiatric Association (APA's) Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. (DSM-IV criteria) (La Torre 2001 30).

Action Plan

Upon getting details of the patient's case history, I (his therapist chalked out the following 10-week Cognitive Behavior Therapy (CBT) intervention plan for this patient:

Week #1: Engaging The Client

The first step I'd take is to try and build ...