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How much does that interfere? Client: Oh, I guess between 4 and 6, maybe 5. Construct a continually developing case formulation At this point, the therapist and client are in a position to begin the process of constructing a case formulation. This is helpful in that it enables the client to consolidate their progress so far and understand how the various aspects of their difficulties hang together. 2. Situation: Busy shops, bars etc. Emotion: Anxiety, panic Thoughts: If I go into these places I’ll faint and make a fool of myself.

My mother never encouraged us to be adventurous, and she was timid herself, so I’ve kind of grown up to avoid life’s challenges. I very much regret that . . I think I could have done much more with my life, potentially, than I have up to now. Determine the impact of the problem, or problems, on the client’s life At this stage in the assessment process, it is becoming clear that, in keeping with people with anxiety disorders generally, and people with phobic anxiety specifically, avoidance is a major factor in maintaining their current phobic anxiety.

The therapist takes the position that the focus is both at the phenomenological level, the client’s inner life world . . and of equal importance is the client’s perception and experiences of the external world, such as conflicts at home, within relationships, experiences at work, and the coping behaviours used in these contexts. , 2008). However, a comprehensive assessment is necessary to begin to develop a good, working case formulation. The main aims of assessment are to: ● ● 20 find out what the client’s problems are in clear, specific and measurable terms; identify the factors that serve to maintain both the problem, or problems, and the client’s vulnerability to such problems; ● determine the impact of the problem, or problems, on the client’s life; ● construct a continually developing case formulation; ● establish a baseline against which to evaluate the progress and success of the CB intervention.

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