Cognnitive Behavioural Therapy Demonstration of Guided Discovery
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
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