Cbt Formulation for Anxiety
Lara is eight years of age, is the eldest of three children and the only one at school.
Shehas presented with a range of problems. She has strong beliefs such as “I must do my best”, “I must not offend my teacher, parents or friends”, and “I must keep out of trouble”. These thoughts cause her to become terrified at just the thought of school, resulting in physiological symptoms such as heart palpitations and sweaty hands. Lara has been experiencing nightmares of monsters surrounding her in the school grounds. These images increase her avoidance of getting up the next morning, especially if it is school morning. Lara has been finding it increasingly difficult to get into the car to attend school, where she sobs and whimpers for the 20-minute trip. Lara is terrified of school. Her peers, who take her pencils and eraser and call her a “four-eye midget”, are bullying her. This isincreasing her dread of attending school.
Lara is not doing well at school. She is unable to add/subtract and has difficulty with Grade 2 reading. Lara perceives hers parents as being strict on her, demanding she achieve straight ‘A’ grades scolding her and comparing her to her cousins when she does not reach their standard. Additionally, the teacher is perceived as being strict on the children’s performance within the classroom, reprimanding when necessary. They have had previous attempts to find a solution to these problems by seeing the school counsellor. The morning rituals of getting Lara ready for school and dropped off is taking a toll on the family as a whole.
It seems that her thoughts and physiological symptoms are triggers. Other triggers are: the car which is modified by whether it is a school day, the teacher which is modified by students getting into trouble, the classroom which is modified by getting reading or math incorrect, school mornings which is modified by the experience of nightmares, and her parents which is
References: Mor, N., & Meijers, J. (2009). Cognitive behavioral therapy in childhood anxiety. The Israel Journal Of Psychiatry And Related Sciences, 46(4), 282-289. Retrieved from http://www.highbeam.com/publications. Westbrook, D., Kennerley, H., & Kirk, J. (2011). An introduction to cognitive behaviour therapy: Skills and applications.2nd ed. Los Angeles: Sage.