Elizabeth is a 21-year-old college student who was recently seen in the local emergency room for panic attacks. She has been prescribed medication and she has been taking it appropriately for two weeks. Her psychiatrist recommended seeing a therapist in addition to taking the medication. Elizabeth shares that the panic attacks are a new symptom, but that she has experienced anxiety in the past.
Since starting this semester at college, she feels her anxiety symptoms have worsened. Her cousin who she was close to passed away from cancer over the summer. This is her first time being away from her family as she has transferred from a community college to a University. Elizabeth is an A-student, but school is a stressor for her and lately she finds herself procrastinating or not doing assignments. Her motivation to attend class is declining. She feels overwhelmed with time management. Her family does not know what she is experiencing, though she feels they would be supportive. She has a boyfriend and a great group of friends who are willing to help her with whatever she needs, though she is having a hard time asking for help.
Questions:
1) Why is Elizabeth a good candidate for CBT? Why is this an appropriate intervention?
2) What assessment scales or measures would you use?
3) How would you help Elizabeth understand her diagnosis?
4) Choose one of these identified thoughts and demonstrate how you would help Elizabeth modify it.
a. “I have never been smart. I think I fooled myself at community college. I am not as smart as these other students.”
b. “My family is great, but if I tell them what is going on they will just worry about me. I don’t want them to think I am ungrateful for the sacrifices they have made for me to go to college and that I am just ruining the opportunity.”