Cognnitive Behavioural Therapy Demonstration of Guided Discovery Essay - 2220 Words



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Cognnitive Behavioural Therapy Demonstration of Guided Discovery

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Text Preview Transcript of guided discovery with a client suffering from social anxiety

Goal of this section was to help the client explore the origins of their social anxiety

Therapist. So now that we have a good description of the problem I think it might be useful to explore how it developed and how we can begin to move on. What do you think?

Client. That sounds sensible but I've been like this as long as I can remember so I don't think I know how it began.

Therapist. That's okay let's just start and see what we can discover?

Client. Okay.

Therapist. In CBT we always start with the situation as it is in the here and now. So can you give me a resent example of when you felt anxious?

Client. Well just yesterday I had a typical scenario, I was attending a meeting at work and a colleague put me on the spot by asking about one of my accounts, I was quite relaxed in the meeting until that happens because we weren't supposed to be dealing with my accounts the meeting was about new accounts and I don't have any at the moment.

Therapist.: So you were at the meeting quite comfortable and someone "put you on the spot" What do you mean by that?

Client: I don't like being on the spot, you know, the centre of attention with everyone looking at me.

Therapist: So when he put you on the spot what did you feel?

Client: Well all my usual symptoms, my heart gave a thump and I started to go red and sweat, my mind goes blank and all I can think of is how anxious I am and how stupid I look. It was only a meeting for god's sake it's ridiculous that I get so het up over these things.

Therapist: So typical fight or flight scenario. What do you think was the fear, the perceived threat?

Client: That I would look stupid. Like I don't know my job or that I'm an inarticulate idiot.

Therapist: Well you always sound articulate and intelligent in therapy, so do you think this is a real threat or just a false alarm?

Client: I know I am intelligent but I don't look it when I get anxious so I think it's a real threat. I'm sure some of my colleagues can see how anxious I am and think I'm a nervous wreck.

Therapist: So the threat is that colleagues will notice you're anxious what if they did?

Client: Well it doesn't look good does it? They're bound to think less of me if they can see I'm not confident, if I have no confidence in myself how can I expect anyone else to have confidence in me?

Therapist: Are you saying you have no confidence in yourself? How would that fit with what you said a minute ago that you know you’re intelligent and capable?

Client: Well I know I am but I don't look it.

Therapist: so how would you sum up the perceived threat in a way that acknowledges your strengths but expresses your fear?

Client: I suppose we could say that even though I know I'm good at what I do that I fear my colleagues will lose respect for me if they see how anxious I am.

Therapist: That sounds reasonable you know you are capable but fear what others might think if they notice your anxiety?

Client: Yes that about sums it up.

Therapist: So do you do anything to try and protect yourself from this fear?

Client: Yes half my time is spent watching out for situations that might put me on the spot.

Therapist: So, you constantly scan for situations that might put you on the spot? and if you see one? What do you do then?

Client: I'll try and avoid it but if I can't get out of it I'll do my best to make sure I can prepare for all contingencies and don't get caught out by anything I'm not prepared for.

Therapist: It sounds like a lot of effort?

Client: yes it is, I really feel drained sometimes trying to make sure I've thought of everything.

Therapist: So when you've thought of everything does that make you feel less anxious?

Client: Well not really you see I'm always worried that something will come up that I've not thought about. So I'm just as anxious.

Therapist: Sounds like you put in... Show More

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